American Indians

The Seminole Tribe, the Miccosukee Tribe and Medicare in Florida

Medicare works the same way for American Indians as for everyone else, and it works alongside tribal and Indian Health Service care. Florida's two federally recognized tribes, the Seminole Tribe of Florida and the Miccosukee Tribe of Indians of Florida, run their own health programs with IHS support. Care from them counts as creditable drug coverage, so you won't owe a Part D late penalty.

By the Benefits Life Editorial Team, licensed insurance agents · Reviewed November 14, 2026

Quick answers

Do I still need Medicare if I use a tribal clinic?: CMS encourages it. Medicare lets your Indian health provider be paid for Medicare-covered care, which brings more resources to the program, and covers you outside it. IHS also expects people to use Medicare before it pays for referred care.
Will joining a Medicare drug plan cut off my tribal pharmacy?: No. Medicare says that if you get drugs through an Indian health pharmacy, you'll keep getting them at no cost and your coverage won't be interrupted. The plan pays the facility.
Is Medicare Advantage a good fit with tribal care?: Check first. CMS says your Indian health care provider may not be in a plan's network and may be paid less or not at all, so contact your provider before you enroll.
Which IHS office serves Florida's tribes?: The IHS Nashville Area. Its roots are in Florida: a program office opened in Sarasota in the early 1970s after Seminole, Miccosukee, Cherokee and Choctaw leaders pushed for more IHS presence in the Southeast, and it moved to Nashville in 1975.
Can tribal members get Extra Help or a Medicare Savings Program?: Yes, if they qualify, like anyone with Medicare. Apply for a Medicare Savings Program through DCF's ACCESS Florida and for Extra Help through Social Security.

Who this guide is for

This page is for American Indian elders and people with disabilities in Florida who have Medicare or will soon, and for the families who help them. Florida has two federally recognized tribes:

Seminole Tribe of Florida, with reservations at Big Cypress, Brighton, Fort Pierce, Hollywood, Immokalee and Tampa. Its Health and Human Services Department runs clinics on the reservations.
Miccosukee Tribe of Indians of Florida, based in the Miami area, which runs its own health program.

The Indian Health Service lists both as "tribally administered programs" in its Nashville Area, and says such programs "operate largely independent of the Indian Health Service and may have different eligibility requirements." Each tribe decides who its programs serve, so ask the program directly. Medicare eligibility is the same for everyone: age 65, a qualifying disability, end-stage renal disease or ALS.

The IHS Nashville Area and Florida

IHS says that in 1970, leaders of the Eastern Band of Cherokee Indians, the Mississippi Band of Choctaw Indians, the Seminole Tribe of Florida and the Miccosukee Tribe pushed for more IHS presence in the Southeast. The answer was a program office in Sarasota, Florida, which moved to Nashville in 1975 and became the Nashville Area Office. Today the Area serves 36 tribes in 15 states. The Seminole Tribe has run its health programs under a self-governance compact with IHS since 2001.

Why enroll in Medicare if you use tribal health care

CMS's Division of Tribal Affairs says enrolling in Medicare benefits you, your family and your community: you get more access to health services, and your tribal health program gets more resources to provide them. With Original Medicare, CMS says, most Indian health care providers are paid for the Medicare-covered services they provide.

There's a practical reason too. Federal regulations make IHS the "payor of last resort" for purchased/referred care, the care your health program arranges and pays for outside its own clinics. IHS won't pay for that care to the extent you're eligible for Medicare or other coverage, or would be if you applied (42 CFR 136.61). More in does IHS purchased/referred care pay after Medicare?

Sign up through Social Security at 1-800-772-1213 (TTY 1-800-325-0778) or ssa.gov. See turning 65 in Florida and do American Indians need Part B and Part D?

Original Medicare or Medicare Advantage?

CMS's guide for tribal Medicare beneficiaries points out differences that matter if you use an Indian health care provider:

	Original Medicare	Medicare Advantage
Your tribal clinic	Most are paid for Medicare-covered services	You can still go, but if it's out of network it may be paid less or not at all
Referred care	Referred-care programs coordinate referrals and often pay Medicare deductibles and coinsurance	You may need to use in-network providers and get prior approval
Doctors outside tribal care	Any provider who accepts Medicare	Usually the plan's network

CMS's advice: contact your Indian health care provider before you join a Medicare Advantage plan to make sure the plan works with it. Medicare Advantage plans may offer extra benefits such as dental, vision, hearing or fitness. Extra benefits vary by plan and county, may have limits and costs, and not every plan offers them. Check a plan's Summary of Benefits or Evidence of Coverage. There is no special enrollment period just for American Indians, so the usual enrollment periods apply.

