I am a member of a federally recognized tribe here in Arizona. I receive all my medical needs through the Indian Health Service at no cost. Do I still have to have Medicare?

Question

Larry Dalton · Accepted Answer

IHS, Indian Health Services, is not health insurance, and it is only available at tribal clinics throughout their nations. Working with many Native Americans in Oklahoma, I have seen that having Medicare alongside the IHS can help provide healthcare providers and specialists outside their IHS clinics and hospitals. Some may find that having this dual coverage will give them the best Healthcare anywhere in the USA.

Answered by Larry Dalton on April 23, 2025

Broker Licensed in OK & TX

Answered by Larry Dalton Medicare Insurance Agent

Daniel Brechin · Answer

Indian Health services will take care of anything there in your local area. With Medicare you will be covered in the USA for emergency problems. If you travel a Medicare Advantage plan might be a good program for additional code.

Answered by Daniel Brechin on November 30, 2025

Agent Licensed in AL, FL, KY, MS & TN

Answered by Daniel Brechin Medicare Insurance Agent

Lt Col Tim Brown · Answer

I don’t know how to answer that.  I know you can use tribal medical care without it I think. But I don’t know how it effects you if you’re say somewhere outside or other state say on vacation.

Terri Reagin · Answer

You are not required to to carry Medicare when you have access to Native American services for prescription drugs. It is important to note, however, you are not legally allowed to carry any Healthcare.gov plans beyond becoming ELIGIBLE for medicare, even if you opt out of it.

Answered by Terri Reagin on August 5, 2025

Broker Licensed in OK, AR, CO & 6 other states

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Voss Speros · Answer

You don't have to get Medicare. IHS and Medicare are 2 different types of insurance. 

You have access to both. Both pay for different things. 

Medicare can be a second of IHS. You can use providers out side of IHS via your Medicare. They work together to give you more overall coverage.

Mark Maliwauki · Answer

Not necessarily. You will be given Part A Medicare automatically when you turn 65. You have to elect to take Part B and it comes with a monthly premium of $202.90. You should check out a couple of things; 1. Go to Medicare.gov and find whether or not there are Medicare plans available to you in your zip code. 2. Ask Indian Health Service whether or not they will pay for your Part B premium so you can have Medicare.

Answered by Mark Maliwauki on January 21, 2026

Broker Licensed in ID, AZ, CA & 13 other states

Answered by Mark Maliwauki Medicare Insurance Agent

Bill Wheeler · Answer

You're asking a great question that many Native American seniors who receive healthcare through the Indian Health Service (IHS) have. While IHS provides many healthcare services at no cost, you may still benefit from enrolling in Medicare, particularly if you meet the eligibility criteria (e.g., turning 65). But you do have to enroll into Medicare if you want it.

Answered by Bill Wheeler on August 5, 2025

Broker Licensed in KY & IN

Answered by Bill Wheeler Medicare Insurance Agent

Jacqueline Proffit · Answer

This is a common question, and the short answer is that while you are not required to have Medicare, enrolling in it is highly recommended and offers significant benefits that support both your health and the Indian Health Service (IHS) system.

Here is a breakdown of why Medicare is beneficial when you already receive free care through the IHS:

1. Expanded Access to Care
IHS is not insurance: The IHS is a healthcare provider system funded by Congress, not an insurance program like Medicare. This means its services may be limited by budget.

Services outside of IHS: Medicare, especially Part B, gives you access to medical care outside of IHS facilities, such as:

Seeing specialists (since IHS may be limited to primary care).

Non-IHS hospitals or clinics if you are traveling or do not live near an IHS facility.

Services your local IHS facility may not be able to provide.

2. Financial Benefit to the IHS
When you have Medicare and receive a covered service at your IHS or Tribal clinic, the facility can bill Medicare for that service.

This reimbursement saves money for the IHS, increasing the overall resources available to provide more services for the entire community. Since federal funding covers only an estimated 60% of care needed, Medicare payments are a vital revenue source for the IHS.

