To apply for Oregon Medicaid, residents use the ONE portal at ONE.Oregon.gov, the single online application for the Oregon Health Plan (OHP). If your gross monthly income exceeds $2,982 in 2026, Oregon requires an Income Cap Trust before it can approve nursing-facility or waiver coverage, so the senior pathway is not the generic "apply online" route. This guide walks each application channel, the Income Cap Trust gate, the documents you will need, and what to expect after you submit.

In This Guide

Before You Apply: Oregon's Income Cap Trust

Oregon is an income-cap state for long-term care. If your gross monthly income from all sources exceeds $2,982 in 2026, you cannot qualify for nursing-facility or home- and community-based waiver coverage without first establishing an Income Cap Trust. The cap equals 300% of the SSI standard ($994 for 2026), and it is set by Oregon Administrative Rule, not by the caseworker.

The instrument has several names. Oregon calls it an "Income Cap Trust"; federal law and other states call the same mechanism a Qualified Income Trust (QIT) or a Miller Trust, authorized by Section 1917(d)(4)(B) of the Social Security Act for applicants whose income exceeds the state's cap. Mechanically, only the applicant's own income may be deposited into the trust each month, and the trust pays toward the cost of care while Medicaid covers the remainder. The deposited income no longer counts against the income limit. Without the trust in place, the ODHS worker processing your application cannot approve long-term care coverage, no matter how much care you need.

Who needs one. Any applicant whose gross monthly income (Social Security, pension, retirement distributions, annuity payments) exceeds $2,982 per month in 2026. The threshold applies to nursing-facility and home- and community-based waiver programs. Coverage for primary and preventive care under the broader Oregon Health Plan uses a different, lower income test.

How to set one up. An elder law attorney drafts the trust document and opens a dedicated bank account in the trust's name. ODHS does not draft trusts on your behalf. You can submit your application while the trust is being established, but you must provide trust documentation before ODHS can approve long-term care coverage. If you are unsure whether your income triggers the requirement, review the figures with ODHS or an attorney before applying.

See our guide to Medicaid planning strategies for how income cap trusts fit into the broader picture.

Oregon Medicaid at a Glance

The figures below are the 2026 long-term care eligibility thresholds an Oregon applicant clears most often. Each is set in Oregon Administrative Rule or by federal standard.

Item 2026 figure
Income limit (nursing facility / waiver) $2,982/month (300% of the $994 SSI standard)
Income above the limit Requires an Income Cap Trust
Resource limit, one-person need group $2,000
Resource limit, two-person need group $3,000
Nursing-facility personal needs allowance $81.28/month ($90 for a veterans pension based on unreimbursed medical expenses)
Community spouse resource allowance (max) $162,660
Transfer look-back 60 months
Home equity limit (federal minimum) $752,000

Every figure in this table traces to Oregon Administrative Rule 461-160-0015 and 461-155-0250 or to the controlling federal standard.,,

How to Apply for Oregon Medicaid

Oregon gives you three channels, and all three lead to the same eligibility determination by ODHS: apply online through the ONE system, by phone, or at a local ODHS office. Pick whichever fits your situation.

1
Step 1

Apply online through the ONE portal

Go to ONE.Oregon.gov and select "Apply for benefits." ONE is Oregon's integrated benefits portal, covering OHP, food assistance, and other state programs from a single application. You can create an account (recommended) or apply as a guest; an account lets you save progress, upload supporting documents after submission, and check your status online, and takes about five minutes to set up. For long-term care applications, the online form asks about income, assets, living situation, and care needs, so answer accurately. ODHS cross-checks financial data with federal and state databases, and incomplete or inconsistent answers slow the process.

2
Step 2

Apply by phone

Oregon Medicaid takes applications over the phone through the Oregon Health Authority benefits line listed on the Oregon Health Plan page. A representative can take your application, answer questions about the process, and route you to ODHS Aging and People with Disabilities (APD) if your situation involves long-term care. Phone applications work well for applicants who need help answering questions or who are not comfortable with online forms.

