Oregon Health Plan (OHP) 2026: Who Qualifies, How to Apply

OHP pays for health care, dental and behavioral health; it isn't cash and it isn't a grant. Every income line by household size is in our Oregon Medicaid income limits guide.

Oregon Health Plan at a Glance (November 2026)

About 1.4 million people in Oregon are enrolled in Medicaid, and 16 CCOs operated in the state in 2025, according to the OHA report on CCO finances released August 12, 2026. Here's how OHP is set up, from the OHA and ODHS pages Grantsights read on November 13, 2026:

Sources: OHA Apply for OHP, OHP Bridge and federal changes pages, ODHS transmittal PT 26-005 and OHA's August 12, 2026 release, checked November 13, 2026.

Grantsights analysis of the PT 26-005 and Bridge figures shows how Oregon closes the usual gap above Medicaid: a single adult in Salem earning $2,300 a month ($27,600 a year) is over the $1,836 OHP Plus line, but well under the $31,920 Bridge ceiling, so instead of shopping for a Marketplace plan, that adult can stay on OHP with no premium.

Who Qualifies for OHP in 2026

OHA lists 5 main OHP programs plus OHP Bridge, and the application sorts you into the right one:

• OHP Plus for children 0 to 18 and adults 19 to 64. It's the full benefit package.
• OHP Plus Supplemental for pregnant adults 21 or older.
• OHP with Limited Drug for adults who qualify for both Medicaid and Medicare Part D. OHP still covers medical, dental and behavioral health for them.
• OHP Dental, a dental-only program for eligible Oregon veterans and Compact of Free Association citizens.
• Qualified Medicare Beneficiary (QMB), which pays Medicare premiums, copays and deductibles but doesn't cover care itself.
• OHP Bridge for adults with income from 133% to 200% of poverty who don't have access to affordable insurance and have an eligible citizenship or immigration status.

You can often keep private insurance and still qualify; OHA says providers then bill the private plan first and OHP picks up copays, deductibles and uncovered services. If you had Medicaid in another state, it doesn't transfer, so you must apply for OHP and cancel the old state's coverage yourself.

Immigration status. The Apply page says that since July 1, 2023, people of any age or immigration status may be eligible for full OHP benefits, through a program called Healthier Oregon. Federal changes are moving some members between OHP programs (see below), but OHA says Oregon, unlike other states, isn't ending OHP for these members. The national Medicaid income limits guide compares Oregon with Washington, Idaho and California.

What OHP Covers, CCOs and Costs

The OHP Summary of Benefits and Coverage shows $0 for the deductible and "no charge" for primary care, specialist visits, generic and brand drugs, imaging, hospital stays, emergency care, mental health and substance use care, and childbirth. Specialist visits need a referral, and some services need preauthorization. For adults, OHA says coverage follows your benefit package and the Prioritized List of Health Services; for children under 21, the Prioritized List doesn't limit coverage.

Dental and vision for adults. OHP Plus includes adult dental care, with cleanings and checkups each year, fillings, extractions and dentures for some people, per the 2026 Open Card handbook. For vision, adults 21 and older get 1 routine eye exam every 24 months, and glasses or contacts only for certain eye conditions such as having no natural lens after cataract surgery. Children 20 and younger, and members who are pregnant or within 12 months after a pregnancy, get eye exams and glasses.

Coordinated care organizations. OHA's CCO page says most people must be in a CCO, a local plan with its own doctors, counselors and dentists. All CCOs offer the same OHP benefits apart from extra services and pharmacies, and some add "flexible services" such as weight loss classes. You choose a CCO when you apply; if you don't, OHA picks one in your area that's open to new members. To change or check your CCO, call OHP Client Services at 800-273-0557 (TTY 711), weekdays 8 a.m. to 5 p.m.

Open Card. Members not in a CCO have OHP Open Card, which pays providers directly with the same benefits. American Indian and Alaska Native members aren't placed in a CCO automatically and can join, change or leave one at any time, though they still choose a CCO for dental care.

Extra benefits for some members. OHP Plus members facing certain life changes may qualify for health-related social needs benefits for housing and nutrition. OHP Bridge doesn't include those, or long-term services and supports.

Costs. OHA says OHP covers care "at no cost to members," and OHP Bridge "has no member costs." Copays start only in October 2028, and only for some adults (see the federal changes section).

How to Apply for OHP, Step by Step

Enrollment in OHP is open 365 days a year, unlike Marketplace and Medicare plans, which have fall enrollment periods.

Step 1: Choose a route

Source: OHA Apply for OHP and OHP Bridge pages, checked November 13, 2026.

For ONE account problems, the technical support line is 1-833-978-1073, 7 a.m. to 6 p.m. Pacific, Monday through Friday. ONE also has direct language lines, such as 800-743-9182 for Spanish.

Step 2: Have information ready

The Apply page asks for each household member's name, date of birth and Social Security number (if they have one), a valid mailing address, proof of naturalization or immigration status, income, expenses and tax deductions for everyone on your federal tax return, and details of any Medicare or private coverage.

