Native American's and Medicare

[insuranceconceptscindy]

This could be a post for Health Insurance Exchange as well, but I thought I'd start here.

I have a prospect who is currently on a marketplace plan, turning 65 in the next couple of months. Because she is Native American, she gets additional cost sharing adjustments on the exchange. She currently pays about $225 per month for her plan- not eligible for Medicaid.

The first question I was asked is if she can keep this plan along with Medicare?
I'm guessing that she could, but the subsidy will be taken away. Am I right? Why would she want a $1000+ med sup?

I know very little about any special rules that Native Americans might have in regards to Medicare. A cursory Google turned up not much, other than statistics.

At first glance, it looks like Medicare+supp+PDP is her best bet, and comparable in price to her current plan. There are no MAPD's in her zip code, since she lives in the middle of nowhere.

Do any of you have any experience in this world? Anything I should look for?

 

[kgmom219]

Everytime I hear the phrase "Native American" used with "Exchange", I want to run.

I have asked Native American questions here before and not gotten anywhere. The general rule is medicare kicks you off the exchange, but Native Americans have their own set of rules.

I would call. And get the name and ID number of who you speak to at the marketplace.

IF she gets a penalty on Part D (ask Medicare) then I would put her on Humana/Walmart PDP and Plan F/G/N. If she doesn't get fined due to Native American AND uses the Reservation pharmacy anyway, I wouldn't put her on Part D.

Just wondering...do Native Americans pay for Part B?

 

[goillini52]

This might be what you're looking for.

American Indian/Alaska Native - Centers for Medicare & Medicaid Services

 

[moonlightandmargaritas]

The first question I was asked is if she can keep this plan along with Medicare?
I'm guessing that she could, but the subsidy will be taken away. Am I right? Why would she want a $1000+ med sup?

Too much firewater?

 

[insuranceconceptscindy]

This might be what you're looking for.

American Indian/Alaska Native - Centers for Medicare & Medicaid Services

I looked at that before posting. It gives absolutely ZERO information.

What do the boots on the ground, with actual experience with NA's do?

 

[goillini52]

I looked at that before posting. It gives absolutely ZERO information.

What do the boots on the ground, with actual experience with NA's do?

I thought the contact links at the bottom might be able to help. That's the government, make everything more difficult than it should be. Good luck

"For more information about CMS initiatives in Indian Country, contact [email protected] or visit your regional CMS Native American Contact (NAC)."

 

[wehotex]

Everytime I hear the phrase "Native American" used with "Exchange", I want to run.

I have asked Native American questions here before and not gotten anywhere. The general rule is medicare kicks you off the exchange, but Native Americans have their own set of rules.

I would call. And get the name and ID number of who you speak to at the marketplace.

IF she gets a penalty on Part D (ask Medicare) then I would put her on Humana/Walmart PDP and Plan F/G/N. If she doesn't get fined due to Native American AND uses the Reservation pharmacy anyway, I wouldn't put her on Part D.

Just wondering...do Native Americans pay for Part B?

If she's one of those 1/64 quantum, does she receive 1/64% discount?

 

[G.Gordon]

Unless she lives a few miles from a tribe clinic she needs part B or she will have a penalty and not be well covered if she needs care away from the tribal facility, she needs part D, most of the time it is easier to use a local pharmacy rather than the drive to the reservation/tribe facility. They can use the tribe's RX benefit in conjunction with part D for higher cost meds such as insulin. Most of my tribe eligible clients have a Medicare supplement as well.

 

[goillini52]

Unless she lives a few miles from a tribe clinic she needs part B or she will have a penalty and not be well covered if she needs care away from the tribal facility, she needs part D, most of the time it is easier to use a local pharmacy rather than the drive to the reservation/tribe facility. They can use the tribe's RX benefit in conjunction with part D for higher cost meds such as insulin. Most of my tribe eligible clients have a Medicare supplement as well.

Does Medicare cover the charges of a Medicine Man?