3
Step 3

Apply in person at a local ODHS office

Visit any local ODHS office. The Aging and People with Disabilities (APD) program within ODHS handles long-term care Medicaid eligibility statewide. Staff can help you complete the application, identify which documents you will need, and flag whether your income is likely to require an Income Cap Trust. Find your local office through the ODHS office finder.

Not sure where to start? Chat with Brevy's care navigator at brevy.com to sort through your options before you apply.

What Documents You'll Need

Gathering paperwork before you apply is the single most effective way to avoid delays. ODHS will request verification for anything it cannot confirm through its own data sources. The financial review is heavy because Oregon applies a 60-month (five-year) look-back to asset transfers, so several years of statements come into play for long-term care applications.

Identity and citizenship:

  • Social Security card or Social Security Administration verification letter
  • U.S. passport, birth certificate, or Certificate of Naturalization
  • Oregon driver's license, state ID, or other government-issued photo ID
  • Already enrolled in Medicare? An existing Medicare enrollment can serve as citizenship verification.

Income (all sources):

  • Social Security award letter or SSA-1099
  • Pension or retirement income statements
  • Railroad retirement benefit letters
  • Annuity income statements
  • If still working: last 30 days of pay stubs

Assets:

  • Bank statements for all checking and savings accounts (at minimum, the current month)
  • For long-term care applications: ODHS typically requests several months of statements and reviews recent financial history for the look-back analysis
  • Statements for retirement accounts, CDs, stocks, and bonds
  • Life insurance policy documents (face value and cash surrender value)
  • Vehicle title or registration

Property:

  • Property deed and most recent tax assessment for any real estate you own
  • Mortgage statement if applicable

Medical and care documentation (for long-term care):

  • Physician letter or records documenting the level of care needed
  • Current care plan from a facility or home care provider, if available

Income Cap Trust (if applicable):

  • Signed trust agreement
  • Bank account statement for the trust account

What Happens After You Apply

Acknowledgment. After you submit through ONE.Oregon.gov, you will receive a confirmation. If you applied by phone or in person, the ODHS worker should give you a reference number.

Document requests. ODHS may contact you to request additional documentation. Check your ONE account and your mail regularly, and respond promptly. A missed document request can trigger a denial even if you are otherwise eligible.

Eligibility determination. Federal law requires the agency to decide most Medicaid applications within 45 days, and within 90 days for applications based on disability. Long-term care applications, which require a functional assessment in addition to the financial determination, routinely run toward the longer end because two reviews must finish before approval.

Functional assessment. For long-term care coverage, an ODHS case manager conducts a Nursing Facility Level of Care (NFLOC) assessment to determine whether you meet the nursing-facility level-of-care standard. The assessment weighs activities of daily living, skilled-nursing needs, and cognitive or behavioral impairment, and the bar is set by the state, not by a single federal definition. Both the financial and functional criteria must be met before coverage is approved.

Retroactive coverage. Federal law requires Oregon Medicaid to pay retroactively for covered services furnished in or after the third month before the month you applied, if you would have been eligible then. This is why the date you apply matters: it anchors the back-coverage window for bills already incurred. Ask the ODHS worker about retroactive coverage when your application is approved.

Important forward change: under Public Law 119-21 (Section 71112), for applications made on or after January 1, 2027, the retroactive window shortens to two months before the application month for most enrollees, and one month for the Medicaid expansion adult group.

Appeals: If You're Denied

You have the right to request a hearing if your application is denied or if you disagree with the terms of an approval. The denial notice states the reason and the deadline. Under federal rule (42 CFR 431.221(d)), the state must allow a reasonable time to request a hearing, not to exceed 90 days from the date the notice of action is mailed. Read your notice for the exact deadline that applies to your decision, and do not wait.

Request a hearing by contacting the Office of Administrative Hearings (OAH) through the information on your denial notice, or by calling ODHS. You can represent yourself or bring an advocate or attorney. The organizations below offer free help to income-eligible applicants, and both provide free Medicaid representation for those who qualify.

Oregon Law Center Free legal help for income-eligible applicants in rural Oregon. 1-888-245-7493 oregonlawcenter.org
Legal Aid Services of Oregon Free legal help for income-eligible applicants in the rest of the state, including Portland. 1-888-610-8764 lasoregon.org
Oregon Long-Term Care Ombudsman Independent help understanding the long-term care and appeals process. www.oltco.org

Want help reviewing a denial? Talk to Brevy's care navigator at brevy.com for guidance on next steps.

