Oregon Medicaid Eligibility

This page provides general guidelines for the Oregon Medicaid eligibility requirements. This is an assistance program that provides medical coverage for low-income people of all ages. The department that handles the Medicaid program is Oregon Health Authority. The name of the state program is Oregon Health Plan. If you have questions or issues about the Medicaid application or the eligibility requirements, contact the Oregon Medicaid office.


Oregon Medicaid Overview

Oregon Health Plan (OHP) is Oregon's Medicaid which serves low-income individuals and families. It contains three programs: OHP Standard, OHP Plus, OHP with Limited Drug Benefit.


Oregon Medicaid Eligibility Requirements - Non Income

For all programs: Enrollees must be Oregon residents and U.S. citizens or qualified non-citizens.


Documents Needed For Oregon Medicaid Application


Oregon Medicaid Benefits

OHP Standard: It covers acupuncture, chemical dependency, dental, emergency/urgent hospital care, hospice and hospital care, immunizations, labor and delivery, laboratory and x-ray, medical equipment and supplies, medical transportation, mental health, physician care, podiatry prescription drugs, vision care.

OHP Plus: It includes OHP Standard benefits, plus hearing aids and hearing aid exams, home health, naturopathy, therapy (occupational, physical and speech) and private duty nursing.

OHP with Limited Drug: It has the same benefits as OHP Plus, but no coverage for prescription drugs that Medicare Part D covers.


Oregon Medicaid & CHIP Eligibility Levels

Below is the modified adjusted gross income (MAGI) eligibility levels for Oregon Medicaid and Children's Health Insurance Program (CHIP).

Eligibility Levels - By Percentage Of Federal Poverty Level (FPL)

Medicaid Expansion Medicaid Children Separate CHIP Pregnant Women Parents Other Adults
Yes
Age 0-1: 185%
Age 1-5: 133%
Age 6-18: 133%
300% Medicaid: 185%
CHIP: N/A
133% 133%

Eligibility Levels - Individual By Monthly Income

Medicaid Expansion Medicaid Children Separate CHIP Pregnant Women Parents Other Adults
Yes
Age 0-1: $1,799
Age 1-5: $1,293
Age 6-18: $1,293
$2,918 Medicaid: N/A
CHIP: N/A
$1,293 $1,293

Eligibility Levels - Family Of Two By Monthly Income

Medicaid Expansion Medicaid Children Separate CHIP Pregnant Women Parents Other Adults
Yes
Age 0-1: $2,425
Age 1-5: $1,743
Age 6-18: $1,743
$3,933 Medicaid: $2,425
CHIP: N/A
$1,743 $1,743

Eligibility Levels - Family Of Three By Monthly Income

Medicaid Expansion Medicaid Children Separate CHIP Pregnant Women Parents Other Adults
Yes
Age 0-1: $3,051
Age 1-5: $2,193
Age 6-18: $2,193
$4,948 Medicaid: $3,051
CHIP: N/A
$2,193 $2,193

Eligibility Levels - Family Of Four By Monthly Income

Medicaid Expansion Medicaid Children Separate CHIP Pregnant Women Parents Other Adults
Yes
Age 0-1: $3,677
Age 1-5: $2,643
Age 6-18: $2,643
$5,963 Medicaid: $3,677
CHIP: N/A
$2,643 $2,643