How to Pay for Senior Care in Oregon

Last updated: September 22, 2025

A practical, Oregon specific guide to paying for in home care, adult foster homes, assisted living and memory care, and nursing homes. Includes programs, eligibility, costs, and the exact places to apply.

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What senior care costs in Oregon

Typical statewide ranges. Actual prices vary by city, care level, and provider capacity.

• In home aide or home health aide: about $35 to $40 per hour. (https://www.genworth.com/content/dam/consumer-corporate/consumer-images/cost-of-care/cost-of-care-us-2024.pdf)
• Adult day health: about $120 to $160 per day. (https://www.genworth.com/content/dam/consumer-corporate/consumer-images/cost-of-care/cost-of-care-us-2024.pdf)
• Assisted living or residential care: often $5,500 to $6,500 per month. Memory care is higher. (https://www.genworth.com/content/dam/consumer-corporate/consumer-images/cost-of-care/cost-of-care-us-2024.pdf)
• Nursing home: about $10,000 to $12,000 per month for a private room. (https://www.genworth.com/content/dam/consumer-corporate/consumer-images/cost-of-care/cost-of-care-us-2024.pdf)

Find local pricing and programs through the ADRC of Oregon. (https://www.oregon.gov/odhs/providers-partners/community-services-supports/Pages/adrc.aspx)

What Medicare does and does not pay for

• Medicare does not pay for long term custodial care in assisted living, memory care, adult foster homes, or long nursing home stays. (https://www.medicare.gov/coverage/long-term-care)
• Medicare does pay for short term skilled care after a qualifying inpatient hospital stay, including skilled nursing facility rehab. You must meet the 3 day inpatient rule. Observation days do not count. (https://www.medicare.gov/coverage/skilled-nursing-facility-care) (https://www.cms.gov/files/document/skilled-nursing-facility-3-day-rule-billing.pdf)
• Home health and hospice can be covered when criteria are met. (https://www.medicare.gov/coverage/home-health-services) (https://www.medicare.gov/coverage/hospice-care)

Get unbiased Medicare help from Oregon SHIBA. (https://dfr.oregon.gov/SHIBA/Pages/index.aspx)

Medicaid in Oregon for long term care

Oregon Medicaid for long term services and supports is delivered through the Oregon Health Plan and OSIPM. It can pay for nursing homes and for services in the community such as in home help, adult foster homes, assisted living, residential care, and memory care.

• Program overview and eligibility. (https://www.oregon.gov/odhs/aging-disability-services/Pages/long-term-care.aspx)
• Independent explainer on Oregon Medicaid eligibility. Cross check details here. (https://www.medicaidplanningassistance.org/medicaid-eligibility-oregon/)
• Community based care licensing pages for assisted living, residential care, and memory care. (https://www.oregon.gov/odhs/licensing/community-based-care/Pages/default.aspx)
• Adult Foster Homes program overview. (https://www.oregon.gov/dhs/providers-partners/licensing/APD-AFH/Pages/Overview.aspx)

Important Oregon rule about room and board

For assisted living, residential care, memory care, and adult foster homes, Medicaid pays the care services portion to the provider. The resident pays room and board from their income at a state set standard. See the rule and payment alerts here. (https://oregon.public.law/rules/oar_411-027-0025) (https://www.oregon.gov/odhs/licensing/adult-foster-homes/Alerts/2023-12-28-medicaid-payment-increase.pdf)

No waitlist structure for many services

Oregon uses the Community First Choice K Plan and other HCBS authorities. This helps avoid the long waitlists seen in other states. Availability still depends on provider capacity. (https://www.oregon.gov/odhs/aging-disability-services/Pages/long-term-care.aspx)

Income cap and Qualified Income Trusts

Oregon is an income cap state. If income is over the limit, a Qualified Income Trust, also called a Miller Trust, can allow eligibility. (https://oregon.public.law/rules/oar_461-180-0044) (https://www.medicaidlongtermcare.org/eligibility/qualified-income-trusts/)

Spousal protections

Federal spousal impoverishment protections apply. 2025 figures, subject to mid year updates:

• Community Spouse Resource Allowance estimated range: $31,584 to $157,920. (https://www.medicaid.gov/federal-policy-guidance/downloads/cib05282025.pdf) (https://attorney.elderlawanswers.com/2025-spousal-impoverishment-home-equity-figures-released-20781)
• Minimum and maximum Monthly Maintenance Needs Allowance estimated range: $2,555 to $3,948. Check Oregon rule for current limits. (https://www.medicaid.gov/federal-policy-guidance/downloads/cib05282025.pdf) (https://ch461rules.odhs.oregon.gov/rules/461-160-0580.pdf)

Estate recovery

Oregon must recover certain Medicaid costs after death, especially for long term care services provided after age 55. Learn what is and is not recoverable, and exceptions. (https://www.oregon.gov/dhs/BUSINESS-SERVICES/OPAR/Pages/estate-admin.aspx) (https://oregon.public.law/statutes/ors_416.350)