3. Avoiding Penalties (Specifically Part B)
You are not penalized for delaying Part D (prescription drug) coverage if you have drug coverage through IHS.

However, if you do not sign up for Medicare Part B (medical insurance) when you are first eligible and later decide you need it, you could face a late enrollment penalty that is added to your premium for as long as you have Part B. There is typically no Special Enrollment Period exemption for having IHS coverage for Part B.

Part A (Hospital Insurance) is generally premium-free if you or your spouse worked and paid Medicare taxes for at least 10 years. You should sign up for premium-free Part A when you are eligible.

Speci

Mark Michael · Answer

1st you are not legally required to enroll in Medicare.  However you are limited in where you receive your medical care. 
      The LHS is not considered a health Insurance plan by Medicare and so if in the future, you want to Enroll in Medicare part A B and D. You would you could incur lifetime penalties, for part B that's 10% for every 12 months you went without.

Arsenio Sallie · Answer

If you receive healthcare through the Indian Health Service (IHS), you are not required to enroll in Medicare. However, there are several reasons why enrolling in Medicare might still be beneficial:

1. **Expanded Coverage:** Medicare can provide access to a broader range of healthcare providers and services that might not be available through IHS alone.

2. **Coordination of Benefits:** If you have Medicare, it can be used in conjunction with IHS services. Medicare can cover services outside of what IHS provides, potentially reducing out-of-pocket costs for certain treatments.

3. **Future Needs:** Enrolling in Medicare when you first become eligible can prevent late enrollment penalties if you decide to use Medicare services in the future.

4. **Access to Specialists:** Medicare can provide access to specialists and facilities that may not be available through IHS.

5. **Prescription Drug Coverage:** Medicare Part D offers prescription drug coverage, which might be beneficial if you require medications not covered by IHS.

It's important to weigh your healthcare needs and consider how Medicare might complement the services you receive through IHS. Consulting with a benefits coordinator at your tribal health facility or a Medicare advisor can help you make an informed decision based on your special situation!

Steven Bleicher · Answer

Since it would make no sense to pick up an added cost for a plan with Medicare, you are not expected to pick up the costly Part B monthly premium. However, ask your Indian Health Service if they know that picking up the TOTALLY FREE Part A (in-patient hospital) is a wise decision since a full-fledged hospital has much more equipment to be used to save your life.

Answered by Steven Bleicher on April 24, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent

Diana Garner · Answer

No, you are not required to have Medicare; however, Medicare can be used alongside the Indian Health Service.

The Indiana Health Service does provide comprehensive healthcare services, but it is not an insurance program and doesn't guarantee coverage for all potential healthcare needs.  

Having Medicare, in addition to IHS, can provide you with access to a wider range of services when IHS facilities or resources are limited, such as when traveling.

Vernon Jones · Answer

Yes, Native American Indigenous Medicare
Yes, you should consider having Medicare because while the Indian Health Service (IHS) provides care, it does not cover all needs or services and is not an insurance program, only offering care within its own facilities and programs. Enrolling in Medicare allows you to receive care outside of IHS facilities, access additional services not provided by IHS, and can even provide reimbursement to the IHS when you receive covered services. This dual coverage expands your healthcare options and can help the IHS function more effectively by covering costs for services received at its facilities.

Steven A James, MBA · Answer

Great question, 

Again, Medicare is a federal medical insurance program for those who turn 65 or before 65 due to permanent disability.

Although you're not required to enroll, it's generally medical insurance for the remainder of your years.  If you have more involved and/or complicated surgeries or necessary hospital stays, the tribal health service may not be fully adequate

If you've worked 10 years/40 quarters, you're fully "vested" and thus would pay no premium for Part A, which covers hospitalizations.  Medicare Part B is the medical insurance for doctor and specialist visits, outpatient surgery, and more.  However, Part B does have a monthly premium, which will be $206.50.  If this is a challenge, one would typically contact State Medicaid for further guidance and assistance.  I'd also consult with the tribal health benefits office to inquire if they provide any similar support.

