You can use Medicare alongside the Indian Health Service (IHS) to receive care outside of IHS facilities. Many people eligible for the IHS can enroll in Medicare at low or no cost to help with coverage gaps.

The IHS provides healthcare to Native Americans and Alaska Natives. It operates in 12 areas across the United States and acts as a healthcare advocate for Native American and Alaska Native populations.

The IHS isn’t an insurance plan. It provides care only at IHS facilities, so you may still need insurance if you use the IHS.

For Native Americans or Alaska Natives who are age 65 or older, Medicare can work alongside IHS to help them get all the care they need.

The IHS is a program of the federal government and the Department of Health and Human Services. It provides free medical care to registered members of 574 federally recognized Native American and Alaska Native tribes.

Across the United States, the IHS operates:

  • hospitals
  • health centers
  • health clinics

Plus, the IHS provides funding for healthcare and acts as a healthcare advocate for Native Americans.

The IHS is not insurance. You cannot use IHS care anywhere but an IHS facility. And it doesn’t provide coverage for care at any other healthcare facility.

In addition, not all services can be performed at IHS facilities. According to the IHS, federal funding only covers about 60% of the care Native American and Alaska Native people need.

But you can use other healthcare plans alongside the care you receive from the IHS. For example, if you’re eligible for Medicare, you can use it to get care beyond the services provided by the IHS.

You can keep seeing the same doctors at your IHS facility when you enroll in Medicare. All IHS facilities will accept Medicare.

Plus, you can use Medicare to get expanded services like specialist visits and services your IHS facility isn’t able to provide. Using Medicare can also help when you’re traveling or if you don’t live near an IHS facility.

You can choose the parts of Medicare that work best for you. The parts of Medicare include:

  • Medicare Part A: Medicare Part A is inpatient hospital care. You can use it to receive care in a hospital or long-term care facility. You can use Part A at an IHS hospital or any other available hospital that accepts Medicare.
  • Medicare Part B: Medicare Part B covers outpatient medical services. You can use it to see a doctor, visit urgent care, get a medical test, or get medical equipment in your home. Part B will cover your costs to see your doctor at an IHS facility and see specialists when you need to.
  • Medicare Advantage (Part C): Medicare Advantage plans must cover everything that Medicare parts A and B cover. They also often include additional coverage for things like dental care, vision care, and prescription drug coverage. Just like with parts A and B, you can use a Medicare Advantage plan to get care at an IHS facility or at a facility outside of the IHS.
  • Medicare Part D prescription drug plans: Medicare Part D is prescription drug coverage. You can use it to get your prescriptions at an IHS pharmacy or another pharmacy that’s convenient for you.
  • Medicare supplement (Medigap): A Medigap plan is designed to cover the out-of-pocket costs of Original Medicare, like copayments or deductibles. Medigap plans can make getting care more affordable.

Care at an IHS facility is free if you qualify.

Medicare costs can vary, and some can change depending on your income.

Many people who use IHS are eligible for Medicare savings programs. These programs can help reduce the cost of your:

  • Part A premium and deductible
  • Part B premium and deductible
  • Part D premium
  • any Part D deductible you have
  • copayments and coinsurance

In 2025, you can qualify for a Medicare savings program if you make anywhere from $1,325 per month as an individual or $1,783 as a married couple, depending on the program you choose or qualify for. These income amounts may change for 2026.

Several types of income that people who qualify for IHS might receive don’t count toward this income calculation. This includes:

  • distributions from the Alaska Native Claims Settlement Act of 1971
  • distributions from trust or reservation property
  • hunting, fishing, or other natural resources income
  • the sale of cultural/subsistence property
  • Bureau of Indian Affairs or tribal student financial aid
  • income under the IRS general welfare doctrine

If you don’t qualify for a Medicare savings program, you’ll pay the standard amount to use Medicare alongside your IHS care. As of 2025, those costs are:

