How to Get Oregon Medicaid Benefits | Best Answers

We have scoured the internet to provide all you need to know about the Oregon Medicaid Benefits.

Medicaid is a joint federal-state program that provides health insurance to low-income individuals who meet certain requirements, including kids, pregnant women, the elderly, and individuals with disabilities. Applying for Medicaid in person, via telephone, or online is simple.

This post will teach you all you need to learn about Medicaid in Oregon.

What is the Oregon Medical Program?

Oregon Medicaid is a service for people and families with income and resources that fall within certain parameters. Resources primarily apply to the elderly, blind, or disabled population within the bounds of specified rules.

Who is eligible for the Oregon Medical Program?

Oregon Medicaid offers certain limited Medicare beneficiaries who are not eligible for the full Medicaid benefit package some partial financial help with Medicare premiums and copayments or coinsurance through the Medicare Savings Plan.

• Expectant mothers
• People who are blind or disabled or who have a spouse who is blind or disabled; 
• People whom someone adopts;
• People whom someone adopted; 
• People who are blind or disabled or have a spouse who is disabled.

The Annual Household Income Limits (before taxes)

*For households with more than eight people, add $6,277 per additional person.

How do I contact Medicaid in Oregon?

Phone

800-699-9075

Mailing Address

Barbara Roberts Human Services Building

500 Summer Street NE, E-35

Fax: 503-947-1119

What are the Medicaid plans in Oregon?

Physician Care Organization Program

Oregon phased out the Physician Provides a great deal program in favor of the full-risk, taking control of the Oregon Health Plan. 

This Program also initially provided all Medicaid-covered medical care to low-income adults and children and later expanded to include populations of the elderly, the blind, the disabled, and foster children.

Oregon Health Program Plus

In counties where case management was unavailable, Oregon Health Program Plus offered primary healthcare case managers or mandated enrollment in fully-capitated MCOs for most benefit groups, except for childless adults. 

The Program covered acute, primary, and specialty care and dental and mental health care were covered by separate prepaid health insurance.

Coordinated Care Organizations

With the introduction of a new managed care model in Oregon, the state’s OHP state actors are being replaced by Coordinated Care Organizations, risk-bearing, locally regulated provider networks. 

These organizations will offer physical health treatments and mental and dental care that were previously excluded from the OHP insurance package to all Medicaid members.

For more details regarding Medicaid plans in Oregon, visit here.

How do I apply for Oregon Medicaid?

Call 800-699-9075 to enroll. 

Apply in person at Barbara Roberts Human Services Building.

Online:  Download and print the application.

Mail: To Barbara Roberts Human Services Building, 500 Summer Street NE, E-35

Fax: 503-947-1119

What is covered by Oregon Medicaid?

Oregon Medicaid covers the following services:

Can I have both Oregon Medicaid and Medicare?

You must be qualified for Medicare Part A, have hospital insurance coverage, be income and resource constrained, and be Dual Eligible to receive Medicaid benefits through the “Medicare Savings Program” (MSP).

Oregon Waiver

• Medically Involved Children’s Waiver;
• ICF / MR Comprehensive Residential;
• Medically Fragile (Hospital) Model;
• Behavioral (ICF/MR) Model;
• ICF/MR Support Services

Copayments?

They do not have to pay a copayment. When a member is 

• under 21 years old; 
• pregnant; 
• Held by the state
• Placed under government supervision
• Native American participants who qualify for Contract Health funding
• Services or Tribal Union of Indian Health Services
• The hospital (inpatient)
• A facility for skilled nursing
• A nursing home

What is not covered by Oregon Medicaid?

In Oregon, Medicaid is not mandated to offer in-home caregiving services or private nursing coverage. Bandages, adult diapers, and other disposable items are frequently excluded from insurance coverage, as are cosmetic surgery and other elective procedures.

What is the highest income limit for Oregon Medicaid?

The highest income limit for Oregon Medicaid is $18,075 for an individual and $24,353 for a family of two per year.

What if a person’s income is too high to qualify for regular Medicaid benefits?

If your income is too high, you may still be eligible for Oregon Medicaid, thanks to the asset spend down option.  

What documents do I need to apply for Medicaid?

The following documents are required with the application:

• The Social Security Number;
• Evidence of citizenship or authorized residency in the United States, such as a passport, driver’s license, birth certificate, green card, or job authorization card
• Evidence of all income sources, both legal and illegal 
• Proof of origin 
• Proof of residency 
• Including the Medicare card, any insurance cards
• Pregnancy;
• When non-parents apply for Medicaid on their behalf, they must provide proof of their financial position.

What is the best Medicaid in Oregon?

The best plan for you is the one that meets your demands and offers the most benefits in terms of health insurance and monetary help because it varies from person to person.

Where do I find the letter showing the reason(s) for denial or discontinuance from Oregon Medicaid?

By signing into your account at Portal, you can see the progress of your Oregon Medicaid application.