Oregon Medicaid Planning Services
Care Funding Solutions is a fee-for-service organization that offers services about Oregon Medicaid Planning by helping families shelter and protect assets, plan for, and assist in the Oregon Medicaid Long-Term Care Program – OHP. We also help Veterans to get qualified for Veteran Pension in Oregon. We provide Professional Value-Added Services about Long Term Care Planning, Income Only Trust, Legal Documents and Medicaid Plans.
Here, we will answer the following questions about Oregon Medicaid:
- What is the Oregon Medicaid or OHP Application Process?
- How to apply for Oregon Health Plan – Oregon Medicaid?
- Reasons Oregon Medicaid /OHP Applications are Denied
- What is OHP – Medicaid Medicaid Eligibility 2025?
- What medical documents do I need for OHP – Oregon Medicaid?
- Reasons Applicants are denied medically for Oregon – OHP Medicaid Benefits.
- Reasons Applicants are Denied Financially for OHP – Oregon Medicaid Benefits.
- What are OHP – Oregon Medicaid Income Limits 2025?
What is Medicaid in Oregon?
Medicaid in Oregon is referred to as the Oregon Health Plan (OHP).
A joint state and federal health care program for low-income individuals of all ages, Medicaid is jointly funded by both. Besides nursing home care, assisted living, and adult foster care, Oregon Medicaid also provides non-medical supports to help frail seniors remain at home or live with a loved one.
Oregon Medicaid Application
There are two ways to start the Oregon Medicaid application process: Do it yourself or with the help of an advisor who is experianced in the OHP application process, Certified Medicaid Planner or attorney.
If you decide to apply for Oregon Medicaid on your own, you should know that over 25 to 50% of all Oregon Medicaid applications or OHP applications are denied, which is in line with national trends.
The denial rate is due to the complexity of the application process.
The resulting cost for unreimbursed care cost due to denial is easily double what an attorney charges to help with the Oregon Medicaid application process and three to five times what a Certified Medicaid Planner will charge for a successful outcome.
Oregon Medicaid denials cost both time and money.
With help from a Certified Medicaid Planner with Oregon Medicaid Planning / OHP Planning, you can avoid having your Oregon Medicaid Application denied.
Oregon Medicaid Secret #1
Make sure you are qualified medically and financially before applying. Here is where Care Funding Solutions and their Certified Medicaid Planners can help.
How to apply for Medicaid in Oregon?
1. You can physically visit your area’s Oregon Medicaid office / OHP office in your county
2. Apply online ONE.Oregon.gov
3. Apply over the phone 1-800-699-9075 (TTY 711)
4. The best way is to apply using a Certified Medicaid Planner 800-543-0530
When you call, tell the receptionist that you want to apply for OHP Oregon Medicaid long-term care benefits.
In this initial call, they will ask you basic questions, which are:
Applicant’s full name
Social Security number
Date of birth
Current address where you reside
Mailing address if different from your current address
Do you have a trust?
Have you gifted any assets in the past 60 months?
If married:
Spouse’s full name
Spouse’s Social Security number
Spouse’s date of birth
You will be given an Oregon Medicaid application number at the end of the call; be sure to write it down, as having it handy will make it easier to get the application status later.
In five to seven days, you will receive a call from the financial caseworker, who will set up an appointment to go into further details about your financial situation.
If they have time and you are prepared, they will sometimes complete the questionnaire.
If not, they will set another appointment.
This phone assessment starts with confirming the information you provided when you opened the case, including your name and social security number.
The formal application is then sent for signatures and a banking and financial information request.
OHP caseworkers allow 15 days for you to return the signed application along with the requested items. This is a hard deadline; your application will be denied if you do not return the signed application and information in that allowed timeline.
Arizona Medicaid has a system that allows them to see all your banking activity.
OHP is contracted with Accuity Asset Verification Services, Inc.
The system is called the asset verification system (AVS).
The AVS system allows an Oregon Medicaid eligibility caseworker to review your banking activity – NOT your bank statements — over the past five years or 60 months.
The system is not perfect; it only sees changes in the monthly account balances with the hope of reducing Oregon Medicaid application fraud.
The AVS system has made the Oregon Medicaid application process more difficult and time-consuming and has caused additional delays and denials.
Arizona Medicaid Secret #2
The AVS system is not 100% accurate.
If the transaction doesn’t exist, say so.
What makes things worst, the AVS system is not 100% accurate!
The AVS system inaccuracy: On more than one occasion, a caseworker has asked for account information that never existed, sometimes accounts in states other than Arizona. The burden of proof falls on the applicant to provide evidence that the account does not exist and never did.
This can be difficult, if not impossible if relating to another state. The financial institution does not share the same urgency. You still have to meet the Oregon Medicaid application required deadlines.
Here is an example of the added burden that the AVS system causes:
Both your father and mother need care due to cognitive impairment.
The AVS system identifies a series of transactions:
- $3043.34 in August 2021
- $9,320.02 in September 2021
- $4,200.12 in July 2022
- $5,602.67 in January 2024
Asking your parents if they recall these banking activities is redundant.
For that matter, can you remember all your banking transactions for the past five years?
Then you must go to a bank branch and try to get the needed information within the time allowed by Oregon Medicaid.
It gets worse when you get the bank statements. You may find that none of these transactions even exist.
The AVS system looks at each month’s beginning and ending balance over the past 60 months.
For example, look at the flagged transaction for July 2023 for $4,200.12. This total was a series of transactions that totaled $4,200.12.
One for $500, one for $1,200.12, another for $3000.00, all totaling $4,200.12.
Each transaction will require an explanation of where the money came from if it was an unusual increase in the balance, or what it was spent on if it reduced the balance.
If these were ATM transactions, it is even more challenging to provide the information Oregon Medicaid is requesting. It will likely cause the application to be denied or assessed as a penalty.
Remember that 25 to 50% of all Oregon Medicaid applications or ALTCS applications are denied, so in this case, you just became part of the 50%!
Here is where Care Funding Solutions can help by helping to develop a response that will help reduce the penalty period or eliminate it.
Call Care Funding Solutions today at 800-543-0530 or us the link to set up a free 30 minuite assessment. Click Here to set an appointment.
https://calendly.com/steve-dabbs-1/free-phone-consultation-1