If you’re an American Indian or an Alaska Native, you may be eligible for new healthcare coverage benefits and protections under the Affordable Care Act (ACA, or Obamacare).
What kinds of benefits could you receive? You could:
- Pay lower (or no) out-of-pocket expenses like deductibles and copays.
- Apply for healthcare coverage during any month, whether or not it’s during an open or special enrollment period.
- Be exempt from tax penalties if you don’t have health insurance.
- Obtain Medicaid and CHIP healthcare coverage with fewer limitations.
Need details? Read on.
Who can claim these benefits?
Health insurance for American Indians and Alaskan Natives is available to members of federally recognized tribes or shareholders in the Alaska Native Claims Settlement Act (ANCSA) Corporation. It also may be available to other people who may obtain services from the Indian Health Service, a tribal program, or an urban Indian health program.
Do I have to pay out-of-pocket expenses for my healthcare?
Maybe. But if you do, they’ll come with a lower price tag.
It all has to do with something called the ‘Federal Poverty Level’ (FPL)—the household income at or below which the federal government defines poverty. In 2015, if you have a household income at or below 300% of the FPL (about $72,750 for a family of four, or $90,960 for the same family in Alaska), and you qualify for premium tax credits you can enroll in a zero cost sharing plan, meaning you won’t pay out-of-pocket expenses for your healthcare when you get coverage through an ACA-sponsored plan which you can apply for through HealthMarkets Insurance Agency.
But even if you make above 300% of the FPL, you can still qualify for lower out-of-pocket expenses with a limited cost sharing plan. This provision allows you to get care through an Indian health provider without paying copayments, coinsurance, or deductibles, and it is available along with any ACA-sponsored plan.
Medicaid and the Children’s Health Insurance Program (CHIP), government health insurance programs for families with limited income, are also more accessible to you. Legislation called the American Recovery and Reinvestment Act (ARRA) says that states cannot charge American Indians or Alaskan Natives premiums for Medicaid coverage if they get their care within the Indian health system.
I’ve heard about the “Indian Exemption.” What is it?
The Indian Exemption is a provision in the ACA that protects you from paying a tax penalty if you don’t have a health insurance plan. You don’t have to pay the tax penalty if you:
- Are enrolled in a federally recognized tribe
- Have Alaska Native Claims Settlement Act (ANCSA) shareholder status (village or regional)
- Are eligible to receive services from a Tribal health clinic or IHS Facility.
Recently, the federal government announced that it would also allow people with a Certificate of Indian Blood (CIB) to claim the Indian Exemption when filing their taxes.
When do I enroll in a government-sponsored health insurance plan?
As an American Indian or Alaskan Native, you can enroll in or change a health insurance plan in any month. There’s no limited enrollment period for you, so ignore all those website warnings that say you’ve missed your opportunity to get affordable healthcare. You haven’t!
Can HealthMarkets help me get health insurance?
Of course! For more information about your particular benefits, exemptions and rights, contact a licensed agent at HealthMarkets. You can call us anytime, day or night, at (800) 827-9990. You can also get a quote online, or even find an agent near you to meet with in person! We’re knowledgeable in all things health insurance, and we can find you a plan that takes advantage of every opportunity available to you.