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Special options for members of tribes

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.

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 ($75,300 for a family of four). This means they do not have to pay for deductibles, co-pays, co-insurance, or prescriptions.

Private plans with reduced out-of-pocket costs: At any income, Tribal members who buy private health insurance through HealthCare.gov can enroll in a plan that requires no out-of-pocket spending when they get care from Indian Health Services, Tribal Clinics, or Urban Indian Clinics. They also can pay nothing when their Tribal clinic refers them to another provider.

Flexible enrollment: Tribal members can enroll in a private health plan any time of year and can change plans up to once a month.

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.
  • Consistent care. Members of Tribes 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.
  • 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 information, contact us.

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