Much of this also depends on where you live.  I happen to live in the Seattle area, and there are multiple noteworthy tribes.  Members may visit tribal clinics ,but because they're so close within the greater metro area, they'd also have access to the same hospitals and clinics as the general population.

Steven James
Contact me.

Deb Haley · Answer

Indian Health Services is a government program that American Indians and Alaskans are eligible for. While they are also eligible for Medicare they do not have to use it. However Medicare may provide some additional benefits in addition to what they get thru IHS.

Answered by Deb Haley on August 16, 2025

Broker Licensed in MA, AZ, CA & 11 other states

Answered by Deb Haley Medicare Insurance Agent

Valentina Gatewood · Answer

Medicare can be helpful for accessing any treatment or emergency services outside of the Indian Health Service. You have the option for only having part A, or part A & pat B. Keep in mind any penalties, or MAPD qualifications.

Answered by Valentina Gatewood on October 6, 2025

Broker Licensed in CA, AZ, ID & NJ

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Arleda Lagrone-Pittman · Answer

It's good have Medicare as an option if you need to see a doctors and hospitals outside of the Indian Health Medical Service. Also, Indian Health care is not considered credible with the federal government, you could incur penalties.

Answered by Arleda Lagrone-Pittman on March 2, 2026

Broker Licensed in NE

Answered by Arleda Lagrone-Pittman Medicare Insurance Agent

Fred Manas · Answer

While receiving care through the Indian Health Service (IHS) at no cost, you are not automatically required to have Medicare. However, if you are 65 or older, or have a disability that qualifies you for Medicare, you can still enroll in Medicare and it can work alongside IHS to provide comprehensive coverage.

Answered by Fred Manas on April 24, 2025

Agent Licensed in NY, CT, DC & 7 other states

Answered by Fred Manas Medicare Insurance Agent

Gary Henderson · Answer

That depends on if you travel because if you receive all your health plans close to your home that's fine while you're close to home. But if you move or go to a outside hospital because the tribal hospital cannot address your needs then it's a good idea to have Medicare

Answered by Gary Henderson on June 3, 2025

Agent Licensed in TX, AK, AL & 46 other states

Answered by Gary Henderson Medicare Insurance Agent

Suzanne Lamperti · Answer

Medicare does not cover any services provided through Indian Health Services. Call Medicare to see if you still need to sign up.

Jack Mayer · Answer

Tribal members on IHS don't need to enroll in Medicare but there would be serious long term consequences since IHS may not cover everything and can be underfunded. Many Tribal members take Medicare and enjoy coverage off the res. If you don't take Medicare and decide to later there will be late enrollment penalties for life

Answered by Jack Mayer on March 16, 2026

Agent Licensed in CA & NV

Answered by Jack Mayer Medicare Insurance Agent

Sam Silva · Answer

When you have Medicare, IHS can bill Medicare for covered services, which helps stretch the IHS budget and allows them to provide more care to the community.
If you ever need to see a doctor or go to a hospital that isn’t part of IHS, Medicare will cover those costs, while IHS generally will not. Without Medicare, you could be responsible for the full cost of any non-IHS care.

Shahwali Hotaki · Answer

You don’t have to enroll in Medicare if you get all your care through IHS, but it’s usually recommended. IHS isn’t health insurance—it only covers IHS facilities. Medicare gives you coverage anywhere, helps with prescriptions, and avoids late penalties if you enroll on time.

👉 In short: Not required, but smart to have for broader care and to avoid future penalties.

Tony Hardwick · Answer

No, in that case Medicare isn't necessary, but they are eligible to enroll as long as they meet standard eligibility requirements. Tribal members can choose to enroll in Medicare and use it along with IHS care for services not available through IHS.

