This page explains how Medicare works with the health programs of the Confederated Tribes of Siletz Indians. 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.
Siletz tribal health services
The tribe's headquarters and its main clinic, the Siletz Community Health Clinic, are at 201 SE Swan Ave. in Siletz, in Lincoln County (541-444-2532). The tribe lists medical care, a pharmacy, dental, behavioral health, community health, non-emergency medical transportation, and patient benefits and insurance verification among its health programs. The tribe says the clinic also serves other community members.
The tribe's Lincoln City clinic, Dan' ch'aa-may-yvlh-srii-dvn (North Doctor Place), is at 1831 SW Hwy 101, Lincoln City (541-444-8341). The tribe says it serves enrolled Siletz members, members of other federally recognized tribes, current Siletz Community Health Clinic patients and Siletz tribal employees.
Siletz Purchased/Referred Care and Medicare
When you need care the clinic doesn't provide, Siletz Purchased/Referred Care (PRC) may pay an outside provider. 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 PRC page says:
- Members living in 11 counties (Benton, Clackamas, Lane, Lincoln, Linn, Marion, Multnomah, Polk, Tillamook, Washington and Yamhill) are PRC Direct; enrolled members outside those counties have out-of-area benefits and get a yearly benefits letter.
- PRC is a benefit, not insurance, and it requires pre-authorization or notification within 3 business days.
- The tribe reimburses enrolled Siletz members for their Medicare Part B and Part D premiums, and it offers some help with copays when you have primary drug coverage such as Part D.
Siletz PRC: 541-444-9677. After hours, weekends and holidays: 800-648-0449 or 541-444-1030. Ask PRC about current amounts and how to apply before you rely on them.
How Medicare works with your Siletz care
- Medicare pays your clinic. 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. 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 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 Lincoln County
CMS data list 4 Medicare Advantage plans open to everyone in Lincoln 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 Lincoln County and tribal health and Medicare in Oregon.
Where to get help
- The Siletz clinic's patient benefits and insurance verification 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
- Confederated Tribes of Siletz Indians — About the Siletz Community Health Clinic
- Confederated Tribes of Siletz Indians — Lincoln City clinic
- Confederated Tribes of Siletz Indians — Purchased/Referred Care
- 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 Siletz members need to enroll in Medicare?
Medicare is your choice, but tribal health care is not insurance. Medicare covers care anywhere in the country, lets the Siletz clinic bill Medicare for covered services, and Purchased/Referred Care expects you to use Medicare and other coverage first.
Does the Siletz Tribe help with Medicare premiums?
The tribe's Purchased/Referred Care page says the tribe reimburses enrolled Siletz members for Medicare Part B and Part D premiums. Call Siletz PRC at 541-444-9677 to confirm current terms and how to apply.
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 Siletz 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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