Oregon Medicaid (Oregon Health Plan)
This guide covers Medicaid eligibility in Oregon, known as Oregon Health Plan. Whether you're a child, parent, pregnant woman, or adult, this guide explains who qualifies and how to apply.
This guide uses 2026 Federal Poverty Level (FPL) data. The FPL is published annually in January by HHS and determines eligibility thresholds for Medicaid and other federal programs.
Medicaid Pathways
General Eligibility Requirements
To qualify for Oregon Medicaid you must:
- Be a resident of Oregon
- Be a U.S. citizen or have qualified immigration status
- Have or apply for a Social Security number (with some exceptions)
- Meet the specific eligibility criteria for at least one Medicaid pathway
- Meet income guidelines (which vary by program)
This guide covers the main categories: children, pregnant women, parents, and adults. Additional pathways exist for seniors (65+), people with disabilities, and specific medical conditions — these often have different income and asset requirements.
Medicaid Eligibility Pathways in Oregon
Oregon offers several pathways to Medicaid eligibility. A 5% income disregard may already be included or may be applied depending on circumstances.
1. Medicaid for Children
Who qualifies:
- Children under age 19
- Oregon residents
- U.S. citizens or those with qualified immigration status
- Meeting income guidelines below
Income limits:
- Infants up to age 1: up to 190% FPL
- Children ages 1–18: up to 305% FPL
| Family size | 190% FPL — Infants up to age 1 | 305% FPL — Children ages 1–18 |
|---|---|---|
| 1 person | $2,527/mo | $4,057/mo |
| 2 people | $3,426/mo | $5,500/mo |
| 3 people | $4,326/mo | $6,944/mo |
| 4 people | $5,225/mo | $8,388/mo |
| 5 people | $6,124/mo | $9,831/mo |
| 6 people | $7,024/mo | $11,275/mo |
| 7 people | $7,923/mo | $12,719/mo |
| 8 people | $8,822/mo | $14,162/mo |
| Each additional person | +$899/mo | +$1,444/mo |
2. Children's Health Insurance Program (CHIP)
Who qualifies:
- Children under age 19
- Family income above Medicaid limits but at or below 305% FPL
- Oregon residents
- U.S. citizens or those with qualified immigration status
- Not currently covered by other insurance
Income range: above Medicaid children's limit up to 305% FPL
3. Medicaid for Pregnant Women
Who qualifies:
- Pregnant individuals
- Oregon residents
- U.S. citizens or those with qualified immigration status
- Income at or below 190% FPL
Income limits — 190% FPL:
| Family size | 190% FPL — monthly limit |
|---|---|
| 2 people | $3,426/mo |
| 3 people | $4,326/mo |
| 4 people | $5,225/mo |
| 5 people | $6,124/mo |
| 6 people | $7,024/mo |
| 7 people | $7,923/mo |
| 8 people | $8,822/mo |
| Each additional person | +$899/mo |
* The unborn child counts as a family member when determining family size. Coverage extends for 12 months postpartum in Oregon. Presumptive eligibility provides temporary coverage for prenatal services while the full application is processed.
4. Medicaid for Adults (ACA Expansion)
Who qualifies:
- Adults ages 19–64
- Not currently eligible for Medicare
- Oregon residents
- U.S. citizens or those with qualified immigration status
- Income at or below 138% FPL
Income limits — 138% FPL:
| Family size | 138% FPL — monthly limit |
|---|---|
| 1 person | $1,835/mo |
| 2 people | $2,489/mo |
| 3 people | $3,142/mo |
| 4 people | $3,795/mo |
| 5 people | $4,448/mo |
| 6 people | $5,101/mo |
| 7 people | $5,755/mo |
| 8 people | $6,408/mo |
| Each additional person | +$653/mo |
5. Medicaid for Parents & Caretaker Relatives
Who qualifies:
- Parents or caretaker relatives of dependent children under age 19
- Must live with and provide care for the child
- Oregon residents
- U.S. citizens or those with qualified immigration status
- Meeting income guidelines below
Income limits — 138% FPL:
| Family size | 138% FPL — monthly limit |
|---|---|
| 2 people | $2,489/mo |
| 3 people | $3,142/mo |
| 4 people | $3,795/mo |
| 5 people | $4,448/mo |
| 6 people | $5,101/mo |
| 7 people | $5,755/mo |
| 8 people | $6,408/mo |
| Each additional person | +$653/mo |
How Income is Counted (MAGI)
Medicaid income limits are based on MAGI — Modified Adjusted Gross Income. This is different from taxable income. To learn exactly how MAGI is calculated, see: How Income is Counted for MAGI →
How to Apply for Oregon Health Plan
There are several ways to apply for Medicaid in Oregon:
- Online: www.oregon.gov/oha/HSD/OHP
- By phone: 1-800-699-9075
- In person: Visit your local Department of Social Services or Medicaid office
- By mail: Request a paper application from your local Medicaid office
ACA Marketplace Coverage
If you don't qualify for Medicaid in Oregon, you may be eligible for subsidized health insurance through the Health Insurance Marketplace.
ACA premium tax credit income limits — 400% FPL
Premium tax credits help reduce monthly premiums for Marketplace plans. You may qualify if your income is between 100% and 400% FPL (and in some cases above 400% FPL).
| Family size | 400% FPL — monthly income limit |
|---|---|
| 1 person | $5,320/mo |
| 2 people | $7,213/mo |
| 3 people | $9,107/mo |
| 4 people | $11,000/mo |
| 5 people | $12,893/mo |
| 6 people | $14,787/mo |
| 7 people | $16,680/mo |
| 8 people | $18,573/mo |
| Each additional person | +$1,893/mo |
How to apply for Marketplace coverage
- Visit Healthcare.gov during Open Enrollment (typically November–January)
- Call the Marketplace at 1-800-318-2596
- Get in-person help from a Navigator or Certified Application Counselor at Healthcare.gov
- Special Enrollment Periods apply within 60 days of qualifying life events (job loss, marriage, new child, etc.)