If you’re in Oregon and struggling with health care costs, the Oregon Health Plan (OHP) could be a lifeline.
This Medicaid program covers low-income adults, children, pregnant people, parents, seniors, and those with disabilities.
Income limits are key because they decide who gets in, and they update yearly based on federal poverty levels.
In 2025, limits reflect rising costs, with expansion covering more adults.
This guide lays out everything: detailed income tables by group, eligibility basics, application steps, and FAQs.
You’ll learn how household size affects limits and what to do if you’re close to the edge.
Whether you’re checking for yourself or a loved one, we’ll help you navigate OHP to get the coverage you need.
What Is Oregon Medicaid (OHP) 2025?
Oregon’s Medicaid, called the Oregon Health Plan or OHP, is managed by the Oregon Health Authority.
It serves low-income residents who need help with medical bills. The program covers kids from birth to 18, pregnant individuals, parents and caregivers, adults 19 to 64, seniors 65 and older, and people with disabilities.
As a Medicaid expansion state since 2014, Oregon lets more working adults qualify.
Benefits include doctor visits, hospital care, prescriptions, mental health services, dental for all ages, vision exams, and long-term care like nursing homes or home aides.
Most services have no copays, making it easier for families to stay healthy.
Oregon Medicaid Eligibility Requirements 2025
To qualify for OHP in 2025, you must meet these rules:
– Residency: Live in Oregon and plan to stay.
– Citizenship/Immigration: U.S. citizen, national, or qualified immigrant (like lawful permanent residents after five years). Some non-citizens get limited emergency care; Healthier Oregon covers more immigrants.
– Income Guidelines: Must be below group-specific limits tied to federal poverty level (FPL). Use modified adjusted gross income from taxes.
– Household Size: Includes you, spouse, and tax dependents; unborn children count for pregnant applicants.
– Disability/Medical Need (ABD Medicaid): For aged, blind, or disabled, prove condition via Social Security or doctor; assets count.
– Pregnant Women: Higher limits; pregnancy adds to household size.
– Asset Rules: Ignore for most groups; for seniors/disabled, $2,000 single, $3,000 couple.
Oregon Medicaid Income Limit 2025; Overview
Oregon bases income limits on the 2025 federal poverty level (FPL), with $15,650 annual for one person. Most groups use modified adjusted gross income, and a 5% disregard often applies if you’re just over. Adults hit 138% FPL for OHP Plus, while OHP Bridge covers 138% to 200% for basic benefits. Kids and pregnant people have higher thresholds. Limits differ between OHP Standard (limited) and OHP Plus (full coverage). Check yearly, as FPL changes in March.
Oregon Medicaid Income Limit Charts 2025
Oregon Medicaid Income Limits for Adults (19–64); 2025 (138% FPL)
This applies to non-pregnant adults without children under Medicaid expansion.
| Household Size | Monthly Limit | Annual Limit |
| 1 | $1,800 | $21,600 |
| 2 | $2,433 | $29,196 |
| 3 | $3,065 | $36,780 |
| 4 | $3,698 | $44,376 |
| 5 | $4,330 | $51,960 |
| 6 | $4,963 | $59,556 |
| 7 | $5,595 | $67,140 |
| 8 | $6,228 | $74,736 |
Children’s Medicaid (OHP Plus) 2025 Income Limits
Kids 0-18 qualify up to 205% FPL; higher for under 1 (305% if needed).
| Household Size | Monthly Limit | Annual Limit |
| 1 | $2,674 | $32,088 |
| 2 | $3,614 | $43,368 |
| 3 | $4,553 | $54,636 |
| 4 | $5,493 | $65,916 |
| 5 | $6,432 | $77,184 |
| 6 | $7,372 | $88,464 |
| 7 | $8,311 | $99,732 |
| 8 | $9,251 | $111,012 |
Pregnant Women Medicaid Income Limit Oregon 2025
Up to 205% FPL; unborn counts in size.
| Household Size | Monthly Limit | Annual Limit |
| 1 | $2,674 | $32,088 |
| 2 | $3,614 | $43,368 |
| 3 | $4,553 | $54,636 |
| 4 | $5,493 | $65,916 |
| 5 | $6,432 | $77,184 |
| 6 | $7,372 | $88,464 |
| 7 | $8,311 | $99,732 |
| 8 | $9,251 | $111,012 |
Parent/Caretaker Income Limits Oregon 2025
For parents with kids under 19: Up to 190% FPL.
| Household Size | Monthly Limit | Annual Limit |
| 1 | $2,478 | $29,736 |
| 2 | $3,349 | $40,188 |
| 3 | $4,220 | $50,640 |
| 4 | $5,091 | $61,092 |
| 5 | $5,962 | $71,544 |
| 6 | $6,833 | $81,996 |
| 7 | $7,703 | $92,436 |
| 8 | $8,574 | $102,888 |
Aged, Blind, Disabled (ABD) Medicaid Oregon 2025
Tied to SSI: $967 monthly single, $1,450 couple. Assets: $2,000 single, $3,000 couple. Spend-down if over: Subtract medical bills to meet limit.
