Written & Reviewed by Akash Biswas, MSW | Former Medicaid Caseworker Trainer | Verified against Oregon Health Authority and Oregon Secretary of State administrative records | Last Updated: May 2026
Oregon Medicaid — called the Oregon Health Plan (OHP) — covers adults, children, pregnant women, seniors, and people with disabilities who meet income requirements.
Most adults qualify at 138% of the Federal Poverty Level (FPL), which equals $1,836 per month for a single person in 2026.
This guide covers every OHP program, income limit table, and step to apply.
Quick Summary:
- OHP covers doctor visits, hospital care, prescriptions, mental health, dental, and more
- Most adults (ages 19–64) qualify at up to 138% FPL ($1,836/month for 1 person)
- Pregnant women and infants qualify at up to 190% FPL ($2,527/month for 1 person)
- Children may qualify through CHIP at up to 305% FPL
- New 2026 income limits took effect March 1, 2026 — based on updated federal guidelines
- Apply online at ONE.Oregon.gov or call 1-800-699-9075
- 👉 Use our Medicaid eligibility in 2026 calculator to check your eligibility in minutes
What Is Medicaid?
Medicaid is a joint federal and state health insurance program for people with low income. It pays for medical care at little or no cost to you.
In Oregon, Medicaid is called the Oregon Health Plan (OHP). It is run by the Oregon Health Authority (OHA). OHP uses a managed care model, meaning most members choose a health plan that coordinates their care.
Who Runs OHP in Oregon?
The Oregon Health Authority (OHA) oversees OHP enrollment and benefits. The Oregon Department of Human Services (ODHS) handles seniors and people with disabilities. Both agencies use the ONE (Oregon Eligibility) system to process applications.
What Is the Federal Poverty Level (FPL)?
The FPL is a number set by the federal government each year. It is based on household size and income. Oregon uses it to decide who qualifies for OHP. New 2026 FPL guidelines took effect March 1, 2026, and apply through February 28, 2027.
| Household Size | 2026 Annual FPL | Monthly FPL (100%) |
|---|---|---|
| 1 | $15,960 | $1,330 |
| 2 | $21,640 | $1,803 |
| 3 | $27,320 | $2,277 |
| 4 | $33,000 | $2,750 |
| 5 | $38,680 | $3,223 |
| 6 | $44,360 | $3,697 |
| 7 | $50,040 | $4,170 |
| 8 | $55,720 | $4,643 |
Source: Oregon Health Authority FPL Chart, effective March 1, 2026
Who Qualifies for Medicaid in Oregon 2026?
Oregon expanded Medicaid under the Affordable Care Act (ACA), so most low-income adults now qualify — not just parents or people with disabilities. Eligibility depends on your income, household size, and the specific OHP program.
To qualify, you generally must be an Oregon resident and a U.S. citizen or qualifying immigrant. Most MAGI-based programs have no asset test, meaning savings and property are not counted.
Adults Ages 19–64 (OHP Plus)
Most working-age adults qualify if their gross monthly income is at or below 138% FPL. This includes the standard 133% FPL limit plus a 5% income disregard. Income is counted before taxes.
Children Ages 1–18 (OHP Plus)
Children qualify at the same 138% FPL income limit as adults through OHP Plus. Children with higher household income may qualify through CHIP at up to 305% FPL. There is no asset test for children’s MAGI programs.
Pregnant Women and Infants Under Age 1
Pregnant women and newborns qualify at up to 190% FPL — a much higher limit than the standard adult program. Women may stay on this coverage pathway for up to 12 months postpartum. This ensures continuous care during and after pregnancy.
Seniors (65+) and People With Disabilities
Seniors and people who are blind or disabled may qualify for OSIPM (Oregon Supplemental Income Program-Medical). This program has separate income and asset limits based on the type of care needed. These are not MAGI programs, so assets and resources are counted.
Children of Immigrants and Special Populations
Oregon covers some immigrant populations who do not qualify for full Medicaid. Special programs like the COFA Dental Program (for Compact of Free Association citizens) and YSHCN (Young Adults with Special Health Care Needs) have their own income limits. Contact OHA for details on your specific situation.
Oregon Medicaid Income Limits 2026
Oregon uses Modified Adjusted Gross Income (MAGI) to measure income for most programs. MAGI includes wages, salaries, self-employment income, and most taxable income. It does not include SSI, child support received, or non-taxable disability payments for children.
