A new report from the Kaiser Family Foundation examines the role of both Medicare and the Indian Health Service (IHS) in providing access to health care for about 650,000 American Indians and Alaska Natives who are age 65 and older or who have permanent disabilities. While Medicare provides important health care coverage for most in this group, its relatively high cost-sharing and gaps in benefits can be problematic for American Indians and Alaska Native Medicare beneficiaries who do not have additional supplemental coverage or who cannot access IHS providers.

Using the most recent data available, this report shows that elderly American Indians and Alaska Natives face persistent disparities in health status, access to health care, and other socioeconomic disadvantages relative to the overall U.S. population age 65 and older.  The report explains the intersection of Medicare and the IHS in health service reimbursement, patient cost sharing, and access to care, and then discusses the implications of potential barriers to enrollment in federal or state programs that could assist American Indians and Alaska Natives with out-of-pocket expenses for health care.  It concludes with a discussion of some of the future challenges and opportunities for improving access to care for American Indians and Alaska Natives through Medicare and the IHS.

A previous brief provides an overview of health coverage and care for American Indians and Alaska Natives in 2013, as well as an examination of the potential implications of the ACA coverage expansion.  The new report, as well as more information on Medicare and disparities between populations in health and access to care, can be found at kff.org.