How to apply

• Apply through ONE. You can apply online, by phone, or by paper. (https://one.oregon.gov/)
• Call the ADRC to reach your local APD or AAA office and schedule a functional needs assessment and a financial screening. Statewide ADRC: 855 673 2372. (https://www.oregon.gov/odhs/providers-partners/community-services-supports/Pages/adrc.aspx)

Oregon Project Independence and OPI M

OPI is a state funded program that provides limited in home supports for adults 60 and older, and some younger adults with dementia. OPI has no hard income or asset limit but uses a sliding fee schedule and may have a waitlist. (https://www.oregon.gov/odhs/providers-partners/community-services-supports/Pages/opi.aspx) (https://www.oregon.gov/odhs/providers-partners/community-services-supports/Documents/opi-fee-schedule.pdf)

OPI M is a newer Medicaid funded option that expands in home services. It is an entitlement once eligible, rather than a capped waitlist. See program FAQ and rule. (https://www.oregon.gov/odhs/providers-partners/seniors-disabilities/Documents/opi-m-faq-en.pdf) (https://apps.oregon.gov/oregon-newsroom/OR/ODHS/Posts/Post/cms-approves-expansion-program-providing-older-adults-people-disabilities-more-options-support-home) (https://www.oregon.gov/odhs/rules-policy/apdrules/411-014.pdf)

Ask the ADRC which program fits your needs and what is available in your county. (https://www.oregon.gov/odhs/providers-partners/community-services-supports/Pages/adrc.aspx)

PACE in Oregon

PACE, the Program of All Inclusive Care for the Elderly, serves people who meet nursing home level of care and can live safely in the community with support. In Oregon this is primarily Providence ElderPlace in the Portland metro and North Coast, and AllCare PACE in parts of Southern Oregon.

• State PACE fact sheet and contacts. (https://www.oregon.gov/odhs/providers-partners/seniors-disabilities/Documents/pace-fact-sheet.pdf) (https://www.oregon.gov/odhs/providers-partners/seniors-disabilities/Documents/pace-contacts.pdf)
• Providence ElderPlace services and FAQs. (https://www.providence.org/services/pace-and-adult-day-programs/elderplace-in-oregon) (https://www.providence.org/services/pace-and-adult-day-programs/elderplace-in-oregon/frequently-asked-questions)

Costs

• If you qualify for Medicaid financially there is usually no monthly premium. Private pay equals the Medicaid rate in your service area. Confirm details with the PACE site. (https://www.providence.org/services/pace-and-adult-day-programs/elderplace-in-oregon)

Veterans options

• VA Aid and Attendance or Housebound benefits can increase a VA Pension to help pay for care at home or in facilities when financial, service, and medical criteria are met. (https://benefits.va.gov/PENSION/aid_attendance_housebound.asp)
• Oregon Veterans Homes at The Dalles and Lebanon are state veterans nursing facilities for eligible veterans and spouses. (https://www.oregon.gov/odva/Vets-Homes/Pages/default.aspx)

Adult Foster Homes and Community Based Care

• Adult Foster Homes are licensed small homes for up to five residents that provide 24 hour support in a home like setting. Many accept Medicaid. (https://www.oregon.gov/dhs/providers-partners/licensing/APD-AFH/Pages/Overview.aspx)
• Community Based Care includes Assisted Living, Residential Care, and Memory Care. These settings are licensed and overseen by ODHS. (https://www.oregon.gov/odhs/licensing/community-based-care/Pages/default.aspx)
• With Medicaid, the resident pays room and board from income at a state standard and Medicaid pays a service rate to the provider. See the rule and payment notices. (https://oregon.public.law/rules/oar_411-027-0025) (https://www.oregon.gov/odhs/licensing/adult-foster-homes/Alerts/2023-12-28-medicaid-payment-increase.pdf)

Long term care insurance and Oregon Partnership

Traditional and hybrid long term care insurance can fund in home care, adult foster homes, assisted living, and nursing facilities, subject to policy terms.

• Oregon Long Term Care Partnership policies provide Medicaid asset disregard, which can protect assets equal to the benefits your policy pays. (https://dfr.oregon.gov/help-insurance/basics/long-term-care/Pages/ltc-partnership.aspx)

Tax related help

• Medical expense deduction can include qualified long term care services and a portion of assisted living costs when primarily for medical care. Check annual limits and thresholds. (https://www.irs.gov/publications/p502)
• Eligible LTC insurance premiums have age based deduction caps. The 2025 per diem cap for tax free LTC benefits is $420 per day. Confirm current numbers in IRS guidance. (https://www.irs.gov/irb/2024-45_IRB#RP-2024-40)
• Some working caregivers may qualify for the Child and Dependent Care Credit for an adult dependent who cannot self care. Expenses must be work related. (https://www.irs.gov/newsroom/child-and-dependent-care-credit-faqs)

This section is not tax advice. Speak with a qualified professional.

