Tribal Member Health Plan Information
For the past year, the Wichita Executive Committee, has been working toward the development of a Tribal Member health care Plan that will provide access to quality medical, dental, and vision care for all Tribal Members. Many of our members have no health insurance and those of us who do have insurance find that the high deductibles, and co-pays we are required to pay are often the reason we delay needed healthcare.
The Tribal Member Plan meets the specific needs of all our Tribal Members, regardless of age or existing health conditions. The Plan has been developed with special consideration given for the unique needs of infants, children, working age adults, and elders. The Plan benefits are unlike any "standard" insurance products. It is a Native American benefit plan developed by Native Americans for Native Americans.
The Wichita Executive Committee has unanimously approved the Tribal resolution authorizing the implementation of the Wichita and Affiliated Tribes Tribal Member Health Plan.
We believe that the plan will grow to cover more and more benefits in higher amounts in the coming years. This plan will only be allowed to cover enrolled members of the Wichita and Affiliated Tribes.
Here are some of the highlights:
- Benefits limit is $1,500 per year
- YOU WILL NOT GET 1099'S OR HAVE TO PAY TAXES ON THESE SERVICES!
- Maternity care and newborn baby care
- Physician office visits, including all child immunizations
- Inpatient and Outpatient hospital care
- Emergency room visits
- Diagnostic testing including CT scans, MRI's, and lab tests
- Preventive care including mammograms, colonoscopies, and annual physicals
- Hospice care and hospice supplemental coverage for end of life final expenses
- Home health nursing care to help our elders who are homebound due to illness
- Skilled nursing facility care
- Prescription drug benefits for all ages including our elders who are on Medicare
- Dental benefits for all Tribal Members young and old
- Vision care benefits
- Each Tribal Member will receive our own personalized health care identification card the guarantees access to medical, dental and vision care at any provider without complicated paper work or extended delays. The identification card works the same as any health insurance card. Our Tribal Member Health Benefit Plan identification card insures "access" to care when we need it, wherever we choose to go. Networks have been set up all over the country and even out of the country to help make our dollars stretch and so you have minimal out of pocket expense.
Each enrolled tribal member will be enrolled in one of the following plans:
Plan A: This is for tribal members who have no health care coverage at all.
In Network, $20 copay for Physician Office Visits
Emergency Room is a $100 copay
Most all other services pay 90% of the charges without a deductible to the plan maximum for Medical Insurance
Prescriptions: Copays $0 Generic; $25 Name Brand Prescriptions up to $500 each year per member
Plan B: This is for tribal members who already have insurance to include Group Health Plans, Medicare, Medicaid or any other type of health insurance coverage already taken.
In Network, no copay for Physician Office Visits
Emergency Room $25 copay
All other services pay at 100% in network to the plan maximum after the primary coverage has paid.
Prescriptions: Copays $0 For Prescription balances not paid by the Primary Insurance Payment up to $500 each year per member
1. RX is limited to $500 per Member per benefit year.
This will be paid through the VSP network with the following:
- Eye Exam every 12 months, Frames or Lenses every 24 months paid at 100% up to $150.
Pays 100% for teeth cleaning, x-rays and twice yearly checks ups.
Basic services such as fillings will be paid at 90%
Major services such as crowns will be paid at 80%
All services are subject to a total of $400 per member per year
End of Life Expenses Benefit
This benefit pays the lessor of actual cost or $7,000 for the following:
- Hospice Care
- End of Life Home Care
- Funeral dinner expenses
- Funeral Expenses
All expenses will be paid directly to the vendor providing the services.