What are the Special Provisions for Native Americans?

Health Coverage for American Indians and Alaska Natives: Native Americans who are members of a federally recognized tribe are exempt from the individual mandate. Native Americans who earn less than 300% of the …

Health Coverage for American Indians and Alaska Natives:

  • Native Americans who are members of a federally recognized tribe are exempt from the individual mandate.
  • Native Americans who earn less than 300% of the Federal Poverty Level (FPL) are exempt from cost sharing; for example, they will not have to pay copayments or deductibles when they use medical services.
  • There are special provisions for the calculation of Modified Adjusted Gross Income for Native Americans, meaning that some revenue earned on reservations and from Federal Trust payments are exempt.
  • Native Americans can change Qualified Health Plans (QHPs) once per month, and they are not bound to the open enrollment dates.

Frequently Asked Questions:

  • Why do I need health insurance coverage if I get services from the Indian Health Service, a tribal program, or an urban Indian health program?
  • What American Indian and Alaska Native income do I include on my application?
  • My children and I are tribal members, but my spouse is not. Can we enroll as a family with a Special Enrollment Period?
  • Will I need my tribal documents when applying for coverage?
  • How do I apply for the Indian exemption?

     

Posted in: Individuals