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Health Insurance Signups

March 4, 2014


Navigators assist with health coverage
BISMARCK (UTN) – A team of health insurance experts made a house-call February 6 at United Tribes Technical College.
           “We’re focusing on the students and staff at United Tribes because we really want them to know of the benefits of having health insurance,” said Tinka Duran (Sicangu Lakota/Rosebud).
           Duran manages the Navigator Program of the Great Plains Tribal Chairman’s Health Board, headquartered in Rapid City, SD. She supervises two people each in South Dakota and North Dakota. All are tribal members with experience in “navigating” the health insurance marketplace of the Affordable Care Act, or Obama-Care.
           The uninsured Native population in North Dakota is about 32 percent, or one-in-three, according to Duran. In South Dakota about 44 percent are without insurance.
           The day-long session at UTTC’s wellness center was aimed specifically at reaching tribal students.
           “Many students are eligible for free or low-cost health insurance,” said Duran.
           At UTTC the navigators assisted two dozen clients, describing the benefits, providing information and in some cases going online and enrolling them in plans. Two of those who signed up were single men.
            “It’s especially beneficial that the State of North Dakota has expanded Medicaid,” said Duran. “So many people are now eligible and especially single men, whereas in the past they were not.”
           Signing up for Medicaid involves calling an 800 number and answering a series of questions to see if an individual is eligible.
            “If a person makes less than $34,470 annually and is a member of a federally recognized tribe, there are no co-pays and no deductibles no matter where they go,” said Duran.

           For those not eligible it means shopping in the health insurance market place.
“Many of our people who go to the market place are getting free or very low-cost health insurance,” said Duran.
           The number of signups under the new health insurance law has been on the rise since the first of the year, both nationally and in the region; a contrast to the slow roll-out in the fall.
           Taking a look at the program gives people a chance to see what they’re eligible for, according to Duran. They don’t have to take the insurance. But for those hindered by funding shortfalls of the Indian Health Service, the new system can produce almost immediate results.
           “I had a women come in the other day with a chip in her elbow. She was told it would be six months to a year to be referred-out and get fixed,” said Duran. “She was able to sign up in the marketplace…for totally free health insurance. She was so excited. When the insurance kicked-in she was going to have her elbow taken care of.”
            March 31 is not a deadline that members of federally recognized tribes need to be worried about. Special provisions in the Affordable Care Act allow members to enroll whenever they need or want. They’re not tied to annual enrollment dates and deadlines required of non-Indians.
            Duran says that health care is viewed as an extension of treaty rights and the new law should be seen as another opportunity to access the health care services that tribal people need.
            The Great Plains Navigator Program is currently funded by the Center’s of Medicaid and Medicare through August 2014. In North Dakota, navigator Elaine Keepseagle serves Bismarck, Standing Rock, Three Affiliated and the Trenton Indian Service Area. The other North Dakota tribal areas, Turtle Mountain, Spirit Lake and Sisseton-Wahpeton, are served by Sandy Lujan-Delorme.
           “This is a great opportunity for people of the tribal community to make sure they can get the health care services they need,” said Duran urging tribal people not to miss out.
            United Tribes Technical College will continue hosting sign-up sessions at its wellness center.
           “This is a great service for United Tribes staff and students,” says Marsha Azure, director of UTTC’s Community Wellness Services.
           Navigator Elaine Keepseagle from Standing Rock will be available on site periodically to continue assisting students and staff members with information and/or signing up. To schedule an appointment, please contact Lora Grey Bear at the Lewis Goodhouse Wellness Center, United Tribes Technical College, 701-255-3285 x 1264, lgreybear2@uttc.edu.


  • Social Security Numbers
  • Tribal Enrollment Documents (CIB, BIA form, Tribal ID)
  • Pay stubs, W-2 Forms, or Wage and Tax Statements
  • Policy Numbers for Current Health Insurance


  • Exempt from open enrollment deadline
  • Not required to maintain minimum health insurance coverage
  • Cost sharing reductions for those eligible for services from an Indian health care provider
  • No out-of-pocket expenses for individuals earning less than $34,470/year or families of four earning less than $70,650/year, like co-pays for services covered by their marketplace health insurance plan


  • Lower costs of health insurance premiums
  • Increased access to health care
  • Supplement and strengthen HIS
  • Permanent reauthorization of Indian Health Care Improvement Act
  • Medicaid expansion in ND

Great Plains Tribal Chairman’s Health Board
1770 Rand Road, Rapid City, SD 57702
Toll Free1-877-209-1215

Sandy Delorme-Lujan (Turtle Mountain), health insurance navigator, counsels a United Tribes staff member February 6 about health insurance coverage through the Affordable Care Act.

Tinka Duran, Health Insurance Market Place program manager




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