Affordable Care Act: AI/AN Special Provisions

Important: Members 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 Indians enrolled in a U.S. federally recognized tribe who have a household income between 100% and 300% FPL may have to pay premiums. Enrolling in bronze plan will provide the same zero-cost-sharing benefit as a silver or gold plan, but bronze plan premiums usually cost less
  • Members 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 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)
  • American Indians and Alaska Natives may qualify for a tax credit that may lower your premiums based on your monthly income.
  • Tribal members 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.
  • The normal Marketplace open enrollment begins each year from November 1st to December 15th.
  • Even though 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.