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 is not an insurance company. 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.
Circle of Health provides additional benefits for specific items such as hearing aids, eyeglasses, orthodontia, and durable medical equipment for enrolled tribal members only. All enrolled members are eligible for Circle of Health benefits no matter where they live.
Circle of Health is the payer of last resort. All other means of health care insurance or third-party payment must be exhausted before Circle of Health will make payment. All members must apply for alternate resources and remain compliant with such programs.
Circle of Health requires all Band member households to enroll and update annually in order to maintain accurate and current personal information.
– Active primary insurance coverage.
– All Medicare recipients must submit their annual awards letter in order to receive Medicare reimbursements
– Tribal/CIB’s for all enrolled members
– SSN’s for everyone on the policy
– Birth Certificates for all non-band member dependents and descendants
– Marriage Certificate for spouses
– Court order for name changes/ Divorce decree.
Medicaid determination (must update when there is a change of circumstance)
Guardianship Paperwork, Custody, or Court orders for all permanent or temporary guardians (must update unless permanent)
Band members can contact Circle of Health for Health Insurance enrollment or Benefit coordination questions or issues. We are here to help you!
Band members can contact a claims processor regarding their individual claims or reimbursements. The alphabet is divided according to Band members’ last names.
Claims Processor for A-F
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 Circle of Health Director.
Forms and Links
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