Medicaid in Oregon does pay for care at home, and for most older adults and younger people with physical disabilities it pays through the K Plan, the state's main in-home benefit.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR Families searching for Oregon Medicaid HCBS waivers are usually looking for exactly this: the home and community-based services (HCBS) that let someone who needs a nursing-facility level of care stay in their own home or a community setting instead of moving into an institution.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR Oregon runs these services through two coordinated programs, both administered by the state's human-services department and its aging and disability office (ODHS APD).Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR
In This Guide
- What Are Oregon Medicaid HCBS Waivers?
- The K Plan and the 1915(c) APD Waiver in Detail
- Who Qualifies for Oregon Medicaid HCBS Waivers?
- What These Programs Cover
- Waitlists and How Enrollment Works
- How to Apply
What Are Oregon Medicaid HCBS Waivers?
Home and community-based services (HCBS) is the part of Medicaid that pays for long-term care delivered outside an institution: in your own home, a family member's home, or a community setting rather than a nursing facility. Federal Medicaid law gives states several tools to provide it. The best known is the 1915(c) waiver, named for the section of the Social Security Act that lets a state waive certain rules so Medicaid dollars can follow a person into the community.
Oregon uses two of these tools together. Its main in-home benefit is the K Plan, Oregon's version of Community First Choice, a Medicaid state plan option authorized under the Affordable Care Act that draws a six percent increase in federal medical assistance funds for the services it covers.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR Running alongside it is the 1915(c) Aged and Physically Disabled Waiver (waiver number 0185.R07.00), which adds services the K Plan does not carry: case management, housing support services, and transition services.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR
One quick note on the name. People search for "Oregon Medicaid HCBS waivers," but only one of Oregon's two programs is technically a waiver. The K Plan is a Medicaid state plan option, so it operates as a state plan benefit; the Aged and Physically Disabled Waiver is the actual capped 1915(c) waiver.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR Both deliver HCBS, both are run by the same office, and most families use the phrase loosely to mean either one, so this guide does too.
The K Plan and the 1915(c) APD Waiver in Detail
The K Plan is the workhorse. As Oregon's Community First Choice option, it funds in-home services and supports for people who need assistance with regular daily activities and want to stay in their own home or a community setting.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR Because it is a state plan option, the federal government pays Oregon a six percent higher share of the cost for the services it covers, which is part of why the state leans on it as the primary benefit.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR
The 1915(c) Aged and Physically Disabled Waiver works as the companion piece. It adds three things the K Plan does not: waiver case management (the person who coordinates your plan), housing support services, and transition services, meaning the help someone needs to move out of a nursing facility and re-establish a household in the community.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR
Both authorities are up for renewal soon. The 1915(c) Aged and Physically Disabled Waiver and a companion 1915(b)(4) Case Management and Agency with Freedom of Choice Waiver are approved by the Centers for Medicare and Medicaid Services (CMS) through December 31, 2026, and Oregon is applying to renew them.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR A renewal like this normally continues services without a break, but if your care depends on the waiver, it is worth confirming the current status with your case manager as the deadline approaches.
Who Qualifies for Oregon Medicaid HCBS Waivers?
Qualifying comes down to two tests: a functional one and a financial one.
The functional test is a nursing-facility level of care. Both the K Plan and the 1915(c) waiver serve individuals ages 65 or older and individuals with physical disabilities ages 18 to 64 who meet that level of care, meaning their need for help with daily activities is serious enough that they would otherwise qualify for nursing-home placement.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR
The financial test uses the same standards that apply to nursing-facility coverage, set by Oregon's Medicaid long-term-care financial-eligibility program (OSIPM).Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR Oregon is an income-cap state, so there is a firm monthly income limit:
- Income limit: $2,982 a month in 2026, which is 300 percent of the SSI federal benefit rate, the figure Medicaid calls the Special Income Level.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR
- Asset limit: $2,000 in countable resources for a single Oregon applicant in 2026.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR
If your income is over the cap, you are not automatically disqualified. Oregon lets applicants route the excess through an Income Cap Trust, the state's version of a qualified income trust, so that income above $2,982 no longer counts against the limit.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR Setting one up correctly matters, so many families work with their case manager or an elder-law attorney on it.
Married couples get an extra layer of protection. When one spouse needs HCBS and the other stays in the community, the at-home spouse can keep a higher share of the couple's assets, up to $162,660 in 2026, under the community spouse resource allowance.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR Our Oregon Medicaid spousal impoverishment guide walks through how that protection works.
One thing HCBS changes is your setting, and setting affects your money. If you entered a nursing facility, most of your monthly income would go toward the cost of that care, and federal rules would let you keep only a small personal needs allowance (PNA) of at least $30 a month.U.S. Government Publishing Office. (n.d.). 42 U.S.C. 1396a(q)(2) — Minimum monthly personal needs allowance deduction (govinfo.gov USCODE). govinfo.gov. Retrieved Jun 24, 2026, from https://www.govinfo.gov/link/uscode/42/1396a The K Plan is built to fund care in your own home or a community setting instead, which is the whole point of home and community-based services.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR Ask your case manager whether any monthly contribution toward your care applies in your situation, since that piece varies from case to case.
