S moke S ignals
july 15, 2014
FAQs regarding the Affordable
Care Act (ACA)and Skookum
Health Assistance Program
Question: What if I already have insurance through my job or am
already on Medicaid?
Answer: If you have health insurance through your employer or have
health care through a government-sponsored program, such as Medi-
care, Medicaid, CHIP, Veterans Affairs or TRICARE, there is nothing
you need to do – you are covered.
Question: I have Contract Health Services. Do I still need to apply?
Answer: Yes, if you do not have primary insurance coverage, you will
need to apply.
Question: Isn’t my Skookum Health Assistance Program an insur-
ance?
Answer: No, Skookum is not an insurance plan. Therefore, it is not
considered to be insurance by definition. You should not reference
Skookum as insurance, as it is not. It is assistance you receive from
the Tribe because you are an enrolled Tribal member.
Question: Am I required to pay for insurance through my employer?
Answer: We encourage 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.
Question: I’m an American Indian/Alaska Native. What do I need to
know about the Health Insurance Marketplace?
Answer: The Health Insurance Marketplace will benefit American
Indians and Alaska Natives (AI/AN) by providing opportunities for
enrolling in affordable health coverage. You might be eligible to enroll
in a private health plan in the new Health Insurance Marketplace, or
you might be eligible for Medicaid or the Children’s Health Insurance
Program (CHIP). There will be one application to determine whether
you are eligible for a marketplace health plan, Medicaid or CHIP.
Question: What are the special protections for AI/ANs who enroll in
the Health Insurance Marketplace?
Answer: Members of federally recognized Tribes with a household
income at or below 300 percent of the federal poverty level (roughly
$70,650 for a family of 4 in 2013 or $88,320 for the same family in
Alaska) who are also eligible for the tax credit won’t have any out-of-
pocket costs like co-pays, co-insurance or deductibles for services
covered by their Marketplace health plan.
Question: How can I apply for an exemption from the shared respon-
sibility payment?
Answer: To get an exemption, members of federally recognized Tribes
may apply through the Marketplace or provide the appropriate informa-
tion when they file their federal income tax return. AI/ANs who aren’t
members of federally recognized Tribes, but who are eligible for or get
services from an I/T/U, (Indian Health Service, Tribal clinic or urban
Indian clinic) must apply through the Marketplace and will need to verify
their AI/AN status or eligibility for services through an I/T/U.
Question: Will I be able to get assistance with paying the cost of my
premium if I enroll in a Marketplace health plan?
Answer: While AI/ANs are NOT exempt from paying premiums, they
may be able to get lower costs on monthly premiums through a new tax
credit that is paid to insurance plans each month to reduce an individ-
ual’s premium. Eligibility for the tax credit depends on income, family
size and access to other coverage. Members of federally recognized
Tribes can use tax credits to pay for premiums on certain plans and
still receive cost-sharing reductions as well. The type of cost-sharing
reduction depends on income and whether an individual is enrolled in
a zero cost-sharing plan or limited cost-sharing plan.
Question: Are there special protections for AI/ANs who enroll in
Medicaid?
Answer: AI/ANs who are eligible for or get services from an I/T/U,
including Contract Health Services, are exempt from Medicaid pre-
miums and enrollment fees and, if they have ever used one of these
programs, they are also exempt from other cost sharing, such as co-
payments, co-insurance, and deductibles. Certain Indian resources and
payments are not counted for Medicaid eligibility. AI/ANs can continue
to get services through an I/T/U even if the I/T/U is not a provider in a
managed care network.
Links to assist you in learning more about
the ACA and Marketplace products:
• www.healthcare.gov: Click on see plans now;
• www.coveroregon.com: Go to learn more and click on the link.
If you have questions, please contact
• Tresa Mercier, tresa.mercier@grandronde.org
• Loretta Meneley, loretta.meneley@grandronde.org
• Melody Baker, melody.baker@grandronde.or
• Barbara Steere, barbara.steere@grandronde.org
Or call 800-775-0095 to speak to anyone listed above.
1
ATTENTION TRIBAL
MEMBERS WITH CONTRACT
HEALTH SERVICES
As most of you are aware, Contract Health Services (CHS) is a feder-
ally funded program and a payor of last resort. With all of the health
care changes recently, we would like to take a minute to remind you that
ANY alternate resource you have needs to be utilized correctly. That
means in order for CHS to cover a “patient responsibility,” you must use
providers who are in-network with whatever health care coverage you
have primary, including the Tribal Health Assistance Program, Skoo-
kum. If you choose not to use providers who are in-network or receive
services that are not covered, you will be responsible for any patient
balance. Services include: Medical, Dental and Behavioral Health. We
apologize for any inconvenience this may cause you, but to keep serv-
ing our Tribal community, we must exhaust all other resources available
to our membership.
CHS also wants to remind you that there are some services that
are not covered by CHS, but are covered by Skookum. If you choose
to receive these services, you will be responsible for paying the co-
payments. They are as follows: Chiropractic care, Naturopathic care,
Massage and Acupuncture, as well as outpatient drug and alcohol
treatment. This does not mean that you cannot use those services; it
simply means that CHS will not be responsible for any patient balances.
You can still keep those appointments; you just need to pay whatever
your co-pay is. We understand that this can all be a little confusing, so
please feel free to give us a call if you have ANY questions and we’ll be
happy to help.
• Tauni McCammon, 503-879-1406
• Erica Mercier, 503-879-2080
• Melody Baker, 503-879-2011
• Tresa (Teri) Mercier, 503-879-2008
Free online learning source
The information includes:
Everyday life
Math and money
Computer training
Online classes
Work and career information
Check it out at www.gcflearnfree.org
CTGR Recreation Department
Gymnasium-Fitness Center
Hours/Access Updates
Hours of Operation:
6am – 9pm Monday – Friday
8am – 12pm Saturday
Closed
Sunday
*Hours of Operation are subject to change without notice due to scheduled events.
Fitness Center Access:
Tribal/Community 6am – 8am & 5pm-9pm (Monday-Friday) Contact Security
8am – 5pm (Monday-Friday)
Contact Recreation/YED
8am – 12pm (Saturday)
Contact Security
*Access is granted to Tribal/Community Members only during the hours above.
Everyone who enters the gym or fitness center from 6am-8am & 5pm-9pm must sign-in.
CTGR Employees
Access by Employee Badge
*In the event your employee badge does not grant access to the gym after hours,
contact Security, show your employee badge, and the officer on duty will let you in.
Age Access Policy:
MUST Be 18 years or older to be in the Fitness Center
Youth 13-17 may use the Fitness Center with adult supervision (over 18)
Youth 8-12 may access the Fitness Center with adult supervision, but
may not use equipment.
Youth ages 7 and under are not permitted in the Fitness Center
Contact information:
Recreation Staff
Recreation Coordinator
Recreation Assistant
(Matt Mosley)
(Kendra Steele)
503-879-1369
503-879-1921
YED Front Desk
Administrative Assistant
(Tiffany Mercier)
503-879-2101
Security
503-879-2183