Native American Benefits

How do I qualify?

1. Membership in a federally recognized tribe is a requirement.

2. The estimated annual household income should fall between 138 percent and 300 percent of the income chart guidelines. (Even though you may make too much to be eligible for the zero dollar plan. You may still be eligible for a large tax subsidy and a low cost plan)

3. The age limit is 64 years or younger.

4. Individuals should not be enrolled in other federally subsidized insurance programs such as Medicare, VA, Tricare, or have health insurance through their employer. There is an exception through the family glitch that you do not have to enroll in your employer’s health plan if your monthly premium is more than 9.12% of your monthly income.

What are the benefits?

• Zero dollar monthly premiums: Native Americans who qualify will not have to pay any monthly premiums.

• Zero dollar copays: Out-of-pocket costs like copayments, deductibles, and coinsurance amounts will be covered, resulting in no additional expenses.

• Access to more options: Private health insurance provides more choices for seeking care. If a referral is required, having private health insurance can help avoid waiting lists and allow timely access to specialists.

• Potential reimbursement for tribes: Even though care provided through Indian Health Services is free to the individual, the tribe can bill the insurance and receive reimbursement for the services they provide, benefiting the tribe financially.