Mixed households: covering tribal and non-tribal family members on HealthCare.gov.

Why separate policies matter.

A policy that includes someone who is not an enrolled member cannot carry the tribal cost-sharing protections. If a tribal member is on a family policy with a non-member spouse, the tribal member can lose zero or limited cost-sharing. HealthCare.gov lets you pick one plan for the enrolled members and another for everyone else.

Setting it up.

1. Put the whole household on one application so the premium tax credit is figured for everyone.
2. Mark each enrolled member as American Indian or Alaska Native.
3. When you pick plans, choose one plan for the enrolled members and one for the others.
4. The tax credit is split across the two policies.

Two policies means two deductibles for the non-member policy and two premiums, so compare the total. With zero cost-sharing, the enrolled members' policy has no deductible at all.

Children.

Children who are enrolled members get the protections on their own. Children who are not enrolled but are eligible for IHS services may still get the Medicaid and CHIP protections. Check your tribe's enrollment rules for children; enrolling them can make a difference.

Questions people ask.

Sources.

1. CMS, American Indians and Alaska Natives in the Health Insurance Marketplace, fact sheet for agents and brokers. cms.gov
2. 45 CFR 155.420(d)(8), Special enrollment period for Indians. ecfr.gov
3. 45 CFR 155.350, Special eligibility standards for Indians. ecfr.gov
4. HealthCare.gov, Health coverage for American Indians and Alaska Natives. healthcare.gov

General information for Texas and Oklahoma residents, not tax or legal advice. Rules and numbers can change; this page is reviewed on the date shown above. Your eligibility and prices are set by HealthCare.gov or the insurer when you apply.