Special ACA Protections and Benefits for American Indians and Alaska Natives

If you are an American Indian or an Alaska Native you may have new health insurance benefits and protections in the Marketplace. Some benefits are available to members of federally recognized tribes. Others are available to people of Indian descent or who are otherwise eligible for services from the Indian Health Service, tribal program, or urban Indian health program.

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).

If you're a member of a federally recognized tribe:

Native Americans who enroll in a Bronze or Silver Plan in the Health Insurance Marketplace will not pay out-of-pocket costs like deductibles, copayments, and coinsurance (also called “Cost-Sharing”) for Essential Health Benefits (also called EHBs) if your income is up to $70,650 for a family of 4 ($88,320 in Alaska).

Native Americans can enroll in Marketplace health insurance any month during the year, not just during the yearly open enrollment period.

Native Americans who do not have commercial health insurance can apply for the Native American Exemption and avoid the Shared Responsibility Payment. Application available at www.healthcare.gov.

If you’re an American Indian or Alaska Native or are otherwise eligible for services from the Indian Health Service, tribal program, or urban Indian health program:

You may 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.

If you are eligible for Indian Health Services, you can apply for the Native American exemption. You must see a Patient Benefit Advocate at your tribal healthcare facility and request documentation that verifies you receive healthcare services at an Indian Health facility and mail it in with your application.

Indian Health and Marketplace Insurance
  • If you enroll in a private health insurance plan through the Health Insurance Marketplace:
  • You can continue to receive healthcare services from the Indian Health Service, tribal health programs, or urban Indian health programs.
  • You can also get healthcare services from any providers on the Marketplace plan.