This page explains how Medicare works with the health programs of The Klamath Tribes. 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 Klamath Tribal Health & Family Services directly.
Klamath Tribal Health & Family Services
The tribe's administration office is at 501 Chiloquin Blvd. in Chiloquin. Its health organization, Klamath Tribal Health & Family Services, lists these locations (main line 541-882-1487):
- Medicine Place, 330 Chiloquin Boulevard, Chiloquin: the tribes' Wellness Center, with medical, dental and pharmacy staff.
- Healing Place, 6000 New Way, Klamath Falls: opened in 2023 as a satellite of the Chiloquin center, with behavioral health, dental, pharmacy pickup and medical care.
- Youth & Family Guidance Center, 6000 New Way, Klamath Falls (541-884-1841).
Klamath Tribal Health says it serves the Native American population living in Klamath County, and that American Indians and Alaska Natives from federally recognized tribes are eligible for direct services.
Purchased/Referred Care and Medicare
When you need care the clinics don't provide, Klamath Tribal Health's Purchased & Referred Care program may pay an outside provider. It also runs a Patient Benefits Program. 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). With Medicare, outside providers bill Medicare first. Ask PRC how referrals and approvals work before you schedule outside care.
How Medicare works with your Klamath tribal 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 tribal pharmacy 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 Klamath County
CMS data list 6 Medicare Advantage plans open to everyone in Klamath 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 Klamath County and tribal health and Medicare in Oregon.
Where to get help
- Klamath Tribal Health's Patient Benefits and Purchased & Referred Care staff, 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
- Klamath Tribal Health & Family Services — Locations and services
- The Klamath Tribes — Grand opening of the Klamath Falls tribal health center (2023)
- The Klamath Tribes — Administration Department
- 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
Frequently asked questions
Do Klamath Tribes 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 federal rules make Purchased/Referred Care the payer of last resort when Medicare or other coverage could pay.
Where are the Klamath tribal health clinics?
Klamath Tribal Health & Family Services lists the Medicine Place at 330 Chiloquin Boulevard in Chiloquin and the Healing Place at 6000 New Way in Klamath Falls. Both use 541-882-1487.
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 tribal 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.
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