Health Insurance Marketplace

Do you need affordable health insurance coverage?

The Health Insurance Marketplace benefits American Indians and Alaska Natives (AI/ANs) by providing opportunities for affordable health coverage through Marketplace health insurance plans, Medicaid, and the Children’s Health Insurance Program (CHIP).

  • If you buy a Marketplace plan and your income is between 100% and 300% of the federal poverty level, you can enroll in a “zero cost sharing” plan. This means you won’t have to pay any out-of-pocket costs — like deductibles, copayments, and coinsurance — when you get care.
  • If you get services from an Indian Health Care Provider, you won’t have any out-of-pocket costs like copayments, coinsurance, or deductibles, regardless of your income. (This benefit also applies to Purchased and Referred Care.)
  • You can enroll in a Marketplace health insurance plan any time, not just during the yearly Open Enrollment Period. You can change plans as often as once a month.
Indian Health Services and Marketplace insurance

If you enroll in a private health insurance plan through the Health Insurance Marketplace®:

  • You can get (or keep getting) services from the Indian Health Service, tribal health programs (also known as tribal 638 programs or tribal health clinics), or urban Indian health programs.
  • You can also get services from any providers on the Marketplace plan.
one application, one time, and you and your family can explore every qualified insurance plan in your area!

As part of the Affordable Care Act, the Marketplace offers private health insurance plans in a side by side comparison, written in simple language, so you can see what plans fit you and your family best. Every health insurance plan in the Marketplace offers essential health benefits, including doctor visits, preventative care, hospitalization, prescriptions and more.

what makes it affordable?

The Marketplace can provide your family with tax credits to make premiums affordable and minimize out of pocket expenses. The cost sharing reductions and tax credits are based on your income level, so you never have to pay more than you can afford. Tax credits are available for individuals making less than $48,560 or a family of four making less than $100,400. Tax credits and cost sharing is only available to individuals and families who do not have affordable health insurance available to them from an employer.

where can i learn more?

SDUIH has Certified Patient Navigators who are trained to answer your questions about the Marketplace and can help you apply and enroll. They are available by appointment at each clinic site. Contact your local clinic to set up an appointment today!

Kris Bluestone, Pierre
kirsten.bluestone@sduih.org
(605) 945-5493

 

 

 

 

 

Shannon Marshall, Sioux Falls
shannon.marshall@sduih.org
(605) 335-2596