How to Apply for Medicaid in Oregon

You can apply for Medicaid online by clicking here.  You can also submit a paper application, which you can find on the state website (here), or get assistance applying via an attorney.

Medicaid Eligibility Program Overview

Medicaid pays for the cost of Nursing Home care in Oregon that meets certain financial and health criteria.  The average cost of Skilled Nursing Care in Oregon is $128,730 per year, so securing Medicaid coverage is essential.  There are 130 nursing homes in Oregon, most of which accept Medicaid insurance as a form of payment.  Nursing homes in Oregon are currently 57.2% occupied with an average of 6,235 patients currently using the 10,898 available beds.

Oregon Medicaid Asset Limitations for 2023

Individuals in Oregon are allowed to keep $2,000 when they apply to Medicaid for long-term care.  If they are over this amount, they must spend down on care.  It’s important to note that individuals are not allowed to give gifts of any amount for a period of 5 years (60 months) before applying for Medicaid.  If an individual’s assets are more than $2,000, they should learn about Medicaid Planning strategies.  This asset limit only applies to assets that are considered countable.  Countable assets include; savings accounts, checking accounts, retirement accounts and a second home.  If you have multiple assets and are looking to access Medicaid, it may make sense to speak with a Medicaid Planner or Elder Law attorney in Oregon.

Couples that both require Medicaid for long-term care in Oregon are allowed to keep $3,000 in assets.  If one spouse requires care and one does not, the spouse that does not receive care is known as the Community Spouse.  The Community Spouse is allowed to keep 50% of their assets up to $123,600 in countable assets, which is known as the Community Spouse Resource Allowance.  The Community Spouse is allowed to keep 100% of their marital assets up to $24,720.

The maximum amount of home equity allowed when applying to Medicaid is $572,000.  Despite the fact that the home is not a countable asset, Medicaid can look for repayment in probate court from the sale proceeds after it stops paying for care.  It is important to understand if your home may be subject to the Medicaid repayment process.

Income Limits in Oregon For Medicaid

In Oregon, the individual receiving Medicaid cannot earn over $2,250.  If their income exceeds that amount, they will need to do some Medicaid planning to create eligibility.  One strategy that works well is a Miller Trust, also known as a Qualified Income Trust.  If an individual is married, the spouse’s income does not typically count towards the income cap, but it is important to maximize income protection via the Monthly Needs Allowance rules.  The maximum amount of income the Medicaid office allows a community spouse to keep in Oregon is $3,090.  All of an individual’s monthly income must go towards their cost of care, which can include medical bills, prescriptions and other health care costs.  $60 can be set aside for the personal needs allowance.  The income limits are based on a percentage of the Supplemental Security Income defined by the Social Security Administration’s Federal Poverty Levels (FPL) and change annually.

Penalty Information in Oregon For Medicaid

If a gift of any amount is given in Oregon during a period of 5 years before applying to Medicaid, a penalty period will be initiated. This penalty period in Oregon is called a look-back period, and it can make an individual not eligible for Medicaid.   Medicaid will not pay for care until the penalty period is over.  The penalty is calculated by dividing the total amount of gifts given by $8,425, which creates a several-month period before Medicaid coverage begins.

The average cost of Nursing home care (private room) in Oregon is $11,113, so penalties can become very costly for a family that has not planned appropriately for Medicaid.

Oregon Medicaid Eligibility Information 2023SingleCouple
2023 Oregon Medicaid Income Limits $2,250 $4,500
2023 Oregon Medicaid Asset Limits $2,000 $3,000
2023 Oregon Home Equity Limits $572,000 $572,000

Medicaid Waiver in Oregon