Step by step: how families typically pay

1. Start with benefits screening. Contact the ADRC for options counseling and screening for OPI, OPI M, OSIPM, PACE, and local programs. Call 855 673 2372. (https://www.oregon.gov/odhs/providers-partners/community-services-supports/Pages/adrc.aspx)
2. Price the care setting. Compare in home care, adult foster homes, assisted living, memory care, and nursing homes. Use current market data and a 12 month projection because needs often increase. (https://www.genworth.com/content/dam/consumer-corporate/consumer-images/cost-of-care/cost-of-care-us-2024.pdf)
3. If staying at home, consider OPI or OPI M and check PACE service areas if you meet nursing home level of care. (https://www.oregon.gov/odhs/providers-partners/seniors-disabilities/Documents/opi-m-faq-en.pdf) (https://www.oregon.gov/odhs/providers-partners/seniors-disabilities/Documents/pace-fact-sheet.pdf)
4. If moving to a community or nursing home, review OSIPM eligibility. If income is over the cap, discuss a Qualified Income Trust with counsel before applying. (https://oregon.public.law/rules/oar_461-180-0044)
5. Confirm spousal protections and estate recovery in writing before finalizing. Know the expected cost share and the room and board standard for your setting. (https://www.medicaid.gov/federal-policy-guidance/downloads/cib05282025.pdf) (https://oregon.public.law/rules/oar_411-027-0025) (https://www.oregon.gov/dhs/BUSINESS-SERVICES/OPAR/Pages/estate-admin.aspx)
6. Layer in other sources. Long term care insurance, VA Aid and Attendance, and possible tax benefits. (https://benefits.va.gov/PENSION/aid_attendance_housebound.asp) (https://www.irs.gov/publications/p502)

FAQs

Does Medicaid pay for assisted living in Oregon

Yes. Medicaid can pay the care services portion in assisted living, residential care, and memory care for eligible residents. Room and board is paid by the resident from income at a state standard. (https://oregon.public.law/rules/oar_411-027-0025)

What is an Adult Foster Home

A licensed home for up to five residents that provides 24 hour support in a home like setting. Many accept Medicaid. (https://www.oregon.gov/dhs/providers-partners/licensing/APD-AFH/Pages/Overview.aspx)

Will Medicare pay for assisted living

No. Medicare does not pay for long term custodial care in assisted living or similar settings. It does pay for short term skilled care after a qualifying inpatient stay and for home health and hospice when criteria are met. (https://www.medicare.gov/coverage/long-term-care) (https://www.medicare.gov/coverage/skilled-nursing-facility-care) (https://www.medicare.gov/coverage/home-health-services) (https://www.medicare.gov/coverage/hospice-care)

What is the 3 day rule for rehab

To get Medicare skilled nursing facility coverage you generally need a 3 day inpatient hospital stay. Observation days do not count toward the 3 days. (https://www.cms.gov/files/document/skilled-nursing-facility-3-day-rule-billing.pdf)

Can my spouse keep assets and income

Yes. Spousal impoverishment protections allow the at home spouse to keep a portion of the couple’s assets and income within set limits. Check current CSRA and MMMNA amounts. (https://www.medicaid.gov/federal-policy-guidance/downloads/cib05282025.pdf) (https://ch461rules.odhs.oregon.gov/rules/461-160-0580.pdf)

Will the state take the house

Oregon must seek estate recovery after death for certain Medicaid costs, with exceptions for surviving spouses and other protections. Learn how recovery works before you apply. (https://www.oregon.gov/dhs/BUSINESS-SERVICES/OPAR/Pages/estate-admin.aspx)

How do I apply for help

Use the ONE system for Medicaid programs and call the ADRC to connect with your local office for assessments and counseling. (https://one.oregon.gov/) (https://www.oregon.gov/odhs/providers-partners/community-services-supports/Pages/adrc.aspx)

Who to call first

• ADRC of Oregon: 855 673 2372. Statewide options counseling, benefit screening, and local resources. (https://www.oregon.gov/odhs/providers-partners/community-services-supports/Pages/adrc.aspx)
• SHIBA: unbiased Medicare counseling. (https://dfr.oregon.gov/SHIBA/Pages/index.aspx)
• Local APD or AAA office: apply for OSIPM, OPI, OPI M, request assessments, and discuss care settings. Use ADRC to find your office. (https://www.oregon.gov/odhs/aging-disability-services/Pages/older-adults.aspx)

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Disclaimers and update policy

This page shares general information. It is not legal, financial, insurance, or tax advice. Rules, limits, and rates change each year and sometimes mid year. Always verify eligibility, benefits, and amounts with the official sources linked above and with your local agency or a qualified professional. We refresh this page at least annually in the first quarter and again mid year if state or federal limits change.