Private health plans through Explore Health and public health coverage programs, such as the Oregon Health Plan (OHP), Medicare, and Veterans Affairs (VA) health care, may include special protections, benefits, or services for American Indians and Alaska Natives who are members of federally recognized Tribes, bands, or pueblos, and Alaska Native Corporation shareholders.
American Indians and Alaska Natives who enroll in private health insurance through Explore Health qualify for additional savings and flexible enrollment options.
Private plans with no out-of-pocket costs
Tribal members who buy private health insurance through Explore Health may qualify for a zero cost-sharing plan if their income is at or below certain limits for their family size. This means they may not have to pay:
- Deductibles
- Copays
- Coinsurance
- Prescription costs
Private plans with reduced out-of-pocket costs
At any income level, enrolled Tribal members may qualify for a plan with no out-of-pocket costs when receiving care from Indian Health Care Providers (IHCPs) such as Indian [M(1] Health Service (IHS) clinics
- Tribal clinics
- Urban Indian clinics
They also pay nothing when their Indian Health Care Provider refers them to another provider, such as specialty care.
Flexible enrollment
American Indians and Alaska Natives can enroll in or change Marketplace health plans more often than other consumers. Eligible individuals can enroll year-round and may change plans up to once each month.
Premium sponsorship
Some Tribes may help pay monthly health insurance premiums for eligible members enrolled in qualified health plans.
Tribal members may contact your Tribal organization or health program to learn more about available premium sponsorship programs.
Learn more on the Explore Health website.
American Indians and Alaska Natives enrolled in OHP can continue receiving care through Tribal and Urban Indian health programs while also accessing services covered by OHP.
OHP members benefit from:
- Low or no-cost coverage
- Access to preventive care and other health services
- Care coordination with Tribal and Urban Indian health providers
Some Tribal members may also qualify for both OHP and Explore Health savings, depending on income and household size.
Learn more on the OHP website.
American Indians and Alaska Natives with Medicare can continue to receive services through Tribal and Urban Indian health facilities.
Medicare may work together with:
- Indian Health Service (IHS)
- Tribal health programs
- Urban Indian health programs
- Other health coverage, including Marketplace plans or OHP in some situations
People with Medicare may also qualify for programs that help lower costs such as premiums, deductibles, or prescription drug expenses.
Veterans who are American Indian or Alaska Native may be able to receive care through both VA health care and Tribal or Urban Indian health programs.
VA health coverage can work alongside other health coverage programs, including:
- Explore Health plans
- OHP
- Medicare
Using more than one health coverage program may help improve access to services and providers.
Learn more on the VA website.
Additional benefits for Tribal members and eligible individuals
Enrolled Tribal members and others eligible for services from Indian Health Service, Tribal Clinics, or Urban Indian Clinics may have access to:
- No out-of-pocket costs for services received through Indian health programs
- Continued care from trusted community providers
- Financial help to lower monthly insurance costs
- Premium sponsorship programs offered by Tribes, Tribal organizations, or Urban Indian organizations
Need help or have questions?
For more information about health coverage options and special protections for Tribal members,
find local help or contact your Tribal health organization.