Affordable Care Act (ACA)

Important: Special Enrollment for AI/ANs in Marketplace Coverage

Citizens of federally recognized American Indian tribes and Alaska Native Claims Settlement Act (ANCSA) shareholders (AI/ANs) can enroll in Marketplace coverage any time of year. There is no limited enrollment period, and they can change plans as often as once a month.

Health Insurance Marketplace for American Indians and Alaska Natives:

  • Special protections are available to American Indians and Alaska Natives (AI/ANs) who enroll in a Marketplace plan.
  • AI/AN eligibility for cost-sharing for zero cost sharing plans (between 100- 300% FPL) or limited cost-sharing plans (below 100% and above 300% FPL)
    • Consumers enrolled with zero cost sharing plans won’t have to pay any out-of-pocket costs — like deductibles, copayments, and coinsurance — when they receive care
    • Remember, American Indian and Alaska Native individuals are not exempt from paying premiums for Marketplace insurance, but they can qualify for tax credits that will lower premiums based on income

Year-Round Marketplace Enrollment for AI/ANs and ANCSA Shareholders

  • Citizens of federally recognized tribes, Alaska Native Claims Settlement Act (ANCSA) shareholders, and non-tribal members who apply on the same application can enroll in a Marketplace health insurance plan at any time, not just during the yearly Open Enrollment Period. You can change plans as often as once a month through a special enrollment period.
    • Enrollment on or before the 15th of any month will provide active coverage on the 1st of the following month (Example: Enroll on or before April 15 for coverage on May 1)
    • After the 15th of any month, coverage will activate on the 1st day of the second month (Example: Enroll July 18 for coverage on September 1)

Tax Credit Eligibility for American Indians and Alaska Natives
American Indians and Alaska Natives may qualify for a tax credit that may lower your premiums based on your monthly income.

Marketplace Open Enrollment Period
The normal Marketplace open enrollment begins each year from November 1st to December 15th.

Tribal citizens with existing marketplace coverage should come back to shop and review their coverage options by December as new, better, or more affordable plans may be available for them in the next year.

AI/ANs can enroll anytime throughout the year, it is important to understand—open enrollment is a time to review new plan options, premium pricing or change in benefits for the following calendar year.

No one can be denied because of a pre-existing condition like high blood pressure or asthma.

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