Key threshold: If your income is below $22,025 (individual) or $45,540 (family of 4), you likely qualify for Oregon Health Plan (OHP) with free or very low-cost coverage. No premiums, no deductibles.
Oregon Medicaid Income Limits 2026
The following table shows the key income thresholds for Oregon in 2026:
| Household Size | 100% FPL | 138% FPL (Medicaid Limit) | 400% FPL (Subsidy Limit) |
|---|---|---|---|
| 1 | $15,960 | $22,025 | $63,840 |
| 2 | $21,640 | $29,863 | $86,560 |
| 3 | $27,320 | $37,702 | $109,280 |
| 4 | $33,000 | $45,540 | $132,000 |
| 5 | $38,680 | $53,378 | $154,720 |
| 6 | $44,360 | $61,217 | $177,440 |
If your household income falls below the 138% FPL column, you qualify for Oregon Health Plan (OHP). If your income is between 138% and 400% FPL, you qualify for ACA marketplace subsidies to help pay for private insurance.
About Oregon Health Plan (OHP)
Who Qualifies for Oregon Health Plan (OHP)
If you're an Oregon resident trying to navigate the complexities of health coverage, understanding the Oregon Health Plan (OHP) and marketplace subsidies is key to accessing affordable care. The Oregon Health Plan (Medicaid) provides free or low-cost health coverage to eligible Oregonians. Adults aged 19-64 can qualify with incomes up to 138% of the Federal Poverty Level (FPL). For a single person, this means a monthly income of about $1,800, or an annual income of approximately $21,800. For a family of three, the income limit is around $3,065 per month, or about $37,000 annually. Children and teens up to age 18 can qualify with family incomes up to 305% FPL, and pregnant individuals up to 185% FPL. As of 2023, approximately 987,200 people are enrolled in Medicaid or CHIP in Oregon, demonstrating it's a vital program for a significant portion of the state's population.
If You're Near the Income Line
If your income is slightly above the OHP threshold, you may still have excellent, affordable options through the HealthCare.gov marketplace. Oregon has a benchmark Silver plan costing around $485 per month. If your income falls between 138% and 200% of the FPL, you might qualify for OHP Bridge, a new program launching in July 2024. This program offers comprehensive medical, dental, and behavioral health coverage with $0 premiums and no cost-sharing, similar to OHP Plus. For a single person, this means an annual income between $20,820 and $31,300, and for a family of three, between $35,448 and $53,300. If your income changes, you could shift between OHP and marketplace plans, so it's important to report any income fluctuations to ensure you remain in the correct program. After the end of the COVID-19 public health emergency, Oregon successfully maintained coverage for over 80% of its Medicaid members during the "unwinding" period, and those who lost coverage can reapply at any time if their circumstances change.
What Oregon Health Plan (OHP) Covers
The Oregon Health Plan provides comprehensive benefits, including medical, dental, prescription, and behavioral health care, typically at no cost to members. Unlike some other states, Oregon does not have an asset test for most OHP applicants, meaning your savings or property generally won't prevent you from qualifying based on income. Oregon also has unique programs like "Healthier Oregon," which, as of July 2023, provides full OHP benefits to eligible individuals regardless of immigration status. Additionally, Oregon's 1115 Medicaid Demonstration waiver, running until September 2027, includes initiatives to address health-related social needs such as housing, nutrition, and climate supports, along with extended continuous eligibility for children (birth to age six) and adults (two years). Telehealth services are also widely covered, allowing you to access care from home via video, phone, or online appointments.
Tips for Applying
When applying for OHP or managing your coverage, be aware of a few key things. While Oregon has made efforts to streamline the process, you may still experience processing delays for applications or renewals, especially if submitting paper documents. It's crucial to provide all requested documentation promptly, such as proof of income, birthdate, and Social Security number, to avoid delays. Keep your contact information updated with OHP, as official notices regarding your eligibility or renewals will be sent by mail. If you have questions or concerns about your OHP services or providers, you can contact OHP Client Services or your coordinated care organization (CCO). To take an immediate step, gather your household's income and demographic information and visit ONE.Oregon.gov to start your application and see what coverage you qualify for.
