Health Insurance for Low-Income
The Oregon Medical Assistance Program, also known as Medicaid, is a Federal and State funded program providing medical and health-related services for eligible Oregon residents.
The Executive Office of Health and Human Services (EOHHS) administers the Medicaid program to provide health insurance for low-income families with children, pregnant women, senior citizens, people with disabilities or special needs, and other residents struggling to access affordable healthcare.
Oregon Medicaid Plan Options
Oregon Health Plan is the Medicaid program that offers coverage for low-income Oregon residents. It is provided through a coordinated care effort that involves providers coordinated care to ensure that costs are contained. The care provided is the highest quality possible.
Below are different types of coverage available through Oregon Health Plan:
- OHP Plus - Available for children and adults with a household income less than 138% of the Federal Poverty Line (FPL)
- OHP Plus Supplemental - Available for pregnant adults age 21 and over with a household income less than 138% of FPL
- OHP CHIP - Available for children ages 0 - 18 with a household income less than 300% of the FPL
Oregon Medicaid Services Offered
The following services are also provided various Oregon Medicaid Programs:
Oregon Independent Choices - If you qualify for Oregon LTSS, you may be able to hire and manage your own caretaker to help you with bathing, dressing, and other home activities through the Independent Choice Program.
Emergency Payment Program for Aliens
The Emergency Payment Program for Aliens provides coverage for a medical emergency to immigrants that meet the requirements for Medicaid eligibility except for their immigration status.
Medicaid Buy-In for Workers with Disabilities program
Medicaid Buy-In for Workers with Disabilities (MBIWD) provides healthcare coverage to working Oregon residents (between the age of 16 and 64) with disabilities. MBIWD was created to enable those with disabilities to work and still keep their health care coverage.
Home and Community-Based Services – Waiver Programs
Oregon Medicaid Long-Term Services and Supports provides opportunities for children, older adults or the disabled to continue participating in their community activities. Services range depending on the situation, but the goal is to improve the qualify of life of the entire family.
Medicare Costing Savings programs
The purpose of Medicare Costing Savings programs is to assist individuals by paying their Medicare premiums and by making payments to medical providers for coinsurance and deductibles for Medicare services.
The Qualified Medicare Beneficiary (QMB) program pays for Medicare Part B premiums, coinsurance, and deductibles for those eligible and enrolled in Medicare Part A.
The Specified Low Medicare Beneficiary (SLMB) program provides payment of Medicare Part B premiums only for individuals who would be eligible for the QMB program except for excess income.
The Qualified Individual (QI-1) program provides payment of Medicare Part B premiums only for individuals who would be eligible for the SLMB program except for excess income.
The Qualified Disabled Working Individual (QDWI) program provides payment of Medicare Part A premiums only for individuals meeting income limits.
Oregon Medicaid FAQs
- What is Medicaid?
Medicaid is a state funded insurance that that provides coverage to low income families, pregnant women, newborns, and children that may not be able to afford to purchase their own care.
- Who is eligible for Medicaid?
The following individuals are eligible for Oregon Medicaid:
- All Oregon residents with a household income less than 133% of the Federal Poverty Limit (FPL);
- Children 0-18 years with a household income less than 300% of the FPL;
- Pregnant women with a household income less than 185% of the FPL.
- How do I find out if I am eligible for Medicaid?
To find out if you are eligible for Medicaid, you must fill out an application for Medicaid or CHIP. You may fill out an application at any time of the year. See more on Medicaid.
- Will Medicaid cover my children?
Your household income level will determine if your child or children can be covered by Medicaid.
- What is CHIP?
CHIP is a program that supports children in families that cannot afford private health insurance, but whose household income is too high to qualify for Medicaid.
- Does Medicaid satisfy the health insurance requirement?
Yes, Medicaid will satisfy the Affordable Care Act (Obamacare) health insurance requirement for the covered individuals.
- What information and documents should I have when I'm signing up for Medicaid?
Depending on the Medicaid program being applied for, you will need the following: Identity, Social Security, proof you live in Oregon, proof of income, proof of medical costs, and bank account information.
- How does Obamacare work with Medicaid?
Because of Oregon's Medicaid eligibility requirements, Obamacare does not impact people who qualify for Medicaid and vice versa. As such, tax credits are only available for people who are not eligible for other plans.
- What is Oregon HealthPlan?
Oregon HealthPlan is the Medicaid option for pregnant women, newborns, and children offered through managed care programs. This is the program that provides the majority of the coverage for Oregon residents that qualify for Medicaid.
