Health coverage for American Indians & Alaska Natives

If you’re an American Indian or an Alaska Native you may have new health coverage benefits and protections in the Marketplace.

Some benefits are available to members of federally recognized tribes or Alaska Native Claims Settlement Act (ANCSA) Corporation shareholders. Others are available to people of Indian descent or who are otherwise eligible for services from the Indian Health Service (also known as an Indian hospital or Public Health Service (PHS)), a tribal program, or an urban Indian health program.

Members of federally recognized tribes and ANCSA shareholders can enroll in Marketplace coverage any time of year. There’s no limited enrollment period for these individuals, and they can change plans up to once a month.
Special Marketplace protections and benefits for American Indians and Alaska Natives

The Health Insurance Marketplace benefits American Indians and Alaska Natives (AI/ANs) by providing opportunities for affordable health coverage.

This coverage can be through a private health plan bought in the Marketplace, Medicaid, or the Children’s Health Insurance Program (CHIP).

Members of a federally recognized tribe and ANCSA Corporation Shareholders

If you buy private insurance in the Health Insurance Marketplace and your income is between $24,250 and $72,750 for a family of 4 ($30,320 to $90,960 in Alaska) and you qualify for premium tax credits, you can enroll in a zero cost sharing plan. This means you won’t have to pay out-of-pocket costs like deductibles, copayments, and coinsurance when you get care. If your income is below $24,250 or above $72,750 for a family of 4 (or below $30,320 or above $90,960 in Alaska), you can enroll in a limited cost sharing plan and pay no out-of-pocket costs when you get services from an Indian health care provider or from another provider if you have a referral from an Indian health care provider.
You can enroll any time. You can enroll in a Marketplace health insurance plan any month, not just during the yearly Open Enrollment period.
American Indians, Alaska Natives, and others eligible for services from the Indian Health Service, tribal program, or urban Indian health program

You may qualify for Medicaid and CHIP more easily. You have special cost and eligibility rules for Medicaid and the Children’s Health Insurance Program (CHIP) that make it easier to qualify for these programs.
You don’t pay out-of-pocket costs for Indian health programs. Regardless of income, you won’t have any out-of-pocket costs for items or services provided by the Indian Health Service, tribal programs, or urban Indian programs (known as I/T/Us), including Purchased/Referred Care.
If you don’t have health insurance, you won’t have to pay the fee that most other people without health insurance must pay. To get a health coverage exemption from paying the fee, you’ll need to claim the exemption when you file your federal income tax return or fill out an exemption application and mail it to the Marketplace. Learn how to apply for this exemption.
Indian Health Services and Marketplace insurance

If you enroll in a private health insurance plan through the Health Insurance Marketplace:

You can get (or keep getting) services from the Indian Health Service, tribal health programs (also known as tribal 638 programs or tribal health clinics), or urban Indian health programs.
You can also get services from any providers on the Marketplace plan.