One of the following DDD health plan choices

• United Healthcare Complete Plan;

• Mercy Care Plan; or

• DDD American Indian Health Plan (DDD/AIHP)

NOTE     When enrolling with DDD/AIHP, the customer can also choose to have behavioral health services provided by the Tribal Regional Behavioral Health Authority (TRBHA).

The tribe that serves that reservation. The customer does not have to be a member of the contracting tribe. 

Example:

A Hopi customer living within the bounds of the Navajo Tribal Nation is enrolled with the Navajo Nation.

NOTE     If the tribal nation is not served by one of the seven tribes identified as an American Indian program contractor, the person is enrolled in Native American Community Health (NACH).

Exception:

Persons who reside within the bounds of a tribal nation, but lack any tribal membership are enrolled with an elderly and/or physically disabled (EPD) program contractor.

An EPD program contractor based on the customer’s county of fiscal responsibility.

NOTE     When the customer has a Dual Eligible Special Needs Plan (DSNP) with Medicare,  the customer will be automatically moved to the EPD Program Contractor that is aligned with their Medicare DSNP.

Seven American Indian tribes deliver case management services and provide directly or arrange for services to American Indians who are elderly and/or physically disabled and reside on-reservation. These tribes are:

• Gila River Indian Community;

• Hopi Tribe;

• Navajo Nation;

• Pascua Yaqui Tribe;

• San Carlos Apache Tribe;

• Tohono O’Odham Nation; and

• White Mountain Apache Tribe.

NACH provides case management services to elderly and/or physically disabled American Indian ALTCS customers who live on-reservation and do not receive ALTCS case management from a tribe.

42 CFR 422.107

ARS 36-2932 and 2933

AAC R9-28-415