Oregon HealthCare.gov

Special benefits for members of tribes

Private health plans available through HealthCare.gov and public plans (such as the Oregon Health Plan) include special benefits for American Indians and Alaska Natives who are enrolled in a federally recognized tribe.

Special benefits for enrolled tribal members

  • Private plans with no out-of-pocket costs: Enrolled tribal members who buy private health insurance through HealthCare.gov​ can enroll in a "zero cost sharing plan" if their income is at or below the limit for their family size ($70,650 for a family of four). This means they do not have to pay for deductibles, co-pays, co-insurance, or prescriptions when they get care.

  • Flexible enrollment: Tribal members can enroll in a private health plan any time of year and can change plans up to once a month. They are not limited to open enrollment periods.

Enrolled tribal members and others eligible for services from Indian Health Services, Tribal Clinics, or Urban Indian Clinics can get:​

  • No out-of-pocket costs for Indian health programs. Regardless of income, they do not have to pay for services or items provided by Indian Health Services, Tribal Clinics, or Urban Indian Clinics.
  • Consistent care. They can continue to get care from their community providers at Tribal and Urban Clinics and may be eligible for financial savings to lower the cost of monthly premiums for private health insurance.
  • No penalty for not having health insurance. They do not have to pay the federal penalty that most others have to pay if they do not have health insurance.
  • Premium sponsorship. Tribes, tribal organizations, and urban Indian organizations may choose to pay premiums for qualified health plans on behalf of tribal members. To find out more about the Tribal Premium Sponsorship Program, contact us or your tribal organization.

For more information, contact us.​