The tables below show the monthly income limits for each OHP program as of March 1, 2026. You can also compare limits nationally in our guide to Medicaid income limits by state in 2026.
OHP Plus — Adults (19–64) and Children (1–18) at 138% FPL
This is the main Medicaid program for most Oregonians. The income limit is 138% FPL — 133% plus a 5% disregard — per the Oregon Secretary of State Permanent Administrative Order DMAP 7-2026, effective March 1, 2026.
| Household Size | Monthly Income Limit |
|---|---|
| 1 | $1,836 |
| 2 | $2,489 |
| 3 | $3,142 |
| 4 | $3,795 |
| 5 | $4,449 |
| 6 | $5,102 |
| 7 | $5,755 |
| 8 | $6,408 |
| Each additional person | +$654 |
Source: Oregon Secretary of State, Permanent Administrative Order DMAP 7-2026
Pregnant Women and Infants Under Age 1 at 190% FPL
The income limit is 190% FPL (185% plus a 5% disregard). This higher limit helps ensure pregnant women and newborns have access to full health coverage.
| Household Size | Monthly Income Limit |
|---|---|
| 1 | $2,527 |
| 2 | $3,427 |
| 3 | $4,326 |
| 4 | $5,225 |
| 5 | $6,125 |
| 6 | $7,024 |
| 7 | $7,923 |
| 8 | $8,823 |
| Each additional person | +$900 |
Source: Oregon Secretary of State, Permanent Administrative Order DMAP 7-2026
OHP Bridge — Adults with Income Between 133–200% FPL
OHP Bridge launched July 1, 2024. It covers adults aged 19–64 whose income is too high for standard OHP Plus but still below 200% FPL. There are two tracks:
- OHP Bridge – Basic Medicaid: Primarily for American Indians and Alaska Natives with income below 205% FPL monthly.
- OHP Bridge – Basic Health Program (BHP): For adults with annual income strictly between 133–200% FPL who lack access to affordable employer insurance.
Effective July 1, 2026, OHP Bridge – BHP income standards update to reflect 200% of the 2026 FPL.
| Household Size | Annual Income Range (133%–200% FPL) |
|---|---|
| 1 | $21,228 – $31,920 |
| 2 | $28,788 – $43,280 |
| 3 | $36,336 – $54,640 |
| 4 | $43,896 – $66,000 |
| 5 | $51,456 – $77,360 |
| 6 | $59,004 – $88,720 |
| 7 | $66,564 – $100,080 |
| 8 | $74,112 – $111,440 |
Source: Oregon Secretary of State, Permanent Administrative Order DMAP 7-2026, Page 3
CHIP — Children at 305% FPL
Children who do not qualify for OHP Plus may still qualify for CHIP. The income limit is 305% FPL (300% plus a 5% disregard).
| Household Size | Monthly Income Limit |
|---|---|
| 1 | $4,057 |
| 2 | $5,501 |
| 3 | $6,944 |
| 4 | $8,388 |
| 5 | $9,832 |
| 6 | $11,275 |
| 7 | $12,719 |
| 8 | $14,163 |
| Each additional person | +$1,444 |
Source: Oregon Secretary of State, Permanent Administrative Order DMAP 7-2026
Breast and Cervical Cancer Treatment Program (BCCTP) at 250% FPL
This program covers women diagnosed through the CDC’s cancer screening program. The income limit is 250% FPL.
| Household Size | Monthly Income Limit |
|---|---|
| 1 | $3,325 |
| 2 | $4,509 |
| 3 | $5,692 |
| 4 | $6,875 |
| Each additional person | +$1,184 |
Source: Oregon OHA Hospital Presumptive Eligibility Quick Guide, effective March 1, 2026
Long-Term Care Medicaid — OSIPM (Seniors and People with Disabilities)
OSIPM covers seniors (65+) and people who are blind or disabled who need nursing home or home-based care. Unlike MAGI programs, OSIPM has both income limits and asset limits.