Step 3: Pick a CCO

Call your current doctor or clinic and ask which OHP plan it takes, then pick that CCO on the application so you can keep the same provider.

Step 4: Track the decision

According to the OHA application guide, ODHS may take up to 45 calendar days after it gets your completed application, in line with 42 CFR 435.912 (opens in a new tab), and longer if the decision rests on a disability. Online applicants can see status in the ONE dashboard; mail applicants can call 1-800-699-9075 after 45 days. After approval, show your Oregon Health ID card at each visit.

For example, one applicant in Medford, a 47-year-old single home health aide earning $2,500 a month, is over the OHP Plus line and under the Bridge ceiling. If her job doesn't offer affordable coverage, she'd apply on ONE.Oregon.gov, land in OHP Bridge, and keep the same CCO doctors if her income later drops (an illustration built from OHA's 2026 figures, not a real case).

OHP Work or Activity Rules Starting 2027

OHA's federal changes page, updated September 18, 2026, says some adults 19 to 64 must meet work or activity rules starting in 2027 each time they apply or renew. The rules cover adults who aren't pregnant, don't have Medicare, don't get SSI and don't qualify for OHP based on disability or certain other factors. Members the rules apply to got a notice in September 2026, and OHA says it had to send it even to people who are likely exempt.

Three ways to meet the rules:

Source: OHA OHP work or activity rules page, updated September 18, 2026, checked November 13, 2026.

Volunteer hours must come through an organized program with a public agency or nonprofit that tracks hours, and political or partisan work doesn't count.

Which months count. For a new applicant, ODHS checks the month before the application month, and sometimes the application month. At renewal, it checks for at least 1 month in the six months before your renewal date.

Exemptions. OHA lists more than 15, including: American Indian or Alaska Native; pregnant, or pregnant with OHP coverage in the last 12 months; caring for a child 13 or younger; caring at least 80 hours a month for someone with a disability or serious condition; a serious or disabling health condition, including SSDI or SSI; a 100% VA disability rating; a night in a hospital or residential facility; seven or more days away from home for medical care; drug or alcohol treatment within the past 5 years; Medicare; release from jail or prison within 4 months (new applicants) or 9 months (renewals); meeting SNAP or TANF work rules; former foster youth 19 to 26; and living in a high-unemployment or federally declared disaster county.

Proof in 2027 versus 2028. In 2027, OHA says you can simply tell ODHS an exemption applies, without documents. In 2028, proof will be required for more exemptions.

If you don't meet them. Your OHP could end, but you can reapply at any time, and ODHS will check the month before. You may move to the Marketplace, though OHA warns you may not get premium tax credits. On November 13, 2026, CMS announced an optional hold harmless period through June 30, 2027, when states check the rule without ending coverage only for missing it; OHA's page didn't say whether Oregon will use it when Grantsights checked that day.

Renewals, Back Coverage and Other Federal Changes

Most OHP members now renew only every 2 years, and children under 6 don't renew until their sixth birthday, according to the OHA federal changes guide. Both end in late 2027:

• Six-month renewals for adults 19 to 64 who don't have Medicare, aren't on a disability or pregnancy program and aren't American Indian or Alaska Native. When it starts for you depends on when your household renews.
• Yearly renewals for everyone else, children included.

Back coverage. New members can get help with up to 3 months of past medical bills today. From January 1, 2027, that falls to 1 month for most adults 19 to 64 who don't qualify through disability, pregnancy or certain other factors, and to 2 months for all other members. If you have a recent hospital bill and no coverage, applying in 2026 keeps the longer window.

Noncitizen moves. OHA's page says about 7,000 OHP members with statuses such as refugee, asylee and some humanitarian parolees were set to move to Healthier Oregon in October 2026, with the same benefits. In January 2027, Healthier Oregon members move to OHP Open Card, so ask your doctors whether they take Open Card, or call 800-562-4620 after January 1 for help finding one.

Copays from October 2028. Some adults will pay small copays for certain care. OHA says they won't apply to people with Medicare or disability-based OHP, to members earning under $15,000 a year, or to checkups, emergency care, mental health care, prenatal care, substance use treatment or community health clinics.

What OHA Doesn't Tell You

Grantsights analysis of the OHA and ODHS pages found 6 gaps OHP applicants should plan around:

1. The CCO table is old. OHA's CCO plan table says it was last updated October 11, 2022, while OHA's August 2026 release counts 16 CCOs in 2025. Call 800-273-0557 or the CCO itself before you pick.
2. The benefits summary is from 2024. The posted Summary of Benefits and Coverage lists a 2024 coverage period. OHA's benefits pages are newer, so check your coverage letter in ONE for your package.
3. Bridge needs no affordable job coverage. The Bridge page lists access to affordable insurance as a bar, but doesn't define "affordable." Answer the job-coverage questions carefully.
4. Adult glasses are limited. One eye exam every 24 months is covered, but most adults pay for their own glasses.
5. Two-year renewals end. Many members are used to renewing every two years. From late 2027, many adults renew twice a year.
6. The hearing pages were hard to reach. The OHA appeals page refused automated reads on November 13, 2026, so rely on the deadline in your notice.

