Navigating long-term care options can be complex, especially when considering how to pay for these essential services. For individuals with limited income and resources, programs like Medicaid offer a crucial lifeline. In Oregon, Medicaid is known as the Oregon Health Plan (OHP), and it encompasses various programs designed to provide community based long term care services. These services aim to support individuals in their homes or in community settings, offering assistance with daily living and health-related needs.
Understanding Oregon Medicaid (OHP) for Long-Term Care
The Oregon Health Plan provides access to long-term care benefits for eligible individuals who meet specific criteria based on income and need. These programs are designed to offer a range of services, from help with daily activities to skilled nursing care, all within the community or at home whenever possible. The goal of these community based services is to enable individuals to maintain their independence and quality of life in the least restrictive environment.
To determine if you or a loved one qualifies for OHP long-term care benefits, it’s important to understand the eligibility requirements and the application process.
How to Apply for Oregon Medicaid Long-Term Care
Applying for Medicaid long-term care benefits in Oregon is a straightforward process with multiple access points:
- Phone: For immediate assistance and guidance, you can call the Aging and Disability Resource Connection (ADRC) at 855-673-2372.
- Online: The most convenient method is to apply online through the ONE Online portal. You’ll need to create an account to begin your application.
- In Person: If you prefer face-to-face interaction, you can schedule an appointment at your local Benefits office. Contact them to arrange a suitable time to apply in person.
Learn more about applying for OHP on their website
OHP and the Healthier Oregon Program for Inclusivity
Oregon is committed to ensuring healthcare access for all residents. Through the Healthier Oregon Program, more individuals now qualify for OHP, regardless of immigration status, as long as they meet the income criteria. This initiative expands access to essential healthcare services, including community based long term care services, to a broader population within Oregon.
Explore the Healthier Oregon Program
Healthier Oregon for individuals with developmental disabilities
It’s important to note for immigrants that while most Medicaid benefits are not considered in a public charge test, long-term care in a nursing facility or mental health institution could be a factor. For personalized advice regarding public benefits and immigration, Oregon Legal Aid offers a hotline at 800-520-5292 and resources like the Know the Facts about Public Charge flyer.
Oregon Project Independence (OPI): Another Avenue for Home-Based Support
For individuals who need assistance to remain at home but do not qualify for Medicaid long-term care benefits, Oregon Project Independence (OPI) offers another valuable program. OPI is a program that provides community based long term care services focused on enabling people to stay in their own homes for as long as possible. Services under OPI can include home-delivered meals, in-home help, personal care, transportation, and respite care.
It’s worth noting that some areas may have waiting lists for OPI, and priority is typically given to those with the most critical needs and who are at immediate risk of losing their ability to live at home without adequate support.
Discover more about Oregon Project Independence
Other Long-Term Care Payment Options: Insurance and Medicare
While programs like OHP and OPI offer significant support, it’s also wise to be aware of other options. Long-term care insurance can be a helpful resource for some, although it may not be suitable for everyone. The Oregon Insurance Division website provides information to help you decide if long-term care insurance is right for your situation.
Find answers to common questions about long-term care insurance
Lastly, it’s crucial to understand Medicare’s role in long-term care. Medicare, the federal health insurance program primarily for those 65 and older, generally does not cover long-term care costs. However, Medicare does assist with expenses for skilled nursing or home health care needed for rehabilitation following a hospital stay. It’s not designed to be a program that provides community based long term care services for ongoing needs.
Visit the federal Medicare website for comprehensive information
Access free Medicare assistance through SHIBA (Senior Health Insurance Benefits Assistance)
In conclusion, Oregon offers a range of programs to support individuals needing long-term care, with a strong emphasis on community-based services. From Medicaid’s OHP and the Healthier Oregon Program to Oregon Project Independence, there are resources available to help people receive the care they need in their homes and communities. For personalized guidance and to explore your options further, contacting the ADRC is a recommended first step.