| Program Type | Monthly Income Limit | Asset Limit |
|---|---|---|
| Nursing Home / Institutional Medicaid | $2,982/month | $2,000 |
| HCBS Waivers (home and community care) | $2,982/month | $2,000 |
| Regular Medicaid (Aged, Blind, Disabled) | $994/month | $2,000 |
Key figures for married couples (one spouse applying — Nursing Home or HCBS):
- Non-applicant (community) spouse asset protection: up to $162,660
- Minimum Monthly Maintenance Needs Allowance (MMMNA): $2,643.75/month
- Maximum Monthly Maintenance Needs Allowance: $4,066.50/month
- Home equity interest limit (applicant alone): $752,000
- Personal Needs Allowance for nursing home residents: $81.28/month
Source: Medicaid Planning Assistance, updated March 4, 2026; OAR 461-155-0250
Oregon Project Independence – Medicaid (OPI-M) at 400% FPL
OPI-M helps seniors and adults with physical disabilities who need daily living assistance but want to remain at home. The income limit is 400% FPL for a household of one.
- Gross monthly income limit (effective January 1, 2026): $5,320
- Resource limit (July 1, 2025 – June 30, 2026): $99,656
Source: Oregon ODHS OPI-M Income and Resource Standards, updated January 16, 2026
Medicare Savings Programs (Help Paying Medicare Costs)
These Medicaid-funded programs help people who have Medicare pay their premiums and cost-sharing. Income limits below are effective March 2026 through February 2027.
| Program | Who It Helps | Monthly Limit (Individual) | Monthly Limit (Couple) |
|---|---|---|---|
| QMB | Part A & B premiums, deductibles, co-pays | $1,330 (100% FPL) | $1,804 |
| SLMB | Part B premiums | $1,596 (120% FPL) | $2,164 |
| QI / SMF | Part B premiums | $1,796 (120–135% FPL) | $2,435 |
| Full Dual Eligible (LIS) | Full Medicare cost-sharing | $2,660 (200% FPL) | $3,607 |
Source: Oregon ODHS Medicare Savings Programs page, updated May 15, 2026
Special Programs — Income Limits at a Glance
| Program | Income Standard | Monthly Limit (Household of 1) |
|---|---|---|
| Veteran Dental Program | 400% FPL | $5,320 |
| COFA Dental Program | 133% FPL | $1,769 |
| Young Adults with Special Health Care Needs (YSHCN) | 200% FPL | $2,660 |
Source: Oregon Secretary of State, Permanent Administrative Order DMAP 7-2026, effective March 1, 2026
What Does Medicaid Cover in Oregon?
OHP provides comprehensive health coverage at no cost or very low cost for most members. Benefits are broad and cover the full range of medical needs for eligible Oregonians.
Here is what OHP covers:
- Primary care — doctor visits, checkups, and preventive care
- Hospital care — emergency room visits, surgery, and inpatient stays
- Prescription drugs — generic and brand-name medications on OHP’s formulary
- Mental health care — counseling, therapy, and psychiatric services
- Substance use treatment — outpatient and residential programs
- Dental care — preventive and restorative dental services for adults and children
- Vision care — eye exams and glasses for children; limited adult coverage
- Prenatal and maternity care — full coverage for pregnancy and delivery
- Long-term care — nursing home and home-based services (OSIPM program)
- Medical transportation — rides to covered medical appointments
What Medicaid Does Not Cover
OHP does not cover every service. Cosmetic procedures, most private-duty nursing, and some experimental treatments are not covered. For specific services, check with your OHP managed care plan or call OHA.
How to Apply for Medicaid in Oregon
Applying for OHP is free and can be done any time of year — there is no limited enrollment period for Medicaid. You can apply online, by phone, by mail, or in person at a local ODHS office.
Here is how to apply step by step:
- Go to ONE.Oregon.gov — the official Oregon benefits portal
- Create an account or log in if you already have one
- Start a new application and select health coverage
- Enter your household information — names, dates of birth, Social Security numbers
- Report your income — include all household income sources (wages, self-employment, etc.)
- Submit your application — you will receive a confirmation number
- Watch for a letter — OHA will mail you a decision within 45 days (often sooner)
- Choose a health plan — if approved, select an OHP managed care plan in your area
Other Ways to Apply
You do not have to apply online. You can also:
- Call: 1-800-699-9075 (ONE Customer Service Center)
- Mail: OHP Customer Service, P.O. Box 14015, Salem OR 97309-5032
- In person: Visit your local ODHS office
What Documents Do You Need?
You may need to provide proof of identity, residency, and income. Common documents include a photo ID, recent pay stubs, Social Security card, and proof of Oregon address. OHA can often verify income electronically through state wage records.