Estate Recovery

After the death of a Medicaid recipient age 55 or older who received long-term care services, Oregon pursues federally mandated estate recovery and may file a claim against the estate for the cost of services paid. Federal exceptions apply (surviving spouse, minor child, adult disabled child), and Oregon offers an undue-hardship waiver process. See our guide to Medicaid estate recovery for a detailed breakdown.

Frequently Asked Questions

Can I apply for Oregon Medicaid if my income is too high?

Yes, if you establish an Income Cap Trust first. Oregon is an income-cap state, so applicants with gross monthly income above $2,982 in 2026 cannot qualify for nursing-facility or waiver coverage without one. The trust channels excess income toward the cost of care each month and removes it from the income calculation, under the authority of Section 1917(d)(4)(B) of the Social Security Act. An elder law attorney sets it up.

What is the difference between OHP and long-term care Medicaid in Oregon?

The Oregon Health Plan is Oregon's overall Medicaid program, covering primary care, hospital services, prescriptions, and more for eligible Oregonians. Long-term care Medicaid is a subset: it covers nursing-facility care and home- and community-based services for people who meet both a financial eligibility test and a functional level-of-care assessment. The financial rules are stricter for long-term care, and the application involves both OHA and ODHS Aging and People with Disabilities.

How long does it take to get approved?

Federal law requires the agency to decide most Medicaid applications within 45 days, and within 90 days for applications based on disability. Long-term care applications take longer in practice because they require a functional assessment in addition to the financial review. Having every document ready when you apply is the most effective way to reduce delays.

What assets does Oregon exempt from the $2,000 limit?

The primary home, one vehicle, household goods, personal effects, and a prepaid burial arrangement are generally exempt. The home is exempt subject to a federally indexed home-equity limit, which for 2026 starts at a federal minimum of $752,000. A spouse who remains in the community may keep half the couple's countable assets up to $162,660, the 2026 maximum Community Spouse Resource Allowance.

Can someone else apply on my behalf?

Yes. A family member, legal guardian, or person with power of attorney can complete and submit the application. When applying through ONE.Oregon.gov, the authorized representative can create or use their own account and identify themselves as applying on behalf of someone else. Bring documentation of the legal authority (power of attorney documents, guardianship order) to any in-person visit.

What is the 60-month look-back and how does it affect my application?

Under federal law, Oregon reviews asset transfers made in the 60 months before your application. Gifts, sales below market value, or other uncompensated transfers during that window can trigger a penalty period during which Medicaid will not pay for long-term care. The penalty length depends on the value of the transferred assets divided by the state's average monthly private-pay nursing-facility cost. If you made significant gifts in the past five years, discuss the implications with an elder law attorney before applying.

Learn More

MedicaidHow to Apply for Medicaid by State: Steps, Documents, and Where to ApplyApplying for Medicaid follows the same federal steps everywhere; the agency and portal are your state's. What to gather, how long it takes, and where to apply. MedicaidOregon Medicaid Programs OverviewOregon Health Plan (OHP) covers long-term care under a $2,982 income cap and Income Cap Trust. See 2026 asset, spousal, and estate-recovery rules to apply. MedicaidOregon Medicaid Eligibility and Income LimitsOHP income limits 2026 by household size: most Oregon adults qualify at 138% of poverty (~$1,836/mo for one), no asset test, plus the long-term-care cap. MedicaidHelp Paying Medicare Premiums in OregonOregon Medicare Savings Programs in 2026: QMB, SLMB, and QI income limits, no asset test, and how to apply for help paying your Medicare Part B premium. MedicaidMedicaid Planning StrategiesSee which assets you keep, how the 5-year look-back works, and the legal moves that qualify you for Medicaid long-term care without losing the house. MedicaidMedicaid Estate Recovery ExplainedMedicaid estate recovery explained: federal law, 51-state matrix, categorical protections, hardship waivers, and 2025-2026 reform updates. Verify before acting.

Find personalized help applying for Oregon Medicaid at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.