AI/AN DEFINITION AND VERIFICATION PROCESS
American Indian and Alaskan Natives may be eligible for special Washington Apple Health (Medicaid) protections and for special
benefits through the Health Benefit Exchange. Skip this section if no one you are applying for is of American Indian or Alaskan
Native descent. Complete the table below for anyone you are applying that is of American Indian or Alaska Native descent.1
Name of Person
Tribe Name
Eligible for Indian Health
Member of a Federally Descendant of a Federally
Services, Tribal Health
Recognized Tribe, Band, Recognized Tribe, Band,
Services or Urban Indian
Pueblo or Rancheria;
Pueblo or Rancheria;
Health Services, including
Shareholder in an Alaska Shareholder in an Alaska
as a California Indian,
Native Regional or Village Native Regional or Village
Eskimo, Aleut or other
Corporation
Corporation
Alaska Native
In order for AI/AN to receive special provisions and protections, there must be an Indian verification
process incorporated into the Exchange system. Tribes and urban Indian programs currently conduct
their own verification process prior to serving AI/AN in their health clinic; therefore, Certified Tribal
Assisters through the Washington Exchange In-Person Assister Program will have the ability to verify an
individual is an AI/AN as highlighted above. If an Indian individual receives assistance from a Tribal
Assister, the verification of that individuals Indian ‘status’ can be completed during the on-line
application process. The Tribal Assister can simply check the “Tribal Member Statement” box on-line
(see page 3 of this document) for those individuals they have already verified through other channels or
they can scan and download documentation provided by the Indian individual at the time the
application is being completed if verification has not already been completed (see Proof of Verification
form on page 2 of this document).
For those AI/AN who need to document their enrollment status and do not have the documentation
with them at the time of applying (either on their own or without a specific Tribal Assister), they can
become enrolled in a qualified health plan and be afforded the Indian provisions but will be required to
provide documentation of their Tribal enrollment status within 90 days of enrolling in an Exchange
qualified health plan. There is a “good faith effort” clause in the ACA language, meaning if an individual
has demonstrated a good faith effort of attempt to obtain documentation, there may be room for an
extension of time. Normally, if documentation is not provided with 90 days, the AI/AI will still be eligible
to participate in the qualified health plan, but they would no longer be eligible for the Indian provisions
described above.
1
Chart Source: WA Healthplanfinder Paper Application