8 Key Healthcare Benefits for Recognized Tribe Members

The Affordable Care Act (ACA) and the Centers for Medicare & Medicaid Services (CMS) offer several key healthcare benefits to members of federally recognized tribes, aiming to improve access and quality of care. Here are some of the notable benefits:

Expanded Coverage

The ACA includes provisions that expand Medicaid coverage to more individuals, including many Native Americans who may qualify for these expanded benefits. This expansion helps reduce the uninsured rate within tribal communities.

Tribal Health Programs

Native Americans can access healthcare through the Indian Health Service (IHS), tribal health programs, and Urban Indian Health Programs (UIHPs). The ACA supports these programs by providing funding and resources to improve facilities and services.

No Co-Payments or Cost-Sharing

For services provided by IHS or tribal health programs, there are generally no co-payments or deductibles, reducing out-of-pocket costs for Native Americans.

Special Enrollment Periods

Tribal members can access special enrollment periods for health insurance plans through the Health Insurance Marketplace, allowing them to enroll outside the standard open enrollment period.

Coverage for Dependents

The ACA allows for the inclusion of dependents up to age 26 on a parent’s health plan, which can be particularly beneficial for Native American families.

Preventive Services

The ACA mandates coverage for preventive services without cost-sharing. This includes screenings, vaccinations, and counseling services that are crucial for maintaining health and preventing diseases.

Protection Against Discrimination

The ACA includes provisions that protect against discrimination based on pre-existing conditions, which can be particularly relevant for those with chronic conditions or disabilities.

CMS Support

CMS provides funding and technical assistance to tribal health programs, helping to ensure that these programs can effectively deliver care and improve health outcomes in tribal communities.

Overall, these benefits are designed to enhance healthcare access, reduce financial barriers, and support the unique needs of Native American communities.