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Oregon Health Plan Requirements

Oregon's Department of Human Services offers three Oregon Health Plans---OHP Plus, OHP with Limited Drug and OHP Standard--to eligible state residents. Qualified Oregonians receive health care services at little or no cost, depending on income and other factors. To get an idea whether you meet OHP requirements, try the state's prescreening website. This won't guarantee you'll receive benefits, however; you can only find out if your eligible for OHP by applying, according to Oregon Helps.

  1. Basic Requirements

    • You must be an Oregon resident and U.S. citizen or qualified non-citizen to receive medical assistance under the Oregon Health Plan. You must show original documents that prove your identity and citizenship status, according to the DHS. You will be asked to present your U.S. passport, Certificate of Naturalization or Certificate of U.S. Citizenship, which will verify both your citizenship and identity. If you cannot produce these documents, you can show your driver's license to prove your identity and your U.S. birth certificate to verify your citizenship. See the citizenship and identity requirements under References for more details.

    Income Limitations

    • To receive OHP benefits, you must fall under certain income limits, since the program is designed to help low-income individuals, families and children. When deciding if you are eligible, the department considers how many people live in your household, your total income-=-from work, child support and government programs-- and any financial resources you have (property is not included). You are required to show OHP proof of income, such as pay stubs or a letter from your employer, as part of the application process.

      In order to qualify for OHP Plus, or the health benefits package that is comprehensive, you must have an income that is under 200 percent of the federal poverty level (FPL), as stated by DHS. (References 3) For a family of four, 200 percent of the FPL means an annual income under $44,100, or $3,675 per month, according to the 2009 Progress Report by Children First for Oregon, an organization concerned about the welfare of Oregonian children. (Resources 2)

    Eligible Groups

    • In addition to satisfying basic and financial requirements, you may qualify for traditional Oregon Medicaid (OHP Plus) if you are receiving financial assistance through the Temporary Assistance for Needy Families program, or if you are under 19 years old, pregnant, elderly, blind or disabled.

      For people who get both Medicaid and Medicare Part D, which is a prescription drug plan, you may qualify for OHP with Limited Drug, according to DHS. It provides members with all the benefits that one would receive as an OHP Plus member excluding the drugs that Medicare Part D covers.

      Other options are available if you have low income but do not fall into any of the categories mentioned; for example, OHP Standard is available to low-income adults age 19 to 64 who do not fit the criteria for OHP Plus. Standard is limited, however, in terms of how many applicants can be admitted. To be considered, you have to sign up on the OHP Standard Reservation list; if randomly selected, you will be sent an application.

    Social Security Number

    • When applying for OHP benefits, you are required by law to disclose your Social Security number to DHS. The department uses it to make sure the information you reported about your income and resources matches the government's information, including IRS, Social Security, unemployment and child support records.

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