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If you are identified as an American Indian or Alaskan Native, then you will more than likely seek healthcare services via the Indian Health Service (IHS) which is an agency within the HHS (Department of Health and Human Services). You can have private health insurance, but I believe that the IHS will always be considered/filed primary and then the other insurance secondary if there is a remaining balance.

http://www.ihs.gov/index.cfm

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Q: Do Native Americans pay for health insurance?
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