This page explains how Medicare works with the health programs of the Confederated Tribes of Grand Ronde. It is published by Benefits Life, a licensed insurance agency. We are not affiliated with the tribe. For tribal eligibility, benefits and current hours, contact the tribe's health programs directly.
Grand Ronde tribal health services
The tribe's headquarters and the Grand Ronde Health & Wellness Center are at 9615 Grand Ronde Road, Grand Ronde (main line 503-879-2002 or 800-775-0095). The tribe lists primary care, same-day sick visits, lab and X-ray, a pharmacy, dental, optometry, behavioral health, community health (including medical transportation and medication delivery) and adult foster care at its Elder Care Lodges.
Who each service is for varies. For example, the tribe says optometry serves Grand Ronde members and their families, other Native Americans and tribal employees, and dental serves all Native Americans. Ask the clinic what applies to you.
Purchased/Referred Care, Skookum and Medicare
Under federal rules, the Indian Health Service is the payer of last resort: it does not pay when Medicare, Medicaid or other coverage would pay (42 CFR 136.61). The tribe's health page says:
- Purchased/Referred Care (PRC) helps enrolled Grand Ronde members and eligible descendants get care beyond what the tribal clinics provide. It is the payer of last resort and is considered only after all other alternate resources. Eligibility is limited to a seven-county service area, with some exceptions. PRC: 503-879-2080.
- Skookum Health Assistance Program is a secondary resource, not insurance, for eligible services other sources don't pay. Enrolled members are eligible, and certain spouses 55 or older may qualify. The tribe asks you to notify the Skookum office immediately if you become eligible for Medicare. Skookum: 503-879-2487.
Because both programs pay after Medicare, enrolling in Medicare on time keeps them working for you.
How Medicare works with your Grand Ronde care
- Medicare pays your clinic. CMS says you can keep using your Indian health care provider, and the provider bills Medicare for you.
- Part B. The standard Part B premium is $202.90 a month in 2026. Tribal health 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 pay 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; ask the clinic pharmacy (503-879-2342) which plans it works with.
- No special enrollment rules. Tribal members use the same enrollment periods as everyone else. Open Enrollment for 2027 coverage runs October 15 to December 7, 2026.
- Help paying. If your income is limited, you may qualify for a Medicare Savings Program, Extra Help or the Oregon Health Plan.
Medicare plans in Polk and Yamhill counties
CMS data list 19 Medicare Advantage plans open to everyone in Polk County and 27 in Yamhill County for 2027. Networks vary by plan, and a tribal clinic may not be in a plan's network; CMS advises checking with your Indian health care provider before you enroll. Original Medicare pays any provider in the country that accepts Medicare. See Medicare in Polk County, Yamhill County and tribal health and Medicare in Oregon.
Where to get help
- The tribe's PRC and Skookum offices, for questions about your tribal benefits.
- 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.
See all Oregon tribal Medicare guides.
Sources
- Confederated Tribes of Grand Ronde — Health & Wellness (clinic, PRC and Skookum)
- Confederated Tribes of Grand Ronde — Official website
- 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
- Medicare.gov — Avoid late enrollment penalties
Frequently asked questions
Do Grand Ronde members need to enroll in Medicare?
Medicare is your choice, but tribal health care is not insurance. Medicare covers care anywhere in the country and lets the clinic bill Medicare, and the tribe's Purchased/Referred Care program pays only after all other alternate resources, including Medicare.
What should I do with Skookum when I get Medicare?
The tribe describes the Skookum Health Assistance Program as a secondary resource, not insurance, and asks members to notify the Skookum office right away when they become eligible for Medicare or other coverage. Call 503-879-2487 or 800-775-0095.
Are there special Medicare enrollment periods for tribal members?
No. American Indians and Alaska Natives use the same Medicare enrollment periods as everyone else: the Initial Enrollment Period around age 65, Open Enrollment from October 15 to December 7, and the Medicare Advantage Open Enrollment Period from January 1 to March 31.
Can I still use the Grand Ronde clinic if I join a Medicare Advantage plan?
Your eligibility for tribal care does not depend on your Medicare choice. CMS advises asking your Indian health care provider before you enroll whether a Medicare Advantage plan works with it, because an out-of-network clinic may not be paid.
Medicare in your Oregon county
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