Drug coverage and Part D

No late penalty. CMS says health care from IHS, a Tribe or Tribal Organization, or an Urban Indian Organization includes creditable prescription drug coverage, so you won't owe a Part D late enrollment penalty if you join later. Ask your Indian health provider for a letter that says so.
Your pharmacy doesn't change. If you get drugs through an Indian health pharmacy, Medicare says you'll keep getting them at no cost and your coverage won't be interrupted.
Your program may benefit. A Medicare drug plan pays the Indian health facility for your drugs, and it covers drugs you fill at outside pharmacies.
Tribal sponsorship. CMS says some tribes pay Part D or other Medicare premiums for members. If you're in a tribe-sponsored Part D plan, joining a Medicare Advantage plan with drug coverage may cancel it.

Seminole Tribe of Florida health services

The Seminole Tribe's Health and Human Services Department lists these clinics: the Betty Mae Jumper Clinic in Hollywood, the Big Cypress Clinic, the Brighton Clinic, the Immokalee Clinic and the Tampa Health Office. Seminole Pharmacy serves eligible patients, and dental clinics operate at Hollywood, Big Cypress, Immokalee and Brighton. The department's social work program helps patients with Social Security and Medicare programs, and patient registration goes through the clinics' registration coordinators.

The Tribe also has a self-funded health plan. Medicare.gov says that if you have health insurance through a tribal health plan, Medicare pays first and the tribal health plan pays second. More in can Seminole Tribe members use tribal clinics with Medicare?

Miccosukee Tribe health program

IHS lists the Miccosukee Tribe of Indians of Florida as a tribally administered program, with contact details P.O. Box 440021, Miami, FL 33144, and 305-894-2369. The same Medicare rules apply: Medicare is an alternate resource for referred care, and tribal health care counts as creditable drug coverage. Ask the Tribe's health program what it offers and how it works with Medicare. More in how does Medicare work with the Miccosukee health clinic?

Help paying Medicare costs

If your income and savings are limited, a Medicare Savings Program (QMB, SLMB or QI) can pay your Part B premium and, with QMB, Medicare deductibles and coinsurance. Apply through the Florida Department of Children and Families (DCF) online at ACCESS Florida, or call DCF at (850) 300-4323. Extra Help lowers Part D costs; apply through Social Security. See Medicare Savings Programs in Florida and Extra Help.

Protect yourself from marketing pressure

CMS warns tribal elders not to say yes to a Medicare plan over the phone without first checking with someone they trust or their Indian health provider's patient benefits coordinator. Medicare won't call you to sell a plan. To report Medicare fraud, call 1-800-MEDICARE (1-800-633-4227) or the Senior Medicare Patrol at 1-877-808-2468. See Medicare fraud in Florida. If you'd like to talk through Medicare options with a licensed insurance agent, check first with your tribal health program; you can also request a call from a licensed insurance agent.

Sources

Every question in this guide

Frequently asked questions

Do American Indians need Medicare if they get care from IHS or a tribal clinic?

Medicare isn't required, but CMS encourages tribal elders to enroll because it brings more resources to tribal health programs and gives you coverage outside them. IHS regulations treat Medicare as an alternate resource that must be used before IHS pays for purchased or referred care.

Does tribal health care count as creditable drug coverage?

Yes. CMS says health care from the Indian Health Service, a Tribe or Tribal Organization, or an Urban Indian Organization includes creditable prescription drug coverage. Ask your Indian health provider for a letter that says so.

Can tribal members get Extra Help or a Medicare Savings Program?

Yes, if they qualify, like anyone with Medicare. In Florida, apply for a Medicare Savings Program through DCF's ACCESS Florida and for Extra Help through Social Security.

Can American Indians change Medicare plans at any time?

No. Federal Medicare rules don't include a special enrollment period just for American Indians and Alaska Natives, so the usual enrollment periods apply. CMS warns to check with your Indian health provider if an agent says you qualify for one.

Can my tribe pay my Medicare premiums?

CMS says some tribes pay Medicare premiums for their members, which it calls sponsorship. Ask your tribal health program whether your tribe does.

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