This hub links to a Medicare guide for each of Oregon's nine federally recognized tribes. Each guide names the tribe's clinic as the tribe or the Indian Health Service (IHS) describes it, explains how Purchased/Referred Care works with Medicare, and lists plan facts for the county. The guides are published by Benefits Life, a licensed insurance agency. We are not affiliated with any tribe or with IHS; for eligibility and benefits, contact your tribe's health programs.
Oregon's federally recognized tribes and their clinics
| Tribe | Clinic | Where |
|---|---|---|
| Burns Paiute Tribe | Wadatika Health Clinic | Burns, Harney County |
| Confederated Tribes of Coos, Lower Umpqua and Siuslaw Indians | Three Rivers Health Center | Coos Bay, Coos County |
| Coquille Indian Tribe | Ko-Kwel Wellness Center | Near Charleston, Coos County |
| Cow Creek Band of Umpqua Tribe of Indians | Cow Creek Health & Wellness Center | Roseburg and Canyonville, Douglas County |
| Confederated Tribes of Grand Ronde | Grand Ronde Health & Wellness Center | Grand Ronde, Polk County |
| The Klamath Tribes | Klamath Tribal Health & Family Services | Chiloquin and Klamath Falls, Klamath County |
| Confederated Tribes of Siletz Indians | Siletz Community Health Clinic | Siletz and Lincoln City, Lincoln County |
| Confederated Tribes of the Umatilla Indian Reservation | Yellowhawk Tribal Health Center | Near Pendleton, Umatilla County |
| Confederated Tribes of Warm Springs | Warm Springs Health & Wellness Center (IHS) | Warm Springs, Jefferson County |
IHS's Portland Area serves tribes in Oregon, Washington and Idaho. In Oregon, the Warm Springs clinic is run by IHS; the other clinics listed are run by the tribes, as each tribe describes them.
How Purchased/Referred Care works with Medicare
When you need care your clinic doesn't provide, the clinic may refer you to an outside provider and pay through Purchased/Referred Care (PRC), formerly called Contract Health Services. Federal rules make IHS the payer of last resort: PRC does not pay when Medicare, Medicaid, private insurance or another resource would pay, or could pay if you applied (42 CFR 136.61). Each tribe sets its own PRC service area and approval rules, so ask your PRC office before you schedule outside care.
Medicare rules for American Indians and Alaska Natives
- Your clinic bills Medicare. CMS says you can keep using your Indian health care provider, and the provider bills Medicare for you. Those payments help the clinic serve your community.
- Part B. The standard Part B premium is $202.90 a month in 2026. IHS and tribal care is not employer coverage, so it doesn't let you delay Part B without a late enrollment penalty.
- Part D. Drug coverage from IHS, a tribe or an urban Indian organization counts as creditable coverage, so you won't owe a Part D late penalty for the months you had it (42 CFR 423.56). Every Part D plan must offer contract terms to Indian health pharmacies in its area.
- Enrollment. There are no special Medicare enrollment periods for tribal members. Open Enrollment for 2027 coverage runs October 15 to December 7, 2026.
- Help paying. You may qualify for a Medicare Savings Program, Extra Help or the Oregon Health Plan. Some tribes help members with Medicare premiums; the Siletz guide describes one example.
Medicare Advantage where the tribes are
CMS data show no Medicare Advantage plan open to everyone in Harney or Umatilla County for 2026 or 2027, and only 1 in Coos County. In those counties most people use Original Medicare. Elsewhere, CMS advises asking your Indian health care provider which plans it works with before you join one. See tribal health and Medicare in Oregon and Medicare by county.
Where to get help
- Your tribe's clinic, PRC or patient benefits office.
- 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048) or Medicare.gov.
- Social Security, 1-800-772-1213, to sign up for Part A and Part B.
- To compare plans that work with your clinic, you can request a call from a licensed insurance agent, or see licensed insurance agents in Oregon.
Sources
- Indian Health Service — Portland Area
- Indian Health Service — Warm Springs Health & Wellness Center
- CMS — Important Facts about Medicare for American Indians and Alaska Natives
- CMS — Medicare and Tribal Medicare Beneficiaries: Original Medicare and Medicare Advantage
- 42 CFR 136.61 — Payor of last resort
- 42 CFR 423.56 — Creditable prescription drug coverage
- 42 CFR 423.120(a)(6) — Access to I/T/U pharmacies
- CMS — CY2027 Medicare Advantage and Part D Landscape files
Frequently asked questions
How does Medicare work with tribal health care in Oregon?
Your clinic bills Medicare for covered services, and you keep your eligibility for tribal care. Purchased/Referred Care is the payer of last resort under federal rules, so it pays only after Medicare, Medicaid or other coverage.
Do tribal members have to enroll in Medicare?
Medicare is your choice. But IHS and tribal care is not insurance or employer coverage, so it doesn't let you delay Part B without a late enrollment penalty. Drug coverage from an IHS or tribal program does count as creditable for Part D.
Can American Indians and Alaska Natives change Medicare plans any time?
No. Tribal members use the same Medicare enrollment periods as everyone else: Open Enrollment from October 15 to December 7, the Medicare Advantage Open Enrollment Period from January 1 to March 31, and the special enrollment periods that apply to anyone.
Do all tribal clinics work with Medicare Advantage plans?
Not necessarily. CMS warns that Indian health care providers may not be in a Medicare Advantage plan's network and advises asking your clinic before you enroll. Original Medicare pays any provider that accepts Medicare.
Medicare in your Oregon county
Plans, local agents and help, county by county: Multnomah · Washington · Clackamas · Lane · Marion · Jackson · Deschutes · Linn · Douglas · Yamhill · Benton · Polk · Josephine · Umatilla · Klamath · Coos · Columbia · Lincoln · Clatsop · Malheur · All 36 counties →
