A limited cost sharing plan is an ACA Marketplace Silver plan with reduced cost-sharing available to members of federally recognized tribes and Alaska Native Claims Settlement Act (ANCSA) shareholders whose income is between 100% and 300% of the federal poverty level. It's similar to, but distinct from, the zero cost sharing plan.
On a limited cost sharing plan, you won't have a deductible for most covered services, and your copayments and coinsurance are significantly reduced compared to a standard Silver plan. You'll still have some cost-sharing (unlike a zero cost sharing plan where everything is $0), but it's much lower than what non-tribal members pay, even those receiving standard cost-sharing reductions.
To qualify, you must be a member of a federally recognized tribe or an ANCSA shareholder, have a household income between 100% and 300% FPL, and enroll in a Silver Marketplace plan. Tribal members with income at or below 300% FPL may qualify for either limited or zero cost sharing, depending on the specifics of their eligibility.
Like zero cost sharing plans, eligible tribal members also enjoy special enrollment flexibility: you can enroll in or change Marketplace plans once per month at any time during the year, not just during Open Enrollment.
If you're not sure which tribal cost-sharing benefit you qualify for, contact the Marketplace or your local Indian Health Service office. The enrollment application will determine your eligibility level based on your tribal membership and income.
Both are available to tribal members and ANCSA shareholders. A zero cost sharing plan eliminates all cost-sharing ($0 for everything). A limited cost sharing plan significantly reduces cost-sharing but doesn't eliminate it entirely. Your income level and specific eligibility determine which you qualify for.
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