Circle of Health

Circle of Health is a tribal member benefit program for enrolled members and their descendants under 18 years of age. Circle of Health program pays for deductibles, co-insurance, copays, and premiums. Circle of Health is the payer of last resort. All enrolled members are eligible for Circle of Health benefits no matter where they live.

Meet the Circle of Health Staff – Summer 2015

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pictured left to right: Roberta Lemieux, Pamela Spears, Jamie Rancour, Ginger Weyaus, Shirley Boyd, Deb Smith, Bonnie John

Circle of Health Monthly Update – February 2017

MNsure Update – Enrolling Outside of Open Enrollment – February 2017

 Enrolling Outside of Open Enrollment: With the end of open enrollment Minnesotans who want to purchase private insurance through MNsure will have to apply for a special enrollment period (SEP). For more information on SEP’s please see February’s webinar, Enrolling in coverage outside of Open Enrollment, and MNsure’s Guide to Special Enrollment Period. Remember, members of federally recognized American Indian tribes may enroll through MNsure or change plans one time per month, year-round, and Minnesotans can enroll in Medical Assistance or MinnesotaCare at any time.

 Circle of Health Forms 

MNSure Offers Low-Cost Cobra Alternative

For people who have experienced a job loss, COBRA can be expensive. Did you know MNsure provides an alternative that could save you money? If you lose your health insurance due to a layoff or experience another qualifying life event, you could be eligible for a special enrollment period to get health coverage. Find out how to enroll or call us at 1-800-491-6106 to explore your affordable options.

Claims Processors

Band members can contact a claims processor regarding their individual claims or reimbursements. The alphabet is divided according to Band members’ last names.

Roberta Lemieux, Claims Processor for A-F: 320-532-7724

roberta.lemieux@hhs.millelacsband-nsn.gov

Deb Smith, Claims Processor for G-N: 320-532-8903

deb.smith@hhs.millelacsband-nsn.gov

Bonnie John, Claims Processor for O-Z: 320-532-8904

bonnie.john@hhs.millelacsband-nsn.gov

Reimbursements

For reimbursement claims, please allow a two- to six-week grace period from the date of submission to process. If you have not received a reimbursement or denial after six weeks, contact your Claims Processor or the Health Benefits Administrator.

Premiums

Circle of Health supplements the Band member’s primary insurance coverage by paying or reimbursing premiums, co-pays, and deductibles for insurance covered services. One policy per family/household is allowed.

Enrolled Tribal Member Coverage Only

Circle of Health also pays for specific items such as hearing aids, eyeglasses, orthodontia, and durable medical equipment for enrolled tribal members only.

Circle of Health Enrollment

To assist Circle of Health with collecting accurate and current personal information from Band members, Circle of Health requires Band member households to enroll and update annually with Circle of Health. Circle of Health works in collaboration Band members will be informed if they need to update.

Amber Kalk, Intake Specialist, 320-532-7740

amber.kalk@hhs.millelacsband-nsn.gov

Health Insurance Enrollment / Benefit Coordination

Band members can contact Circle of Health for Health Insurance enrollment or Benefit coordination questions or issues. We are here to help you!

Pamela Spears, Benefits Coordinator, 320-384-4603 – HINCKLEY OFFICE

pamela.spears@hhs.millelacsband-nsn.gov

Jamie Rancour, Benefits Coordinator, 320-532-4781 – NE-IA-SHING CLINIC OFFICE

jamie.rancour@hhs.millelacsband-nsn.gov

Circle of Health Administration

Ginger Weyaus, Circle of Health Director: 320-532-7723

ginger.weyaus@hhs.millelacsband-nsn.gov

Shirley Boyd, Administrative Assistant: 320-532-7741

shirley.boyd@hhs.millelacsband-nsn.gov

Contract Health Service Update – March 16th, 2015

Circle of Health no longer manages the Contract Health Services program. You can contact the Contract Health Program Hotline at 1-855-502-6247 or the Ne-Ia-Shing Health Center at 1-888-622-4163 or 320-532-4163.

The CHS program is for medical/dental care provided away from our tribal health care facility. CHS is not an entitlement program. A CHS referral does not imply the care will be paid. The patient must meet residency requirements, notification requirements, medical priorities and use of alternate resources. Be aware the requirements each time you are referred or request CHS to pay for medical care away from the clinic.

What is a CHSDA? – The Mille Lacs Band of Ojibwe’s Contract Health Service Delivery Area also known as CHSDA consists of four counties in Minnesota: Aitkin, Kanabec, Mille Lacs and Pine.

Who is CHS Eligible? – CHS will be made available as medically indicated, when necessary health services by (IHS) are not reasonably accessible or available…” American Indians /Alaska Natives must also fall within these categories:

  • Reside within the US and on a reservation; or
  • Does not reside on a reservation but resides within a CHSDA; and/or
  • is a member of tribe which reservation was established, and/or
  • maintains close economic and social ties with the tribe (employed, married..)
  • exceptions – students, transients, other persons

To determine eligibility, all American Indians / Alaska Natives must register as a patient with the Ne-Ia-Shing Health Center and provide proof of tribal enrollment or decendency, and proof of residency.

More information on Contract Health Services can be found on the IHS website: www.ihs.gov/chs/

If the patient does not have health insurance, the patient must apply on MNsure to continue CHS eligibility.

MNsure – Medicaid, MNCare & Insurance Plans - We also assist every patient and tribal member with enrollment with MNsure, signing up for health insurance on the State of Minnesota Health Insurance Exchange.

You can contact Circle of Health staff for assistance or sign yourself up on the MNsure website at www.mnsure.org

Affordable Care Act Facts – Did You Know?

As the April 15th tax season comes to a close, Circle of Health wants to ensure that every American Indian and Alaska Natives understands the benefits of the health care law.

  • Native Americans enrolled in a federally recognized tribe under a certain income level can qualify for reduced or no costs for a private health care policy, including low or zero out-of-pocket costs.
  • Minnesota has expanded Medicaid, you could be newly eligible!
  • Most single, adult Mille Lacs Band members and families are eligible for Medicaid or MinnesotaCare. If you qualify for a plan, Circle of Health will pay premiums for Mille Lacs Band members.
  • If you enroll in a private health care plan, you can still use Ne-Ia-Shing Health Center for you and your family’s health care.

Stop by the Circle of Health offices, located at the Ne-Ia-Shing Health Center, 43500 Migizi Drive in District I, Mille Lacs, Onamia, MN to sign up or inquire about health insurance for yourself and your family members.

We are here to help you! Give us a call at 1-800-491-6106.

American Indian Hardship Exemption Application

Every person needs to have health coverage or make a payment on their federal income tax return called the “shared responsibility payment.”  Some people are exempt from making this payment. This application includes 2 categories of exemptions. There are other applications for other categories of exemptions. You may apply for certain other categories of exemptions when you file your federal income tax return.

If you’re a member of an Indian tribe, you can ask the Internal Revenue Service (IRS) for this exemption when you file your federal income tax return. You do not need to ask for an exemption if you are not going to file a federal income tax return because your income is below the filing threshold. If you are not sure, you may want to ask for an exemption.

A revised hardship exemption application was developed to make it more user friendly for applicants.

To obtain the application for the hardship exemption, please view the following link: http://marketplace.cms.gov/getofficialresources/publications-and-articles/tribal-exemption.pdf