Native Americans

Health Coverage and Indian Country

Below we have provided information about new coverage options and American Indian provisions in the health law. But don’t worry if you have questions or need help applying. There are local enrollment assisters in your community who can help you through the process. Their help is always free and confidential.

Montana Medicaid

Montana Medicaid provides an affordable coverage option for those who are eligible. To be eligible, you must meet the income guidelines, be a Montana resident ages 19 – 64, and be ineligible for/not covered by Medicare.

American Indians (both enrolled members and decedents) who are eligible for Montana Medicaid will not have premiums or copays and will have access to a full set of benefits including:

Doctor, hospital, and emergency services
Prescription drugs
Dental and vision care
Laboratory and x-ray services
Maternity and newborn care
Mental health and substance abuse treatment
Rehabilitative services and supplies
Transportation to appointments

Marketplace Options

Enrolled Members of Federally Recognized Tribes and the Marketplace:
Using a Special Enrollment Period (SEP), enrolled members can apply anytime throughout the year. Depending on their income, members of federally recognized tribes may be eligible for a zero cost-sharing plan. This means that there are no additional out of pocket costs other than the monthly premium.
American Indian Descendants and the Marketplace:
American Indian descendants are not eligible for the same benefits as enrolled tribal members. Descendants may qualify for tax credits or cost-sharing reductions on the Marketplace, depending on their income and family size. Descendants don’t qualify for a Special Enrollment Period that allows them to enroll anytime and generally need to enroll during Open Enrollment.

See What You Qualify For

With just some basic information, the calculator estimates what you qualify for including Medicaid, Healthy Montana Kids, and the Marketplace.

Learn More

Using health insurance and Indian Health Service, Tribal Health, or Urban Indian Health Center services:

Using your health insurance in coordination with IHS, Tribal Health or an Urban Indian Health Center may help increase your access to health care options and save you money. Here are a few helpful tips to keep in mind:

If you are seeing a provider in more than one facility, keep track of your health records! It is important for your primary care provider to have information about care received someplace else. Always ask a specialist or other healthcare provider to share your records with your primary care provider.

If you need to see a specialist or someone outside of your local Tribal Health or IHS Service Unit, you generally need a referral if you want IHS/Tribal Health to pay for that service. If you want to cover your own out of pocket costs, just make sure to look for providers and facilities that are “in-network” as it will save you money.

If you are able to access care through IHS, Tribal Health, or an Urban Indian Health center, ask if there are any ways to save money. For example, can you get affordable prescriptions through IHS? What about imaging because you haven’t yet met your deductible? Again, make sure you are tracking your own health records if you are getting services from multiple providers and facilities.

Insurance can be confusing so don’t be afraid to ask questions! Ask questions of the staff at tribal health and IHS as well as the enrollment assister who helps you enroll in coverage. In addition, you can contact your health insurance company if you have questions about your coverage and benefits. Their contact information is on your insurance card and the paperwork that was mailed to you when you enrolled.

Not sure if you qualify? We can help!

Health insurance can be confusing, especially if you are transitioning from Montana Medicaid, but free, unbiased, confidential help is available. You can call the Cover Montana Help Line to get questions answered and to get help enrolling over the phone: (844) 682-6837. Or click any of the links below for more help. Whether you need phone, virtual, or in-person help, we’ve got you covered!

Cover Montana