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Health Care Benefits for American Indians and Alaska Natives

Your health matters; Find out what you are eligible for today!

Published: July 1, 2014
Audience:
Healthy Tribes
Topics:
Affordable Care Act
Types:
Guide
Tags:
Health

An old adage often repeated in Indian Country is, “don’t get sick after June.” Used in a tongue and cheek manner, the reality behind it still remains that the funding allotted to Indian Health Services, tribal programs or urban Indian health centers (I/T/U) does not always last throughout the year due to the large population each program/facility must care for.

Based on Article I, Section 8 of the Constitution the Federal Government has an obligation to promote healthy American Indian and Alaska Native (AI/AN) people, communities and cultures, and to honor and protect the inherent sovereign rights of Tribes. Traditionally this has been done primarily through the funding provided to an I/T/U; however, there are now a number of other Department of Health and Human Services programs that afford American Indians and Alaska Natives additional health benefits even when used in conjunction with I/T/Us including:

Children Health Insurance Program (CHIP)
The Children's Health Insurance Program (CHIP) which provides free or low-cost health coverage for more than seven million children up to age 19. CHIP covers U.S. citizens and eligible immigrants. Each state designs its own CHIP program, including eligibility, benefits, premiums and cost-sharing, and application and renewal procedures. States can decide on the benefits provided under CHIP, but all states cover regular check-ups, immunizations, hospital care, dental care, and lab and x-ray services. Children get free preventive care, but low premiums and other cost-sharing may be required for other services. Please note that AI/ANs are exempt from all cost sharing, and certain Indian resources and payments are not counted for CHIP eligibility. Learn more about CHIP program in your state.

Medicaid
Medicaid provides health coverage to more than 50 million children, families, pregnant women, the elderly, and people with disabilities. The program pays for a full set of services for children, including preventive care, immunizations, screening and treatment of health conditions, doctor and hospital visits, and vision and dental care. In most cases, these services are provided at no cost to families. AI/ANs who are eligible for or get services from an I/T/U, including Contract Health Services, are exempt from Medicaid premiums and enrollment fees and if they have ever used one of these programs, they are also exempt from other cost sharing, such as copayments, coinsurance, and deductibles. Although certain Indian resources and payments are not counted for Medicaid eligibility, in some states, children are still eligible for Medicaid if their family income is higher. Please note that children in families with even higher incomes may be eligible for CHIP. Learn more about Medicaid and other programs in your state.

Medicare
Medicare is a health insurance program for people age 65 or older; individuals under age 65 with certain disabilities; as well as people of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant). Medicare consists of Part A (Hospital Insurance), Part B (Medical Insurance), and prescription drug coverage. Medicare Part A helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and some home health care. Medicare Part B helps cover doctors' services and outpatient care, as well as some other medical services that Part A doesn't cover, such as some of the services of physical and occupational therapists, and some home health care. Learn more about Medicare.

Health Insurance Marketplace
The Health Insurance Marketplace benefits AI/ANs by providing opportunities for affordable health coverage. This coverage can be through a private health plan bought in the Marketplace, Medicaid, or CHIP.

Some benefits are available to members of federally recognized tribes. Others are available to people of Indian descent or who are otherwise eligible for services from the Indian Health Service, tribal program, or urban Indian health program. Learn more about the Health Insurance Marketplace.

All of these programs allow AI/AN to get better access to treatments the I/T/Us may not provide, with the option to continue getting services through an I/T/U even if the I/T/U is not a provider in a managed care network. In fact, when an AI/AN has insurance and gets services from an I/T/U, the I/T/U can bill the insurance program. This benefits the tribal community by freeing up Indian Health Services funds, allowing I/T/U's to provide more services to others.

You, your family, and your community’s health and wellbeing are priceless; don’t wait, find out what programs you are eligible for today by visiting:

http://www.insurekidsnow.gov
http://finder.healthcare.gov
http://www.healthcare.gov/find-premium-estimates/

 

Last Reviewed: January 1, 2015