Oregon Health Plan (OHP): Oregon’s Medicaid Program Explained for Seniors
What OHP is, who qualifies, income limits, and what it covers
The Oregon Health Plan (OHP) is Oregon’s Medicaid program — a state and federally funded health insurance program for people with limited income. If you’ve seen the abbreviation “OHP” and wondered whether it’s the same as Medicaid, the answer is yes. OHP is simply what Oregon calls its Medicaid program.
For seniors and older adults, OHP can be a critical source of coverage for doctor visits, prescriptions, and long-term care when Medicare doesn’t cover the full cost — or when income is too low to afford additional insurance.
Is OHP Medicaid?
Yes. The Oregon Health Plan is Oregon’s version of Medicaid. Every state runs its Medicaid program under its own name — in Oregon it’s OHP, in Tennessee it’s TennCare, in California it’s Medi-Cal. They are all Medicaid programs funded jointly by the state and federal government.
Get the Complete Medicaid Guide for Seniors →
OHP is administered through Coordinated Care Organizations (CCOs) — regional networks that manage and coordinate health services for members across different parts of the state.
Who Qualifies for OHP?
Eligibility for OHP is based primarily on income, but age, disability status, and household size also play a role. Seniors may qualify through several pathways:
- Income-based eligibility: Adults with income at or below 138% of the Federal Poverty Level (FPL) may qualify for OHP Plus — the full Medicaid benefit.
- Seniors needing long-term care: Older adults who require nursing home or in-home care may qualify even with higher income, through specific long-term care Medicaid rules.
- Dual eligibility: Seniors already on Medicare may qualify for OHP to help cover premiums, copays, and services Medicare doesn’t fully pay.
OHP Income Limits (2026)
For most adults under 65, the income limit for OHP is approximately 138% of the Federal Poverty Level. For seniors 65 and older, different Medicaid rules apply — particularly for long-term care. Here’s a general reference:
| Household Size | Approx. Monthly Income Limit (138% FPL) |
|---|---|
| 1 person | ~$1,732/month |
| 2 people | ~$2,342/month |
| Each additional person | +~$610/month |
Note: Seniors applying for long-term care Medicaid through OHP may have different income and asset rules. Contact Oregon’s Office of Eligibility Policy for the most current figures.
What Does OHP Cover?
OHP covers a wide range of services. For seniors, the most important benefits include:
- Doctor and specialist visits
- Hospital care (inpatient and outpatient)
- Prescription medications
- Mental health and substance use services
- Dental care (included for OHP members)
- Vision care
- Long-term care — nursing home care, in-home personal care, and assisted living when income and care needs qualify
- Preventive care — screenings, vaccinations, wellness visits
Not all services are covered without limits. OHP uses a prioritized list of health services, meaning some treatments are covered and others are not, depending on medical effectiveness and budget.
OHP and Medicare: How They Work Together
Many seniors are enrolled in both Medicare and OHP at the same time. This is called dual eligibility. When a senior qualifies for both:
- Medicare pays first as the primary insurer
- OHP may cover Medicare premiums (Part B), copays, and deductibles
- OHP may cover services Medicare doesn’t include, such as certain dental, vision, and long-term care
For low-income seniors on Medicare, this combination can dramatically reduce out-of-pocket healthcare costs.
How to Apply for OHP
Oregon residents can apply for OHP through ONE Oregon (Oregon’s eligibility system) at healthcare.oregon.gov, by phone, or in person at a local Department of Human Services office. Applications can be submitted at any time — there is no open enrollment period for Medicaid.
When applying, you’ll need to provide proof of income, Oregon residency, and identity. Seniors applying for long-term care Medicaid may also need to provide information about assets and living arrangements.
What This Means for Seniors
If you or a loved one is 55 or older and living in Oregon with limited income, OHP could cover healthcare costs that would otherwise be unaffordable — including long-term care that Medicare won’t pay for.
Understanding whether you qualify, what the income limits are, and how OHP works alongside Medicare is the most important first step. The sooner you understand your options, the better positioned you’ll be to plan for care costs without financial surprises.
Last Updated on 30 June 2026 by ingmin