For IHS-eligible elders and families · Free · No obligation
Medicare and Indian Health Service
Getting Medicare does not mean giving up the care you get at your IHS or tribal clinic. The two work together — Medicare pays for care outside the clinic, and your clinic can bill it for care you already receive. If you are turning 65, or you have been putting off Part B because of the premium, let's sit down and go through it.
What we go through
The four things people ask
You do not give up IHS care
This is the worry we hear first, and the answer is no. The Indian Health Service is not health insurance — it is care you are entitled to. Medicare does not replace it and does not take it away. Medicare sits alongside it and pays for care outside the IHS or tribal clinic: a specialist in Blanding or Monticello, a hospital stay, care while you are traveling.
What Part B costs, and what to do if it is tight
Part B has a monthly premium, usually taken out of a Social Security check. If that premium is a hardship, there are programs that can help pay it — and in some counties there are plans that reduce part of it. Both are worth checking before anyone drops coverage they may not be able to get back cheaply.
Deadlines, and the penalty for missing them
Medicare has enrollment windows around age 65. Missing one without other qualifying coverage can add a permanent penalty to your premium. IHS eligibility on its own does not protect you from that penalty. Knowing your window ahead of time costs nothing.
Whether your clinic can bill it
When an elder is enrolled, the IHS or tribal clinic can bill Medicare for care it is already providing — money that stays in the community health system instead of coming out of its budget. Helping elders enroll is good for the elder and good for the clinic.
Brian Penner has been helping families in San Juan and Grand counties with Medicare for 22 years, from the offices in Monticello and Moab. Education, not advice — and if your coverage is already right, we will say so.
Book a time
Pick a time that works
Brian Penner will call you at the number you provide, or you can call 435-260-3200 and talk to a person. In-person visits at the Monticello or Moab office are welcome.
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Your details
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Where to come Get directions on Google Maps
Would rather not use a calendar? Call (970) 644-6954 and we will put it in the diary the old-fashioned way, or send us the details instead.
Good questions
Before you book
If I sign up for Medicare, do I lose my Indian Health Service care?
No. IHS care is not insurance and is not something Medicare replaces. You remain eligible for care at your IHS or tribal health facility exactly as before. Medicare is added coverage that pays for care outside that system — specialists, hospitals, and care when you are away from home. Nothing about enrolling reduces what you are entitled to.
Why does my clinic want me to enroll in Medicare?
Because when you are enrolled, the clinic can bill Medicare for care it provides you, and that reimbursement stays in the tribal health program. When an eligible elder is not enrolled, that same care comes out of the clinic's own budget. It is not about sending you somewhere else — it is about funding the care you already receive.
I cannot afford the Part B premium. What are my options?
Do not drop coverage before you have looked at this. Medicare Savings Programs can pay the Part B premium for people under certain income and resource limits, and eligibility is more generous than most people expect. Separately, some Medicare Advantage plans in some counties reduce a portion of the Part B premium. Which of these fits depends on your income and your county. Official information is at Medicare.gov or 1-800-MEDICARE, and we can walk you through it at no cost.
Do I have to pick a Medicare Advantage plan?
No. Staying with Original Medicare is a legitimate choice, and in areas where provider networks are thin it is often the better one. Any plan with a network needs to be checked against the providers you actually use and the distances you actually travel. We will tell you honestly when a plan does not fit your area.
Does this cost anything?
No. There is no cost and no obligation, and we are glad to meet in person. Insurance companies pay our fee only if you later choose a policy through us. Many of these conversations end with no change at all.
Medicare On Main is an independent insurance agency. We are not affiliated with, and not endorsed by, the Indian Health Service, any tribal government, or any government agency. We do not offer every plan available in your area. Plan availability and benefits differ by county and change each plan year. For information on all of your options, contact Medicare.gov or 1-800-MEDICARE.
Last updated . Maintained by the Medicare On Main Data Desk · reviewed by Brian Penner, Independent Medicare advisor (NPN 16493717).