Oregon K Plan (Community First Choice): Oregon 2026 Guide

Oregon was one of the first states to use the federal Community First Choice option, which it calls the K Plan. For most older adults and people with physical disabilities in Oregon, the K Plan is the main source of Medicaid-paid long-term care at home and in community settings. It is run by the Oregon Department of Human Services (ODHS), Aging and People with Disabilities (APD).

Below: 2026 eligibility for the K Plan, the tasks it covers, how to get an assessment, and how it compares with Oregon’s waivers and nursing home coverage. For the full statewide rules on income, assets, spouses and the look-back, see our Oregon Medicaid guide.

Figures change periodically. Double-check current amounts before relying on them.

What the K Plan is

Because the K Plan is part of Oregon’s regular Medicaid program, it is an entitlement: people who meet the rules receive services without a cap on enrollment. A case manager assesses needs and authorizes services. Care at home is usually given by homecare workers, who are hired by the consumer and paid by the state, or by in-home care agencies. The K Plan also pays for care in adult foster homes, residential care facilities, assisted living and memory care settings. A separate 1915(c) waiver covers a few services the K Plan does not.

the K Plan pays for a worker to help with activities of daily living and the chores directly connected to them. As a state plan benefit, it is an entitlement in Oregon, so there is no enrollment cap for people who qualify. Service lists are shorter than under a waiver, and an assessment decides the hours.

Who qualifies in 2026

Oregon’s basic requirements are that a person must:

be 65 or older, or 18 or older with a physical disability;
be eligible for Oregon Medicaid with long-term care coverage;
meet an institutional level of care, measured through Oregon’s service priority levels; and
choose to receive services in a home or community-based setting.

The money test. Because the K Plan is a regular Medicaid service, the applicant must first be on Oregon Medicaid, and for older adults the regular income limit is often lower than the special long-term care limit used for nursing homes and waivers. As a result, some people qualify for nursing home Medicaid but not for state plan home care, or only with a spend-down.

In 2026, Oregon’s income limit for long-term care is $2,982 a month (300% of the SSI rate). People above it can use an income cap trust. The single-person asset limit is $2,000.

Oregon’s 2026 long-term care Medicaid numbers, from our state guide:

Item	2026 figure
Income limit (applicant)	$2,982 a month (300% of the SSI rate)
Asset limit (single applicant)	$2,000
Asset limit (couple, both applying)	$3,000
Home equity limit	$752,000
Spouse at home: resource allowance (CSRA)	The greater of half the couple’s resources (up to $162,660) or $32,532
Spouse at home: monthly income allowance	Minimum $2,705 (from July 1, 2026) / maximum $4,066.50
Personal needs allowance (nursing facility)	$81.28 a month
Look-back period	60 months (5 years)

If married. Spousal impoverishment protections may not apply to regular Medicaid in the same way as for waivers, so couples can see different results between programs.

Services the K Plan can cover

Hours are set by the assessment. Covered tasks include:

in-home help with activities of daily living and household tasks
homecare workers hired by the consumer, or agency in-home care
adult foster home care
residential care, assisted living and memory care services
home-delivered meals and adult day services (some through the waiver)
personal emergency response systems
assistive devices and technology
transition services for people leaving a nursing facility
skills training for daily living

Not included. Overnight supervision, rent and chores unrelated to care fall outside the K Plan. If more help is needed, a waiver or managed long-term care program may be the next step.

How to apply for the K Plan

The steps are generally:

Contact the local Aging and People with Disabilities (APD) or Area Agency on Aging office, or the Aging and Disability Resource Connection, and ask for a long-term services assessment.
Apply for the Oregon Health Plan with long-term care through the state’s benefits website or the local office, if not already enrolled.
A case manager completes an in-person assessment of needs and service priority.
The case manager explains which services fit and writes a service plan.
Choose providers, such as a homecare worker, an in-home agency or a community-based care setting, and services start.

Practical tips. Keep copies of everything you send and note the name of each person you speak with. Assessors only see one visit, so describe what a difficult day looks like and have a regular helper in the room. Memory problems, falls and the need for supervision all count, even when the person can still do some tasks alone. If the answer is no, the written notice explains how to request a fair hearing and the deadline.

Waiting lists and timing

Oregon reported no waiting list for older adults and people with physical disabilities in 2026. The usual delays are the financial application and finding an available worker or residential setting.

Because it is an entitlement, state plan personal care should not have an enrollment waiting list. Delays come instead from paperwork, assessments and staffing.

How it relates to nursing home Medicaid

Oregon serves far more people in home and community settings than in nursing facilities. People who meet the same service priority levels can choose a nursing facility, and the same financial rules apply, but in a nursing facility most income goes to the cost of care.

Many the K Plan recipients have needs below a nursing home level of care. It is not meant to replace a nursing home for someone who needs care around the clock. If needs grow, the next steps are usually a waiver, managed care or nursing home care. Because nursing home Medicaid has a higher income limit and spousal protections, being over the limit for the K Plan does not rule out nursing home coverage.

Getting ready for the K Plan

Most families come to the K Plan during a change: a fall, a hospital stay, or a caregiver who can no longer keep up. Planning a little ahead makes each step easier. Start by writing down what help is needed each day, who provides it now, and what would happen if that person were unavailable for a week. It also helps the assessor see real needs rather than a single snapshot.

Paperwork usually includes bank statements, income letters, insurance cards, and proof of identity and residence in Oregon. If long-term care Medicaid may be needed later, five years of records will matter, so it helps to keep them now. Legal documents matter too. A durable power of attorney and a health care directive let a trusted person act on applications without a guardianship.

Needs rarely stay the same, so revisit the arrangement regularly and request a reassessment when things change. Notes on falls, hospital visits and new diagnoses make later reviews easier.

Tips for families

Write down each task, how often it happens and how long it takes before the assessor arrives. If a relative wants to be the paid worker, check the program’s rules early, since rules on paying relatives, training and background checks vary. If hours seem too low, a written decision and a fair hearing are the remedy.

Many families find it worthwhile to talk with a Certified Medicaid Planner before applying for the K Plan. A planner who knows Oregon’s rules can review income and assets, explain which program fits, map the timing against any waiting list, and help with the paperwork. Fees vary: roughly $500 to $6,000 for application help, $2,500 to $15,000 or more for full planning, and $150 to $600 an hour for advice.

Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.