  • Medicare Part A: Most people receive Part A without paying a premium. There’s a deductible of $1,676 before coverage begins. There’s no copayment on your first 60 days of hospital or nursing care in any benefit period. Starting on day 61, you’ll pay $419 per day. Between days 90 and 150, you’ll pay $838 each day while using your lifetime reserve days. And after day 90, you’ll pay all the costs.
  • Medicare Part B: There’s a premium of $185 for Part B. Part B also has a deductible of $257. After your deductible, you’ll pay a coinsurance of 20% of all eligible costs.
  • Medicare Advantage (Part C): Medicare Advantage plans are administered by private insurance companies and overseen by Medicare. Your costs — including premiums, deductibles, copayments, and coinsurance — will depend on the plan you choose. You can often find Medicare Advantage plans at a very low cost.
  • Medicare Part D prescription drug plans: Like Medicare Advantage plans, Part D plans have their own costs set by the private insurers that administer them. Low cost plans are available in most areas.
  • Medicare supplement (Medigap): Medigap plans have premiums set by the companies offering them. But the coverage is standardized by Medicare, so your costs will depend on the Medigap plan you choose.

Use this tool to compare cost and coverage options for different Medicare plans

This online tool from Medicare lets you compare costs and coverage options for Medicare Advantage plans, Medicare Part D prescription drug plans, and Medigap plans near you.

You’re eligible for the IHS if you’re a registered member of a federally recognized Native American or Alaska Native tribe. You can show eligibility in a few ways, including:

  • You have a membership or are enrolled in a federally recognized tribe or group under federal supervision.
  • You live on tax-exempt land or own restricted property.
  • You actively participate in tribal life.
  • You have any other reasonable factors that prove Native American or Alaska Native descent.

If you’re eligible for IHS, some members of your family will also be eligible. This includes:

  • your children, including adopted children and step-children who are under 19 years old
  • your spouse

IHS care is also available for pregnant people during their pregnancy if they’re carrying the child of an IHS-eligible person. It’s also available for household members of IHS-eligible people if an infectious disease is present in the household.

Medicare eligibility is the same whether or not you use IHS. You can become eligible for Medicare in a few ways, such as:

You can enroll in the IHS by going to the patient registration office of your local IHS facility. You’ll need to present proof of your tribal membership to enroll.

You need to enroll in person at an IHS facility. There’s no option to enroll by mail or online at this time.

Your steps for enrolling in Medicare depend on how you become eligible. In some cases, you’ll be enrolled automatically. This includes when you:

  • are receiving Social Security retirement benefits and turn 65 years old
  • are receiving Railroad Retirement Board (RRB) benefits and turn 65 years old
  • have been receiving SSDI for 24 months
  • receive a diagnosis of ESRD
  • receive a diagnosis of ALS

You’ll receive your enrollment information automatically in the mail. At this time, you can also choose a Medicare Advantage, Medicare Part D prescription drug plan, or Medigap plan.

You can apply through the Social Security Administration (SSA) if you’re not automatically enrolled. You can do this in one of four ways:

  • online
  • by phone at 800-772-1213
  • visiting your local Social Security office
  • sending a letter to your local Social Security office stating your name, date of birth, and intent to enroll

You might need to provide some information when you apply.

In some cases, Social Security might already have all the information they need. In other cases, you’ll need to provide information about:

  • your age
  • your citizenship
  • your income
  • any military service you’ve had
Medicare enrollment dates

Here are some of the key enrollment dates:

  • Initial enrollment period: This is a 7-month window around your 65th birthday when you can sign up for Medicare. It begins 3 months before your birth month, includes the month of your birthday, and extends 3 months after your birthday. During this time, you can enroll in all parts of Medicare without a penalty.
  • Open enrollment period — October 15 to December 7: During this time, you can switch from Original Medicare (parts A and B) to Medicare Advantage, or from Medicare Advantage back to Original Medicare. You can also switch Medicare Advantage plans or add, remove, or change a Part D prescription drug plans.
  • Medicare Advantage open enrollment period — January 1 to March 31: During this time, you can switch to another Medicare Advantage plan, return to Original Medicare from Medicare Advantage, and join or leave any associated prescription drug plans.
  • Medigap enrollment: This 6-month period starts after the first day of the month that you apply for original Medicare or from your 65th birthday. If you miss this enrollment period, you may not be able to get a Medigap plan. If you do get one later, you may pay higher premiums for it.

Medicare coverage can supplement the care you receive through the IHS. With Medicare coverage, you can see specialists, seek care outside the IHS, and get services that the IHS doesn’t provide.

Also, you can use your Medicare coverage at an IHS facility, so you can keep seeing the same doctor if you prefer.