Affordable Care Act (ACA) Frequently Asked Questions
Question: I am a member of the Choctaw Nation and I have always thought I had “insurance” through the tribe. Do I?
Answer: Unless you are an employee of Choctaw Nation you do not have “insurance” through the tribe. If you are Native American and have a Certificate Degree of Indian Blood (CDIB) card and/or a tribal membership card you are entitled to Native American health benefits. The term Native American Benefit of Indian Health Services is a health benefit which allows those eligible to seek health care services at an Indian Health Service (IHS), a Tribal or an Urban facility. This benefit is designed to allow health care services to be rendered under the umbrella of Indian Health. If you were to be seen in a health care setting outside of Indian Health, you would be asked if you had health insurance. Outside providers do not bill Indian Health, therefore would expect the patient to provide a source of insurance coverage for payment. This benefit could have limitations for the patient due to the geographic location of an Indian Health care facility. Being Native American allows you to have health benefits at one of the many Indian Health care facilities, but it is not considered health insurance.
Question: If I’m a tribal member and can receive Indian health benefits how is this different from insurance?
Answer: An insurance plan can be purchased privately or received under an employer-sponsored insurance company and often allows the patient to be seen at any health care facility that will agree to submit a claim for services. This allows the patient the flexibility to be treated anywhere, with no or limited restrictions. Health insurance is a contract between you and the insurance company and the company agrees to pay part of the medical expenses when you are sick or get hurt. Under the insurance plan, there are monthly premium costs as well as varying deductibles (depending on the plan) but the insurance will cover the care you need. A standard health insurance policy also gives you access to preventive care to keep you healthy, like vaccines and check-ups. Many plans also cover prescription drugs.
Question: I do not have health insurance but, I am Native American and can be seen at any Indian Health clinic/hospital for care.
Do I need to do anything in 2014 because of the new law that President Obama passed?
Answer: President Obama signed the Affordable Care Act into law which states everyone in the U.S. must have health insurance beginning January 1, 2014. Those that do not have health insurance could face a new health tax penalty that will be applied to the tax household when they file their income taxes. The tax penalty (per individual) for 2014 is $95.00 per person or 1% of annual income (whichever is greater) and this penalty will go up each year for those that remain uninsured.
If you are Native American and uninsured you will need to complete the Native American Exemption form so that you can be “exempt” from the new mandatory insurance requirements. To request an exemption, you must meet the exemption requirements of the Affordable Care Act law: Native American, member of a federally recognized tribe and submit the exemption form for approval. You can obtain the Application for Exemption for American Indians and Alaska Natives from the Marketplace Web site at: http://marketplace.cms.gov/getofficialresources/publications-and-articles/tribal-exemption.pdf
This form needs to be completed as soon as possible so you and/or your family can be considered exempt. Don’t wait until tax season, send the exemption now so that you can be certain you have all that is needed to prevent the additional health tax penalty when you file your federal income tax return!
If you have questions or need assistance you can visit with a Benefit Coordinator or Certified Application Counselor (CAC) at any one of the Choctaw Nation health care facilities or you may call (800) 349-7026.
There will be some Native Americans/Alaska Natives that will have to take an extra step to prevent the IRS from charging a tax penalty. Some may not have documented proof they are a member of a federally recognized tribe. Some examples might be: • Newborn child pending a Social Security card and/or tribal membership. • A Native American that is a member of a state recognized tribe. • A Native American with a CDIB card but no tribal membership due to tribal law limiting membership for various reasons such as blood quantum limitations. • Foster children of a Native American, step-children of a Native American, or a pregnant mom carrying a Native American child. Some will need to complete the Application for Exemption for American Indians and Alaska Natives application and send this request to the Marketplace to receive approval and exemption from the IRS tax penalty.
If you need help with this additional step, please come in and visit with one of our Benefit Coordinators at any one of our clinics for help with this process. This form is only needed in certain circumstances and all others that have a CDIB card and are current members of a federally recognized tribe do not need to do anything at this time. If you have questions or concerns you may call toll-free: (800) 349-7026 or visit any one of the Choctaw Nation health facilities and speak with a Benefit Coordinator for one-on-one help!