The three requirements
| Requirement | Medicaid long-term services and supports (LTSS) |
|---|---|
| Care need | Need for nursing facility level of care, measured as service priority levels 1 to 13 in an ODHS assessment |
| Income | Up to 300% of the federal SSI benefit rate, or higher with an income cap trust |
| Resources | A low limit for a single person (OAR 461-160-0015); for couples, ODHS does a resource assessment |
| Age | 18 or older |
Source: ODHS's LTSS and OPI-M comparison chart, updated February 4, 2026. Federal law also has Medicaid review gifts or transfers of assets made in the 60 months before you apply (42 U.S.C. 1396p(c)).
Where you can get care
- At home, with paid caregivers for help with bathing, dressing, mobility or medications.
- Community-based care, such as adult foster homes, assisted living, residential care and memory care.
- A nursing facility.
- PACE, where available.
ODHS says in-home and PACE services have no cost to you. In community-based care or a nursing facility, you pay part of your income toward your care (your "liability").
If you need less care, or have more income
Oregon Project Independence-Medicaid (OPI-M) provides in-home help with higher limits: income up to 400% of the federal poverty level and resources up to about six months of nursing facility costs. It covers service priority levels 1 to 18, has no monthly fees and no estate recovery, but offers up to 40 hours of in-home services, not facility care.
How to apply
- Call or apply. Apply at one.oregon.gov, call ODHS Aging and People with Disabilities at 1-855-673-2372, or call 1-800-699-9075 (TTY 711).
- Complete the needs assessment. A case manager from ODHS or your local Area Agency on Aging assesses your daily care needs.
- Complete financial eligibility. Gather proof of income, bank statements and property records.
- Choose a setting and provider. Your case manager helps you arrange services.
Keep your Medicare. It still pays first for doctor, hospital and drug costs, and you'll want a Medicare plan that fits your care setting. To review Medicare options, you can request a call from a licensed insurance agent.
Related questions
What is Oregon Project Independence?
In-home help for people 60+.
Will Oregon take my house?
Estate recovery explained.
Medicare vs. Medicaid in Oregon
Who pays for what.
Does Medicare cover nursing homes?
Short stays only.
Sources
- Oregon Department of Human Services — LTSS and OPI-M service program options comparison chart (updated February 4, 2026)
- Oregon Department of Human Services — Long-term care
- Oregon Administrative Rules — OAR 461-160-0015, resource limits
- Medicare.gov — Long-term care
- Medicare.gov — Skilled nursing facility care
More questions in this guide
- Can I have Medicare and the Oregon Health Plan?
- Do I keep my CCO when I get Medicare in Oregon?
- Does OHP pay my Medicare Part B premium?
- What's the difference between Medicare and Medicaid in Oregon?
- What happens to my OHP when I turn 65?
- What is a dual special needs plan (D-SNP) in Oregon?
- What is Oregon Project Independence and who qualifies?
Part of the guide: Oregon Health Plan and Medicare: combined coverage · All questions
Frequently asked questions
Does Medicare pay for long-term care in Oregon?
No. Medicare covers short skilled nursing facility stays after a qualifying hospital stay, up to 100 days, with a daily coinsurance of $217 from day 21 in 2026. It doesn't pay for ongoing custodial care.
Can I get care at home instead of a nursing home?
Yes. ODHS's long-term services and supports can be provided at home, in community-based care such as assisted living or adult foster homes, in a nursing facility, or through PACE.
Will Oregon recover the cost from my estate?
It can. ODHS lists estate claims for long-term services and supports, deferred while a spouse or a child under 21 or with a disability survives. Oregon Project Independence-Medicaid has no estate recovery.
What if my income is over the limit?
ODHS says income can be higher with an income cap trust, which holds the extra income under strict rules. Talk with ODHS or an attorney before setting one up.
Medicare in your Oregon county
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