(Source: American Indian and Alaska Native Trust Income and Modified 

Adjusted Gross Income fact sheet)

Income that is not 

counted toward 

eligibility:

ANCSA distributions

TRUST/RESERVATION

property distributions 

h u n t i n g f i s h i n g 

NATU R AL R ESOU RCES I NCOM E 

sale of cultural/

subsistence property

Bureau of Indian Affairs 

OR TRIBAL STUDENT FINANCIAL AID

Income under IRS 

general welfare doctrine

@CMSGov #CMSNativeHealth

CMS ICN No. 909323-N • June 2016

Signing up for 

health insurance is 

easy and affordable:

 Visit your Indian health program,

 Go online to healthcare.gov/tribal, or

 Call 1-800-318-2596

For more information:

Visit go.cms.gov/AIAN

You can afford 

insurance. 

Several benefits make insurance more 

affordable for members of federally recognized 

tribes and Alaska Native Claims Settlement Act 

(ANCSA) Corporation shareholders. 

Use this brochure to find out about different 

kinds of insurance and benefits, and which 

your family qualifies for.

Additional resources can be found on the 

back of the brochure, including where to find 

charts of the federal poverty level for families 

of different sizes. Your household income 

compared to the federal poverty level is used 

to determine eligibility.

CHIP, Medicaid, 

Medicare, and the 

Health Insurance 

Marketplace at 

a Glance

For American Indians and 

Alaska Natives

Insurance options

Eligibility requirements

Benefits

Learn more 

• CHIP: www.insurekidsnow.gov

• Medicaid: www.medicaid.gov

• Medicare: www.medicare.gov

• Federal Poverty Level:

http://go.cms.gov/fpl

• Modified Adjusted Gross Income:

http://go.cms.gov/magifactsheet

• Additional resources:

Go.CMS.gov/AIAN
Children’s Health 

Insurance Program 

(CHIP)

• Children up to 18 (19 or 20 in some states) in families 

that earn too much for Medicaid

• Families that make 200% of the federal poverty level or 

higher, depending on the state

• Parents and pregnant women in some states

• Free “well child” doctor and dental visits

• American Indians and Alaska Natives don’t have to pay out-of-pocket costs like 

copayments, coinsurance, and deductibles

Medicaid

• Children, pregnant women, parents, and people with 

disabilities

• Income levels vary, but in states with Medicaid 

expansion, families with incomes at or below 133% of 

the federal poverty level

• Indian trust income is not counted in determining 

eligibility

American Indians and Alaska Natives don’t pay premiums, copayments, 

coinsurance, or deductibles

All states: hospital visits, doctor visits, home health services, laboratory and x-ray 

services, family planning, pregnancy/childbirth services, nursing home care, and 

child mental health/behavioral screening

Some states: prescription drugs, dental care, physical/occupational therapy, eye 

care, and more

Medicare

• People 65 or older

• People who are permanently disabled and have 

received disability benefits for at least 2 years

• People with permanent kidney failure

• People with Lou Gehrig’s Disease

Part A: Hospital care only — there is no charge if you or your spouse paid 

Medicare taxes for at least 10 years

Part B: Medical Insurance for doctor’s visits, medical equipment, and other 

treatment ordered by your doctor (you must pay a monthly premium)

Part C (Medicare Advantage): Offers additional benefits for a monthly premium 

through private insurers; you must have Part A and Part B (Part C is generally not 

available to those with permanent kidney failure)

Part D: Prescription drug coverage available through private insurers (you must 

have Part A and Part C and pay a monthly premium)

Health Insurance 

Marketplace: Advanced 

Premium Tax Credits

Households with incomes 100–400% of the federal 

poverty level that buy insurance through the Health 

Insurance Marketplace

Credits to help pay your monthly insurance premium

Health Insurance 

Marketplace: 

Zero Cost Sharing

American Indians and Alaska Natives making 100–300% 

of the federal poverty level who buy insurance through the 

Health Insurance Marketplace

You don’t pay out-of-pocket costs, like copayments or deductibles, for:

• Care from an Indian health care provider

• Essential health benefits from any provider covered by your insurance

Health Insurance 

Marketplace: 

Limited Cost Sharing

American Indians and Alaska Natives who buy insurance 

through the Health Insurance Marketplace, and make:

• less than 100% of the federal poverty level, or

• more than 300% of the federal poverty level

You don’t pay out-of-pocket costs, like copayments or deductibles, for:

• Care from an Indian health care provider

• Essential health benefits from any provider covered by your insurance, if you 

have a referral from an Indian health care provider

Program/

Benefit Who’s Eligible? Benefits