Smoke Signals 1 1
APRIL 1,2013
Save our Skookum (SOS)
Frequently asked questions
Q: What is the point of making members apply for Oregon
Health PlanMedicaid or other state coverage?
A: To save Tribal dollars. If you are eligible for a state plan, this
would become primary and pays claims before Skookum, which
saves Tribal funds.
Q: Does Tribal Council know you're doing this to the mem
bership? A: Yes. This was a directive from Tribal Council. (We are doing this
FOR the membership ... to benefit everyone by keeping the plan
sustainable.)
Q: What information can be submitted to the Skookum Sec
ondary Payer Group if I don't qualify for the state cover
age? A: Income verification, such as a pay stub or tax information showing
you are over the income limits would be acceptable.
Q: If I am an Elder receiving the Tribal Elder Pension, single
family of one, do I have to apply?
A: No, not if you are a single family of one, receiving the Tribal El
der Pension. The Skookum Secondary Payer Group will verify your
pension information with Member Benefits.
Q: If I am a married Elder receiving Tribal Elders Pension,
and my spouse is working, do I have to apply?
A: If you are a family of two, receiving Tribal Elders Pension, the
Skookum Secondary Payer Group will need to verify income informa
tion for your household to help determine whether or not you need
to apply for OHPMedicaid.
Q: If I have a primary insurance, do I have to apply?
A: No, not at this time. This will only affect Tribal members using
Skookum as their only coverage.
Q: Isn't my Skookum Health Program benefit insurance cov
erage? A: No, Skookum is not an insurance plan, therefore, it is not consid
ered to be insurance by definition. You should not reference Skookum
as insurance, as it is not. It is a benefit you receive from the Tribe
because you are an enrolled Tribal member.
Q: What happens if I do not comply?
A: Your claims will be suspended in a pending status at Shasta and
not paid until you fulfill your obligation. Once it is confirmed that
you have fulfilled your obligation, we will instruct Shasta to process
and pay your claims.
Q: I might be getting a job soon; if I do, should I drop my
Medicaid?
A: Keep your Medicaid until you have new coverage in effect and
notify Medicaid of your change in status.
Q: How do I apply for Medicaid?
A: Many states have an online application and eligibility information
or you can call the Department of Human Services in your state to
learn about what is available to you.
Q: Will there be Tribal staff available to answer my questions
about applying for Medicaid?
A: Yes, there will be Tribal staff available to assist you with ques
tions. Q: Am I required to pay for insurance through my employ
er? A: We encourage those Tribal members with alternate resources,
such as employer sponsored insurance, to enroll in those plans and
use Skookum as a secondary coverage to pay for any balances that
are patient responsibility. But, at this time, you aren't required to
enroll in your employer plan if there is an associated premium that
you must pay. (But you may certainly choose to.) B
Thank you to everyone that has responded to this effort and
or provided necessary documentation. We look forwarding to
hearing from you! Please call with your questions. .
Skookum Health Plan Secondary Payer Team
Barbara Steere 503-879-2487; Tauni McCammon 503-879-1406;
Erica Mercier 503-879-2080; Melody Baker 503-879-2011;
Tresa Mercier 503-879-2008; Jim Holmes 503-879-2221.
Save Our Skookum
Dear Smoke Signals:
This is to all my fellow Tribal members for your consideration. Over
the past few months several things have happened in our Tribe that have
bothered me and should bother you, too.
One of our main issues as a people that we should be protecting is our
sovereignty. Over the past few years it seems that our Tribe has moved more
and more to getting people disenrolled and if you read some of the things
of how these people were asked to leave the Tribe you would be outraged.
I have concerns because what is to stop these people who clearly have an
agenda? What is to stop them from going after somebody else who they do
not like? Maybe they will come after you because you do not like them or
their family. Maybe they will come after you because they do not like your
political or social views.
I feel strongly that our strength is found in our people. If our ancestors
could see what our leaders are doing to our own people today I am sure
that our leaders would no longer lead. It should be our number one goal
to keep the people enrolled in our Tribe. You do not see those who were
adopted into our Tribe removed from our list, so why would we remove
those people who have been a part of our Tribe for years and have a true
blood lineage?
Certain people who come into power feel that because their paperwork
was not filled out correctly they should be asked to leave. Our Tribe has
been through a lot these past few years. You would think that our leaders
would be helping us get stronger as a people instead of forcing division
among us. The recession has been with us for quite some time and it does
not look like it is going to be leaving any time soon.
I know this has been a trying time for our Tribal people and as a Tribal
member I feel that we should be doing everything to ensure the strengths
and well-being of all Tribal members and their families. I understand that
we need to have cutbacks in the budget and stick to them as this is important
to the well-being of our Tribe and Tribal future. I do not think as a Tribal
member that we should be guaranteeing any company a three-year loan when
our per capita keeps dropping and we are asking people to leave our Tribe.
When me and my wife lived in reservation housing, we paid over $900 a
month. Now keep in mind, I am on Social Security disability and she worked
at the dental clinic at the time, and we were asked to pay $900 a month to
live on reservation land. We asked why the rent was so high. We were told
that the Tribe was basing rental rates out of Portland, which is two hours
away. There is more opportunity in Portland than there is on a reservation as
we have found and relocated, and we pay only $625 a month for a two-story
duplex. I really do wonder if the people who do not live here locally really
know what is going on. When they come here do they see that there is very
low Tribal employment, that there are a lot of nonTribal members working
for our Tribe, that a lot of those Tribal jobs are held by nonTribal members
who are making more money than most Tribal members?
Now these issues are certainly not new, but what is new is how much
it is getting out of hand. I know, and I'm sure most of you know, that the
recession is not going away. It is going to be here for awhile and I think as
a people we should be pulling together, keeping the people we have here
and strengthening our families and making our leaders more accountable
for their actions.
For example, those who voted to have people disenrolled. We should not
support that decision and we should not re-elect those leaders who support
that come election time. Our leaders have asked us to tighten up and be pa
tient that we're going through a recession. So I understand their point of view
and that is fine, but it does not seem to me that they understand our point
of view because not one of them have or is willing to take a cut in pay.
I strongly feel that we are all family and we should be looking out for
each other instead of tearing each other apart. Our government was almost
successful in this effort, so are we just continuing where they left off?
If we keep this up we will destroy our Tribe emotionally and spiritually.
I am asking you as a fellow Tribal member to contact the council members
and let them know what they are doing is wrong and that you will remem
ber their actions come re-election time.
Michael Bolton
Roll 4762
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