Benefit Coordinators

Choctaw Nation Health Services has benefit coordinators at each clinic to provide one-on-one help with a variety of insurance plans and other federal programs that you may qualify for. These individuals have specialized knowledge in:

  • SoonerCare
  • Medicare
  • ACA/Marketplace
  • Veteran's Affairs
  • Choctaw Nation's Premium Assistance Programs

Although Choctaw Nation Health Services will continue to provide excellent health care in our facilities, we encourage everyone to visit with a Benefit Coordinator to learn more about health insurance and the value of being insured. Having insurance coverage provides tribal members with a safety net in the event of a medical emergency, when you are traveling or away from home, and for any conditions where specialty care might be needed.

Locations

  • Atoka Clinic
    580-889-1981 Ext. 32005
  • Durant Clinic
    580-920-2100 Ext. 83843, 83544, 83844, 83586, and 83788
  • Hugo Clinic
    580-326-7561 Ext. 35024
  • Idabel Clinic
    580-286-2600 Ext. 41215
  • McAlester Clinic
    918-423-8440 Ext. 31018
  • Poteau Clinic
    918-649-1100 Ext. 61275
  • Stigler Clinic
    918-967-9200 Ext. 34020
  • Talihina Hospital
    918-567-7000 Ext. 6617, 6955, 6498, 6655, 6373, and 6953

SoonerCare

Oklahoma SoonerCare provides health insurance coverage for low income adults, families, and pregnant women. Income and eligibility guidelines vary based on the number of people in the household and the plan selected.

Visit with a Choctaw Nation benefit coordinator or oklahoma.gov/ohca.html for more information regarding SoonerCare benefits.

Medicare/Medicare Savings Program

Medicare is health insurance coverage for patients 65 years of age and older, patients with disabilities, and patients with Amyotrophic Lateral Sclerosis aka Lou Gehrig's disease (ALS) or end stage renal disease (ESRD). Patients are typically enrolled automatically in Part A – Hospital Insurance when they become eligible. Part B – Medical Insurance and Part D – Drug Coverages are optional, and the insured must pay a monthly premium for these services. If patients do not enroll in Part B and Part D coverages when they first become eligible, they could incur an increase in monthly premiums for a late enrollment penalty if they choose to enroll in the future, which is why it is so important to start this coverage when you become eligible.

Part A - Hospital Insurance

  • Inpatient hospital services
  • Skilled Nursing Facility (SNF) services
  • Home health
  • Hospice

Part B - Ancillary Charges/Services

  • Doctors' services
  • Durable Medical equipment
  • Medical services and supplies not covered under Part A
  • Ambulance

Medicare Savings Programs

  • Multiple programs with income and resource limits to help patients with limited resources in paying Medicare premiums and other costs.

Medigap/Medicare Supplemental Insurance

  • Helps cover the remaining "gaps" or costs such as copayments, coinsurance, and deductibles.

Visit with a Choctaw Nation benefit coordinator or cms.gov/medicare/medicare for more information regarding Medicare benefits.

ACA/Marketplace

Under the Patient Protection and Affordable Care Act (ACA), the Health Insurance Marketplace provides increased opportunities for affordable health care coverage though a variety of qualified health plans. The Marketplace offers special benefits for American Indians/Alaska Natives such as:

  • Special enrollment periods
  • Tribal members with income at or below 300% of the federal poverty level are eligible for no cost to reduced cost plan premiums through income tax credits, often times with zero cost sharing.
  • Tribal members with income above 300% of the federal poverty level are eligible for limited cost sharing plans.

Visit with a Choctaw Nation benefit coordinator or healthcare.gov for more information regarding ACA/Marketplace benefits.

Veteran Affairs

American Indians/Alaska Native Veterans may receive health care from multiple agencies and under more than one insurance plan. Even with coverage from Veteran Affairs or Indian Health Service (IHS), Veterans may also want to enroll in Medicare, Medicaid, or private insurance.

Tribal Veteran Representatives act as a liaison between tribal communities and Veterans Affairs. These representatives are a good place to start when accessing health coverage.

They:

  • help Veterans access Veteran Affairs benefits
  • assist Veterans with filing claims
  • provide Veterans with information about services available through VA, the tribal community, federal and state governments, and other sources

Visit with a Choctaw Nation benefit coordinator or benefits.va.gov/benefits for more information regarding veteran benefits.

Other Helpful Resource Links