What Happens After You Apply?
After you submit your OHP application, the state has up to 45 days to make an eligibility decision. Most decisions come faster — often within a few days if your information is complete.
Here is what to expect after you apply:
Step 1: Eligibility Decision
OHA will review your application and send you a letter by mail. The letter will say whether you are approved, denied, or need to provide more information. If approved, your letter will include your coverage start date.
Step 2: Choose a Health Plan
If you are approved for OHP Plus, you will receive information about managed care plans in your area. You usually have 10 days to choose a plan. If you do not choose, the state will assign one for you. You can switch plans during open enrollment periods.
Step 3: Receive Your OHP Card
Your managed care plan will mail you a member ID card. You will use this card at doctor’s offices, hospitals, and pharmacies. Keep it with you and show it at every appointment.
Step 4: Annual Renewal
OHP coverage must be renewed each year. Oregon will review your case and contact you if anything is needed. Make sure your address is current in the ONE system so you receive renewal notices.
If You Are Denied
If your application is denied, you have the right to appeal. The denial letter will explain the reason and how to request a hearing. You can also call OHA or visit a local ODHS office for help.
FAQ
Q: What are the Oregon Medicaid income limits for 2026?
A: For most adults ages 19–64, the limit is 138% FPL — $1,836 per month for a single person. Pregnant women qualify at up to 190% FPL ($2,527/month for one person). Children may qualify at up to 305% FPL through CHIP. All limits updated March 1, 2026.
Q: Does Oregon Medicaid cover dental in 2026?
A: Yes. OHP covers preventive and restorative dental care for both adults and children. Services include cleanings, fillings, extractions, and dentures. Coverage may vary by managed care plan. The Veteran Dental Program and COFA Dental Program have separate income limits.
Q: How long does it take for OHP to approve my application?
A: Oregon has up to 45 days to process most OHP applications. Many decisions come within a few days when all required information is submitted online. Emergency Medicaid decisions can be made same-day at qualifying facilities under Presumptive Eligibility.
Q: Can I get Oregon Medicaid if I am undocumented?
A: Full OHP coverage requires citizenship or qualifying immigration status. However, Emergency Medicaid may cover labor and delivery and emergency services regardless of immigration status. Some state-funded programs also cover limited services. Contact OHA for your specific situation.
Q: What is OHP Bridge and who qualifies?
A: OHP Bridge is a program for adults ages 19–64 whose income falls between 133% and 200% FPL — too high for standard OHP Plus. It launched July 1, 2024. There are two tracks: Basic Medicaid (for eligible American Indians and Alaska Natives) and the Basic Health Program (BHP) for others who lack affordable employer coverage.
Q: Does Oregon Medicaid have an asset limit?
A: Most OHP programs — including OHP Plus, OHP Bridge, and CHIP — have no asset test. That means savings accounts, a car, or a home will not disqualify you. Asset limits do apply to long-term care programs like OSIPM and OPI-M, where resource limits range from $2,000 to $99,656.
Sources and Disclaimer
Sources:
- Oregon Health Authority — FPL Chart effective March 1, 2026: oregon.gov
- Oregon Secretary of State — Permanent Administrative Order DMAP 7-2026 (filed February 26, 2026): records.sos.state.or.us
- Oregon ODHS — Medicare Savings Programs page (updated May 15, 2026): oregon.gov/odhs
- Oregon ODHS — OPI-M Income and Resource Standards (updated January 16, 2026): oregon.gov/odhs
- Oregon OHA — Hospital Presumptive Eligibility Guide: oregon.gov/oha
- Medicaid Planning Assistance — Oregon Medicaid Eligibility (updated March 4, 2026): medicaidplanningassistance.org
Want to understand how Oregon fits into the national picture? See our full guide to the Medicaid Fee Schedule 2026 for reimbursement rates and coverage details across programs.
Disclaimer: CheckMedicaid.com is not affiliated with any government agency. This content is for educational purposes only. For official eligibility determinations, contact the Oregon Health Authority at oregon.gov/oha or visit Medicaid.gov.
Last Updated: May 2026 | Written & Reviewed by Akash Biswas, MSW | Former Medicaid Caseworker Trainer | Verified against official Oregon Health Authority and Oregon Secretary of State administrative records.