Marketplace Insurance in Oregon
Oregon residents who do not qualify for Medicaid can purchase private health insurance through the federal marketplace at HealthCare.gov. The average benchmark (second-lowest cost Silver) plan in Oregon costs approximately $485/month for a 40-year-old in 2026.
Premium tax credits (subsidies) are available for households with income between 100% and 400% FPL. Here is what a 40-year-old individual in Oregon might pay for a Silver plan after subsidies, based on the $485/month benchmark:
| Income Level | Annual Income | Your Cost | Monthly Subsidy |
|---|---|---|---|
| 150% FPL | $23,940 | ~$80/mo | $405/mo |
| 200% FPL | $31,920 | ~$173/mo | $312/mo |
| 250% FPL | $39,900 | ~$277/mo | $208/mo |
| 300% FPL | $47,880 | ~$392/mo | $93/mo |
| 400% FPL | $63,840 | ~$485/mo | $0/mo |
These estimates are for a 40-year-old individual on a benchmark Silver plan in Oregon. Actual premiums depend on your age, household size, tobacco use, and plan choice. Households with income between 100-250% FPL also qualify for cost-sharing reductions (CSR) on Silver plans, which lower deductibles and copays. Oregon uses the federal marketplace at HealthCare.gov.
How to Apply for Oregon Health Plan (OHP)
Medicaid enrollment is open year-round — there's no deadline. You can apply through any of these channels:
- Online: Apply through HealthCare.gov — the system automatically checks your Oregon Health Plan (OHP) eligibility when you enter your income. Or apply directly through Oregon Health Plan (OHP).
- Phone: Call Oregon's Medicaid helpline for guided help with your application.
- In person: Visit your local human services office or a certified application counselor.
You'll need proof of income (pay stubs or tax returns), proof of Oregon residency, and Social Security numbers for household members.
Calculate Your Subsidy in Oregon
Enter your income, age, and household size to see if you qualify for Medicaid or marketplace subsidies in Oregon.
Frequently Asked Questions
What is the income limit for Medicaid in Oregon?
In 2026, the Medicaid income limit in Oregon is 138% of the federal poverty level: $22,025 per year for an individual, $29,863 for a household of 2, $37,702 for 3, and $45,540 for a family of 4.
Has Oregon expanded Medicaid under the ACA?
Yes, Oregon has expanded Medicaid under the ACA. Adults aged 19-64 earning up to 138% of the federal poverty level qualify for Oregon Health Plan (OHP).
How do I get help paying for health insurance in Oregon?
Oregon residents with household income between 100% and 400% FPL ($15,960 to $63,840 for an individual in 2026) qualify for premium tax credits that reduce the cost of marketplace health insurance. Apply through HealthCare.gov.
What is the Oregon Medicaid program called?
Oregon's Medicaid program is known as Oregon Health Plan (OHP). It provides health coverage for eligible low-income residents including children, pregnant women, seniors, and adults up to 138% FPL.
What happens if I lose Medicaid coverage in Oregon?
If your Oregon Health Plan (OHP) coverage ends due to income changes or redetermination, you qualify for a Special Enrollment Period on the marketplace. This gives you 60 days to sign up for a private plan through HealthCare.gov. If your income is between 100-400% FPL, you'll likely qualify for subsidies to help cover the cost.
Does working disqualify me from Medicaid in Oregon?
Yes. Medicaid eligibility in Oregon is based on your Modified Adjusted Gross Income (MAGI), not your employment status. If your household income is at or below 138% FPL ($22,025 for an individual), you qualify for Oregon Health Plan (OHP) even if you work full-time. Many Oregon Health Plan (OHP) enrollees are working adults.
What's the difference between Medicaid and marketplace insurance in Oregon?
Medicaid (Oregon Health Plan (OHP)) is free or near-free with no premiums or deductibles. Marketplace plans in Oregon average $485/month before subsidies. If you qualify for Medicaid, it's the more affordable option. If your income puts you just above the cutoff, subsidized Silver plans with cost-sharing reductions are the next best thing.