| Household Size | Monthly Income Limit | Annual Income Limit | Asset Limit |
| 1 (Single) | $967 | $11,604 | $2,000 |
| 2 (Couple) | $1,450 | $17,400 | $3,000 |
Oregon Long-Term Care Medicaid Income Limits 2025
No hard limit for nursing homes (pay share after $62 allowance). HCBS waivers: $2,901 monthly single. Assets $2,000 single. Spousal protections: Income allowance $2,644 min to $3,948 max; asset allowance $31,584 min to $157,920 max.
| Category | Monthly Income Limit (Single) | Asset Limit (Single) | Spousal Income Allowance | Spousal Asset Allowance |
| Nursing Home | No cap (pay liability) | $2,000 | $2,644 – $3,948 | $31,584 – $157,920 |
| HCBS Waiver | $2,901 | $2,000 | $2,644 – $3,948 | $31,584 – $157,920 |
What Counts as Income for Oregon Medicaid in 2025?
Oregon uses MAGI for most groups. Count:
- Earned income like wages, tips, self-employment profits after deductions.
- Unearned income like interest, dividends, alimony, pensions, taxable Social Security.
Exclusions:
– Child support received.
– Tax refunds.
– Gifts and loans.
– SNAP benefits.
– Some scholarships.
– VA aid for long-term care.
For ABD, most income counts with few exclusions.
Oregon Medicaid Household Size Rules 2025
Oregon uses tax rules for household size: you, spouse, and dependents you claim. For non-filers, include those you support more than half. Examples: Single parent with two kids = size 3. Pregnant couple with one child = size 4 (unborn counts). Married couple no kids = size 2. Shared custody: Parent who claims on taxes counts the child. Use OHA’s online tool if unsure.
How to Apply for Oregon Medicaid (OHP) in 2025
1. Gather docs: ID, Social Security number, pay stubs, tax returns, residency proof, immigration papers.
2. Apply online at ONE.oregon.gov; fastest way.
3. Call 800-699-9075 for phone help.
4. Mail or fax a paper form (download from oregon.gov/oha).
5. Visit a local office or community partner for in-person aid.
Processing takes up to 45 days; 90 for disability. Get temporary coverage if urgent.
Oregon Medicaid Renewal Rules 2025
Renew OHP yearly to keep benefits. OHA sends a notice 45 days before your end date. Update income, address, or family changes with proof. Many get auto-renewed if data matches. If not, submit docs online or by mail. Miss it, and coverage ends, reapply fast to restart. Appeal denials within 60 days.
Reasons Oregon Medicaid Applications Get Denied 2025
- Income over the limit for your group.
- Household size listed wrong.
- Missing or incomplete documents.
- Citizenship or ID issues.
- Incorrect info on application.
- No response to OHA requests.
FAQs Oregon Medicaid Income Limit 2025
What are the Oregon Medicaid income limits for 2025?
Limits vary: Adults up to $1,800 monthly for one in OHP Plus; kids $2,674; pregnant $2,674. See charts for details.
What is the income limit for a family of 4 for Oregon Medicaid in 2025?
Adults: $3,698 monthly; children: $5,493; pregnant: $5,091; parents: $5,091.
Does OHP count rent or bills when deciding income in 2025?
No, it uses gross income minus deductions; living costs don’t subtract.
What is the Oregon Medicaid asset limit in 2025?
Ignore for most; ABD/long-term: $2,000 single, $3,000 couple.
Do adults without children qualify for Oregon Medicaid in 2025?
Yes, up to 138% FPL via expansion if 19-64.
How does Oregon calculate Medicaid income in 2025?
Uses MAGI from taxes, excluding child support and refunds.
Do pregnant women get higher Medicaid income limits in Oregon in 2025?
Yes, up to 205% FPL, higher than adults.
What happens if my income goes over the OHP limit in 2025?
Check 5% disregard or OHP Bridge; reapply if it drops.
Does Oregon Medicaid have a spend-down program in 2025?
Yes, for ABD: Spend excess on bills to qualify.
Does Oregon Medicaid cover dental and vision in 2025?
Yes, full dental; vision exams and glasses for kids, limited for adults.
Summary
Oregon Medicaid covers you if income fits limits like 138% FPL for adults ($1,800 monthly single) or 205% for kids ($2,674). Pregnant folks and parents get higher thresholds. Yearly FPL updates mean check often a small change could qualify you. Apply via ONE.oregon.gov or call 800-699-9075 for help. Don’t wait; getting covered means peace of mind for your health.
