S moke S ignals
FEBRUARY 1, 2015
Save Our Skookum team
‘We look forward to working with you’
Photo by Michelle Alaimo
From left, Sydney Clark, Certified Applications
assister, Tauni McCammon, Contract Health
specialist, Erica Mercier, Contract Health specialist,
Barbara Steere, Health Benefits specialist, Tresa
Mercier, Health & Wellness Business Office manager,
Loretta Meneley, Certified Application assister, and
Melody Baker, Senior Contract Health specialist, are the Tribe’s Save
Our Skookum team.
Important tax exemption
information for Native Americans
11
Overcoming obstacles
to dental care
The Save Our Skookum team hopes to make accessing dental care
easier for Grand Ronde members. Starting in January 2015, the Skookum
Health Assistance Program will be changing the way payment for dental
care is made. Dental services will no longer be paid at a percentage of the
fee charged to the program. Dental treatment will be paid at the approved,
charged amount, up to the amount available by the Skookum Health As-
sistance Program. Hopefully, this new way of paying for dental services
will increase Tribal members’ participation in receiving dental treatment.
As always, any primary dental coverage you may have needs to be
used first. To avoid denials of payment by Skookum, make sure you use
in-network providers for any primary dental coverage you may have.
We know this may sound confusing and ask that if you have any
questions, call one of the SOS team members and we will be happy
to explain it further.
The following services are not covered by Skookum or are
covered under medical, as stated:
• Cosmetic procedures;
• Personal care items;
• Splints;
• TMJ periodontal splinting;
• Gold dental treatment;
• Culture and biopsy covered under medical.
*Hospital Services – These services may be covered under the
medical provisions of the health plan with proper documentation of
medical necessity; hospital outpatient services, including anesthesia
for pediatric dental.
Tresa Mercier: tresa.mercier@grandronde.org
Barbara Steere: barbara.steere@grandronde.org
Melody Baker: melody.baker@grandronde.org
Tauni McCammon: tauni.mccammon@grandronde.org
Erica Mercier: erica.mercier@grandronde.org
Sydney Clark: sydney.clark@grandronde.org
Loretta Meneley: loretta.meneley@grandronde.org
Any member of the SOS team also can be reached at 1-800-775-0095.
Certified Application
Assister sets Portland dates
Certified Application Assister Loretta Meneley will be at the Tribe’s
Portland office, 4445 S.W. Barbur Blvd., from 10 a.m. to 3 p.m. Tuesday,
Feb. 10 and 24, and Tuesday, March 10 and 24, to provide information
and answer questions about applying for an exemption from the shared
responsibility payment, as well as to sign up members for health insurance.
For more information, contact Meneley at 503-879-1359 or by e-mail at
loretta.meneley@grandronde.org. n
Fee assistance
An important announcement was made recently by Health and
Human Services Secretary Sylvia Burwell that individuals eligible to
receive health care from an Indian Health Service, Tribal or urban
Indian health care provider will be able to claim an exemption from the
shared responsibility payment through the tax filing process starting
with the 2014 tax year.
This benefit gives individuals who are eligible to receive services
from an Indian health care provider, including the IHS and Tribal clin-
ics, the same filing option as members of federally recognized Tribes
(including Alaska Native shareholders). Both groups will continue to
have the option of submitting the exemption application through the
Health Insurance Marketplace.
Before the announcement, exemptions were available both to in-
dividuals who were members of a federally recognized Tribe and to
individuals who are eligible to receive services from an Indian health
care provider. But members of a Tribe were able to claim an exemption
through the federal tax filing process while individuals who are eligible
to receive services from an Indian health care provider were required
to obtain this exemption through the Health Insurance Marketplace
by filing a paper application.
The availability of the tax filing process to apply for the Indian
health care exemption will save time and reduce the duplication of
effort. Individuals intending to claim this exemption through the tax
filing process should retain the same documentation that they would
otherwise submit to the marketplace as part of their exemption appli-
cation. Above is a diagram to illustrate how to meet Affordable Care
Act requirements for all Americans and individuals eligible for IHS.
If you have questions about the exemption, call Loretta Meneley,
Certified Application Assister, at 800-775-0095 or 503-879-1359. n
Enrolled Tribal members can request assistance with test fees (i.e. GRE,
SAT, LSAT, ACT) and admissions application fees. Contact Higher Educa-
tion for more information at 1-800-422-0232, ext. 2275. n
IF YOU WANT TO
SAVE ON
HEALTH INSURANCE,
THERE’S ONLY ONE
PLACE TO SHOP.
Premium discounts. Cost-sharing subsidies. Low-cost coverage.
Enroll now at:
HealthCare.gov
Need help choosing the right plan?
Find an agent at CoverOregon.com
Paid ad