Regulations for Native Americans
Health insurance Regulations for Native Americans is already a confusing process. Fortunately, the Affordable Care Act and the Indian Health Care Improvement Act may help. It now contains contain provisions and exemptions which assist Native Americans with insurance. Open Enrollment is available during the entirety of the year for those in a federally recognized tribe.
Non-Native Americans only qualify for Open Enrollment once per year. Outside of this short window, they have a 90 day waiting period in between when the application date and when the coverage starts. The ACA regulations for Native Americans change this rule. Native Americans can enroll any time and coverage begins the following month. This will allow those that qualify a change any time of the year to get the best coverage for the most affordable price.
Subsidies are also affected.
During the enrollment process, Native Americans who have a household income within 300% of the Federal Poverty Level will receive a Qualified Health Plan with a Zero Cost Share Reduction. Cost Sharing Reductions help members by lowering deductibles and co-pays for medical services. A Zero Cost Share Reduction will cover all out of pocket expenses leaving the member with no medical bills with in-network providers. Each individual tribe administers this benefit. It’s up to the discretion of the specific tribe how much Cost Sharing Reduction will apply.
Furthermore, Native Americans are exempt from the federal mandate for qualified coverage! Tribal members who choose to be uninsured will not receive a tax penalty or fine.
Our office is always happy to help anyone in need of health insurance advice. Regardless of your situation, our licensed brokers are available all year to provide information and consulting to clients. We have helped thousands of clients navigate the confusing insurance process. Do not hesitate to give us a call at (775) 828-1216.