Common Mistakes and Red Flags

A common mistake is ignoring the September 2026 notice because you think you're exempt. OHA says even exempt people got it; in 2027 you only need to tell ODHS which exemption applies, and no documents are needed until 2028.

Other ways Oregonians lose or miss coverage:

• Not choosing a CCO. OHA will choose one for you, and it may not include your doctor.
• Missing a renewal notice. Keep your mailing address, email and phone current in ONE or the Oregon ONE mobile app.
• Underestimating Bridge. People just over the OHP Plus line often buy a Marketplace plan without checking Bridge first.
• Logging volunteer hours the wrong way. Hours count only through an organized public or nonprofit program that tracks them.
• Waiting into 2027 with an old bill. Back coverage for most adults drops to one month on January 1, 2027.

Red flags: OHP applications are free, and OHP-certified community partners help at no charge. Avoid anyone who charges to fill out the form, asks for your ONE password, or says paying a fee will exempt you from the work rules. Use ONE.Oregon.gov, 1-800-699-9075 or an ODHS office instead.

Hearings: 90 Days for Eligibility, 60 or 120 for Services

For a decision about whether you qualify, ODHS's Notice of Hearing Rights gives 90 days from the date on the notice to ask for a hearing. For a denied medical service, it's 60 days for Open Card members and 120 days for CCO members, who must first appeal to their CCO.

Ways to ask:

• Form MSC 0443, the Administrative Hearing Request, returned to any ODHS office
• For medical eligibility, also by phone, in writing or in person at ODHS
• OHP Hearings Unit fax, for service denials: 503-945-6035 (Open Card handbook)

Hearings are held by the independent Office of Administrative Hearings. To keep benefits the same while you wait, the notice says to ask by the later of the effective date on the notice or 10 days after the notice date (for medical benefits, 10 days after you receive it), and to say so when you request the hearing. Free legal help is available from the Oregon Public Benefits Hotline at 1-800-520-5292, and the Governor's Advocacy Office at 1-800-442-5238 handles complaints about ODHS, though calling either doesn't count as a hearing request.

Other Help in Oregon

The same ONE account handles OHP, food and cash benefits, and a household under the 138% OHP Plus line often qualifies for more than one:

• Food: our Oregon SNAP benefits guide covers how to apply and how much you get, and our Oregon food stamps income limits guide has the income chart.
• Heating and power bills: see our Oregon LIHEAP guide.
• Lost a job: the Oregon unemployment benefits guide explains weekly claims; a drop in income can also move you from Bridge to OHP Plus, so report it.
• Pregnancy and young children: Oregon families can check WIC eligibility in the WIC income limits guide.

Oregonians checking for other benefits can try Grantsights' free eligibility checker, which points to official programs. Only ODHS and OHA can approve OHP.

FAQ: Oregon Health Plan

How do I apply for the Oregon Health Plan?

At ONE.Oregon.gov, by calling 1-800-699-9075, at a local ODHS office or certified community partner, or with the paper OHP application.

What is the income limit for OHP in 2026?

$1,836 a month for one adult on OHP Plus; OHP Bridge goes up to $31,920 a year for one through February 2027.

What is OHP Bridge?

OHP coverage with no member costs for adults between 133% and 200% of poverty without affordable insurance.

When do OHP work or activity rules start?

In 2027, at application or renewal, for some adults 19 to 64; $580 a month, half-time school or 80 hours meets them.

How long does it take to get approved for OHP?

Up to 45 calendar days after ODHS gets a complete application, longer if disability is involved.

How long do I have to ask for an OHP hearing?

90 days for an eligibility decision; 60 days for a service denial on Open Card, or 120 days after a CCO appeal.

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Sources

1. OHA: Apply for the Oregon Health Plan (opens in a new tab), checked November 13, 2026
2. OHA: Oregon Health Plan (OHP) Bridge (opens in a new tab), checked November 13, 2026
3. OHA: OHP Work or Activity Rules and Federal Changes, updated September 18, 2026 (opens in a new tab)
4. OHA: OHP Benefits (opens in a new tab), checked November 13, 2026
5. OHA: Coordinated Care Organization (CCO) Plans (opens in a new tab), checked November 13, 2026
6. OHA: OHP Summary of Benefits and Coverage (opens in a new tab)
7. OHA: Open Card Member Handbook, 2026 (opens in a new tab)
8. ODHS: Policy transmittal PT 26-005, effective March 1, 2026 (opens in a new tab)
9. ODHS: ONE notice with Notice of Hearing Rights (opens in a new tab)
10. OHA: Coordinated care organizations see financial improvements, August 12, 2026 (opens in a new tab)
11. CMS: Hold harmless period for Medicaid work requirements, November 13, 2026 (opens in a new tab)
12. eCFR: 42 CFR 435.912 (opens in a new tab)