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Qualifying for Medicaid and Medicaid long-term services

Medicaid can help pay for the cost of things like doctor visits, medical supplies and equipment and prescriptions. It can also help pay for Medicare premiums, co-pays and deductibles. It can also help with long-term service needs like assistance with activities of daily living at home or in a licensed care setting. You may qualify for a range of Medicaid programs. However, there are strict eligibility requirements.

The eligibility requirements for Medicaid and Medicaid long-term services are very complex. Each program has different requirements for such things as income, resources and cost sharing. The following list touches on some of the requirements. For more detailed information for your situation, Contact the ADRC of Oregon to get connected with someone who can help you.

Eligibility requirements:

  • In some situations you may need a determination of disability or be at least 65 years of age.
  • Your income must fall within certain limits. Some income may not count toward the income limit if certain requirements are met.
  • You may be required to contribute some of your income toward the cost of your care.
  • The value of your resources cannot exceed certain limits in some situations.
  • You may be penalized if you transfer assets to qualify for Medicaid in some situations. You also cannot have transferred any assets in the 60-month period before you apply. An example could be transferring the title of your home to your child.
  • You must require a certain level of help with activities of daily living (ADLs) in order to get long-term services through Medicaid.

Important considerations:

  • When an individual dies, the state can recover certain Medicaid benefits it has paid on the person’s behalf.
  • Tax implications are complex. Consult your tax professional when considering a Medicaid disability trust.
  • Getting long-term services and supports through Medicaid can be challenging and expensive for a person who has worked and saved for the future.

For more information, please Contact the ADRC of Oregon to get connected with someone who can help you.

Find Medicaid resources in your local area.

ADRC of Oregon staff are available to help you explore your options to meet your current needs or create a plan for the future.

Planning Toolkit

Find information, resources and tools to help you start planning.

How much will services cost?

Calculate your future long-term services and supports expenses.

How will I pay for services?

Estimate your likely future financial resources.

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