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Oregon Health Plan Qualifications

Oregon's Department of Human Services administers the Oregon Health Plan (OHP), which provides health insurance coverage to low-income Oregonians. The plan originated in 1989, when the Oregon legislature passed an act extending Medicaid coverage to Oregonians who lived below the federal poverty level, and those turned down by insurers for preexisting conditions. But according to Jonathan Oberlander, associate professor in the departments of social medicine and health policy and administration, University of North Carolina--Chapel Hill, policy miscalculations caused the OHP to unravel. Now who is covered -- and who isn't -- is much less clear cut.

  1. The OHP Plus Program

    • Blind, disabled, pregnant and elderly Oregonians qualify for the OHP Plus Program. So do people under age 19 or those who receive Temporary Assistance for Needy Families benefits.

    The OHP Standard Program

    • Low-income Oregonians enter a lottery to see a doctor.

      The OHP Standard Program is designed to provide low-cost or free coverage to low-income Oregonians, 19 through 64, who don't qualify for regular Medicaid. As of April, 2010, this figure was $1,526 a month for a family of three. But Oregon lacks enough money to cover everybody who qualifies. Oregon increases the enrollment by monthly lottery, adding several thousand qualified applicants at a time.

    Healthy Kids Program

    • Low-income children may qualify for the Healthy Kids Program.

      It is easier for children than for adults to get health insurance coverage under the OHP. Children's eligibility is based on age, residency and income. Children must be under 19, be a legal resident of Oregon, have been without insurance for two months, and qualify as low income. As of April, 2010, to qualify for free coverage under the OHP, a family of four could not make more than $44,000.

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