What These Programs Cover
Oregon describes the K Plan's benefit in broad terms on purpose: in-home services and supports for people who need assistance with regular activities and want to stay in their home or in a community setting and remain as independent, healthy, and safe as possible.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR In everyday terms, the K Plan is the source of the ongoing help that makes staying home workable.
The 1915(c) Aged and Physically Disabled Waiver layers three additional services on top of the K Plan:
- Waiver case management, the person who coordinates your plan and services.
- Housing support services.
- Transition services, for moving from a nursing facility back into the community.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR
Because the exact service menu and any limits are set by the state's aging and disability office and can change, confirm what is covered for your own care plan with your case manager or local office rather than assuming a specific service is included.
Waitlists and How Enrollment Works
Whether you wait for a slot depends on which authority you are enrolling under. The K Plan is a Medicaid state plan option, which means it operates as a state plan benefit rather than a capped waiver.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR The 1915(c) Aged and Physically Disabled Waiver, by contrast, is a capped waiver.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR That structural difference is a big part of why Oregon leans on the K Plan as its primary in-home benefit.
Enrollment runs through the state's aging and disability office. Eligibility and case management for OHP long-term-care services are handled by that office, local ODHS offices, and Area Agencies on Aging.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR Because slot availability and any current interest-list rules can change, ask your local ODHS office where things stand before you plan around a particular timeline.
How to Apply
Applying happens in two connected pieces: a level-of-care assessment and financial approval for OHP long-term services and supports. Both run through the state's aging and disability office, its local offices, and Area Agencies on Aging.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR A good place to start is your local Aging and Disability Resource Connection (ADRC), Oregon's front door that connects you to the right office and the assessment.
Federal rules give you more than one way to file the Medicaid application itself. The state has to accept your application online, by phone, by mail, or in person, so you can use whichever channel works best for you.U.S. Government Publishing Office. (n.d.). 42 CFR 435.907 — Application (eCFR, current). ecfr.gov. Retrieved Jul 13, 2026, from https://www.ecfr.gov/current/title-42/section-435.907
The state also cannot take an unlimited amount of time to decide. Under federal Medicaid rules, an eligibility determination generally may not exceed 45 calendar days, or 90 calendar days when the application is based on disability.U.S. Government Publishing Office. (2024). 42 CFR 435.912 Timely determination and redetermination of eligibility (2024 ed.) — govinfo.gov. govinfo.gov. Retrieved Jun 25, 2026, from https://www.govinfo.gov/content/pkg/CFR-2024-title42-vol4/pdf/CFR-2024-title42-vol4-sec435-912.pdf If your decision drags past those windows without one of the narrow exceptions the rules allow, that is grounds to follow up with your office.
For a step-by-step walk through the state process, see our guide to applying for Oregon Medicaid.
Frequently Asked Questions
Is the K Plan actually a waiver?
Not technically. People lump everything together as "Oregon Medicaid HCBS waivers," but the K Plan is a Medicaid state plan option, Oregon's Community First Choice (CFC) benefit, not a capped waiver.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR The actual waiver is the separate 1915(c) Aged and Physically Disabled Waiver that runs alongside it and adds case management, housing support, and transition services.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR For a family, the practical point is that both deliver home and community-based services (HCBS), and both are run by the same office.
Can I still qualify if my income is above $2,982 a month?
Often, yes. Oregon is an income-cap state with a 2026 long-term-care income limit of $2,982 a month, but income over that amount can be routed through an Income Cap Trust, Oregon's version of a qualified income trust, so it no longer counts against the limit.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR The countable-asset limit is a separate test, $2,000 for a single applicant.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR Because an Income Cap Trust has to be set up correctly, many families handle it with their case manager or an elder-law attorney.
How is this different from Medicaid paying for a nursing home?
The eligibility bar is the same, so the real difference is where the care happens. Both a nursing home and HCBS require a nursing-facility level of care and use the same financial limits.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR Medicaid can pay for a nursing home, but the K Plan and the 1915(c) waiver instead fund that care in your own home or a community setting, for people who qualify for a nursing home but would rather stay in the community.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR
Who do I contact to apply in Oregon?
Start with your local Aging and Disability Resource Connection (ADRC) or ODHS office. Eligibility and case management for these services run through the state's aging and disability office, local ODHS offices, and Area Agencies on Aging.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — Oregon Waiver Factsheet (OR Aged and Physically Disabled Waiver 0185.R07.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR You can file the underlying Medicaid application online, by phone, by mail, or in person.U.S. Government Publishing Office. (n.d.). 42 CFR 435.907 — Application (eCFR, current). ecfr.gov. Retrieved Jul 13, 2026, from https://www.ecfr.gov/current/title-42/section-435.907
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