Health Benefits
Hours:
Monday to Friday, 8:00am to 4:30pm
Closed from 12pm to 1pm for lunch
Closed the first Thursday every month from 12pm-2pm
Contact Information:
Phone: (360) 394-8424
Fax: (360) 598-2709
Email: health_benefits_email@suquamish.nsn.us
What does Health Benefits do?
Health Benefits staff help Tribal Members navigate the healthcare system to get the care and coverage they need, including providing assistance with enrollment in the HMA Tribal Health Plan, Medicare, and Apple Health (also known as Provider One).
We also help locate providers who are in network with the Tribal Member’s health plan, and resolve billing issues between the provider and the health plan.
Click on the options below to see more detail about the services Health Benefits provides.
Tribal Health Medical, Dental, Hearing & Vision Coverage
Enrolled Suquamish Tribal Members living within Kitsap, King, Jefferson, Mason, Pierce, Snohomish, and Whatcom counties and descendants who are under 18 (unless still in high school up to 19 yrs. old) are eligible for Medical, Dental, Hearing and Vision coverage administered by HMA & the Ameritas Dental Network. In addition pregnant spouses/significate others of enrolled Tribal Members may be eligible for pregnancy medical coverage for their pregnancy.
Medical Coverage through HMA
Supplemental Alternative Care Coverage through HMA
Dental Coverage though Ameritas Dental Network
Orthodontia for Children at 100% through Ameritas
Orthodontia for Adults up to $5,500 through Ameritas
Hearing Tests & Hearing Aids
Vision & Glasses/Contacts
Maternity Coverage for eligible spouses/significant others of Tribal Members through HMA
Medicare Assistance
Health Benefits is available to assist Tribal Members who need to enroll in Medicare A, B & D. You must enroll in Medicare if you are eligible. In addition Enrolled Tribal Members living within the above counties are eligible for Medicare premium reimbursements, if the cost of your Medicare is being deducted from you Social Security Income.
Medicaid Assistance
Health Benefits is available to assist Tribal Members and Descendants with applying for and renewing Washington Apple Health Benefits, locating ID# and requesting new ID cards. You must enroll in Apple Health if you are eligible.
Higher Education
Tribal Members enrolled in our Higher Education program and attending college outside of the above counties are eligible to continue to receive Tribal Health Medical, Dental & Vision coverage until the age of 25. This includes students attending college out of state.
Employee Medical Coverage Reimbursement
If your employer offers you medical coverage that you pay for you may be eligible for premium reimbursement up to $200.00 through the Health Benefits department.
Claims Assistance
Health Benefits is here to help with any claims questions! If you are receiving statements from a provider or if you need help finding an in-network provider please give us a call or stop by the office.
CONTACT US
For more information, please contact Health Benefits by clicking one of the buttons below:
Meet The Staff
Martha Mabe
Health Benefits Coordinator
(360) 394-7138
mmabe@suquamish.nsn.us
Services for Elders (55+):
Registration, Medicare, help finding a provider, coverage questions
Dawn Ensminger
Health Benefits Coordinator
(360) 394-8513
densminger@suquamish.nsn.us
Services for Members 54 & Under:
Registration, Health Plan Finder (WA Medicaid), help finding a provider, coverage questions
Shannon VanVleet
Health Benefits Coordinator
(360) 394-8476
SVanVleet@suquamish.nsn.us
Services for Members 54 & Under:
Registration, Health Plan Finder (WA Medicaid), help finding a provider, coverage questions
Kathy Pitts
Health Benefits Coordinator
(360) 394-8684
kpitts@suquamish.nsn.us
Services for all members:
Billing, Reimbursements, Claim Issues
Rebecca Jones
Health Benefits Supervisor
(360) 394-8466
rjones@suquamish.nsn.us
Services for all members:
Appeals & Prior Authorization
Contact Info & Links
Health Benefits Contact Information and Hours
Physical Address: 6968 Enetai Lane NE, Suquamish WA 98392
Department Hours:
Monday to Friday, 8:00am to 4:30pm
Closed from 12pm-1pm for lunch
Closed the first Thursday every month from 12pm-2pm
Health Benefits follows Suquamish Tribal Government guidelines for weather and holiday closures.
Phone: (360) 394-8424
Fax: (360) 598-2709
Email: health_benefits_email@suquamish.nsn.us
Forms for Members
Member Guides
Prescryptive Member Guide
HMA Member Guide
HMA Supplemental Member Guide
SSA Letter Policy Flyer
HMA ID Card Sample