The Role of Medicare and the Indian Health Service for American Indians and Alaska Natives: Health, Access and Coverage

Relative to the overall U.S. population, American Indians and Alaska Natives face persistent disparities in health status, access to health care, and other socioeconomic disadvantages, including higher rates of poverty. Even with Medicare coverage, American Indians and Alaska Natives who are age 65 and older or who are living with permanent disabilities experience these problems at comparatively high rates.

This report, divided into four sections, examines these disparities and describes the roles of both the Indian Health Service (IHS) and Medicare in providing access to health care for American Indians and Alaska Natives. The first section draws from recent surveys and other data sources to compare health and other socioeconomic indicators among elderly American Indians and Alaska Natives to the overall population age 65 and older. The second section of this report describes the ways that IHS and other sources of coverage (including Medicare, Medicaid, and private insurance) may and may not provide access to health care services for elderly and disabled American Indians and Alaska Natives. The third section explores the intersection of Medicare and the IHS in health service reimbursement, patient cost sharing, and access to care, and then discusses the implications of potential barriers to enrollment in federal or state programs that could assist American Indians and Alaska Natives with out-of-pocket expenses for health care. The report concludes with a discussion of some of the future challenges and opportunities for improving access to care for American Indians and Alaska Natives through Medicare and the IHS.

Population of focus: Elderly American Indians and Alaska Natives

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Date: 2014

Organization: Kaiser Family Foundation