Answered by Tony Hardwick on April 28, 2025

Broker Licensed in GA, AL, AR & 32 other states

Answered by Tony Hardwick Medicare Insurance Agent

Patrick Stinson · Answer

While receiving care through the Indian Health Service (IHS) at no cost, you are still eligible to enroll in Medicare. Medicare is a separate federal health insurance program for individuals 65 and older, or those younger with certain disabilities. 
Here's why it's beneficial to have both:
Expanded Coverage:
Medicare can provide additional benefits and coverage, especially for specific medical needs not always covered by IHS. 
Flexibility:
Medicare allows you to access specialists and other providers outside of IHS facilities, according to Healthline. 
Financial Stability:
Medicare can provide financial protection against unexpected high medical costs, says Medigap.
Tribal Support:
Many tribes encourage or support their members to enroll in Medicare. 
Key Considerations:
Enrollment:
You can enroll in Medicare regardless of your IHS eligibility. 
Cost:
While Medicare itself can have premiums, some plans offer lower or zero-cost options, according to MedicareFAQ. 
Coordinating Care:
Your IHS provider can help you understand how Medicare and IHS work together. 
Additional Insurance:
You might also consider supplementary insurance or a Medicare Advantage plan for more comprehensive coverage, according to MedicareFAQ. 
For more information and guidance, consult your IHS provider or the Centers for Medicare & Medicaid Services (CMS).

Jermaine Williams · Answer

If you are 65 of older you may still be required to have Medicare. Just like VA, veterans are still required to enroll in Medicare

Leisha Stevens · Answer

You are not required to enroll in Medicare if you already receive care through the Indian Health Service (IHS). However, enrolling is highly recommended because it acts as secondary coverage, giving you access to specialists and hospitals outside the IHS network.

Answered by Leisha Stevens on May 26, 2026

Broker Licensed in OH, CA, FL & NC

Answered by Leisha Stevens Medicare Insurance Agent

Tosha Morell · Answer

While you’re eligible for care through the Indian Health Service (IHS) at no cost, IHS isn’t considered comprehensive health insurance, it’s dependent on federal funding and availability of services.

Answered by Tosha Morell on November 2, 2025

Agent Licensed in GA & FL

Answered by Tosha Morell Medicare Insurance Agent

Elliot Andrews · Answer

No, Medicare is not required for anyone.  If someone is eligible for Medicare it is always worth considering as a healthcare option, but it is not required.

Michael Hixson · Answer

Let me ask you a question, are you ever in need of care and not be close to a Tribal Health Facility? I bet the answer is Yes. I am Michael Hixson and I am Cherokee and live in the Oklahoma City Metro Area and the closest Indian Hospital is in Ada, Oklahoma over an hour away. Yes, you could go to a local Emergency Hospital but you better submit your claim within 72 hours to Indian Health Services and then hope that it gets approved. With having Original Medicare, you have more options for your health care and have peace of mind that you won't be paying 100% of the bill. If you are Native and need help with your Medicare Options, give me a call. I can explain your unique situation.

Answered by Michael Hixson on April 28, 2025

Broker Licensed in OK, AR & TX

Answered by Michael Hixson Medicare Insurance Agent

Ricky Gonzalez · Answer

Even if you receive care through Indian Health Service at no cost, enrolling in Medicare is still important because it helps expand your access to care outside the IHS system, especially for specialized treatments or emergencies. 

Medicare also helps fund IHS when they bill Medicare for your care, which strengthens the resources available to you and your community while protecting you in case you ever need services IHS doesn’t provide.

Gabrielle Sones · Answer

No, it's not mandatory, but it's still advised to go ahead and enroll when you are eligible. If you decide to enroll later on there could me penalties.

Mark Mullinax · Answer

The short answer is no. If you decide to enroll in medicare it could help pay for treatments for yourself, which in turn would help to save tribal funds since the tribe is putting out all pf the money for you now I hope this helps with your decision.

Answered by Mark Mullinax on March 2, 2026

Agent Licensed in GA, AL, FL & NC, SC, TN & TX

Answered by Mark Mullinax Medicare Insurance Agent

I am a member of a federally recognized tribe here in Arizona. I receive all my medical needs through the Indian Health Service at no cost. Do I still have to have Medicare?

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I am a member of a federally recognized tribe here in Arizona. I receive all my medical needs through the Indian Health Service at no cost. Do I still have to have Medicare?

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