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    • Home
    • About Us
      • Our History
      • Our Team
    • Services
      • FSA & LPFSA
      • Dependent Care
      • HRA
      • HSA
      • COBRA
      • Plan Benefit Card
    • Forms / Resources
    • 24/7 Account Access
    • OTAP Info.
    • FSA Store / HSA Store
    • Keystone Sponsorships
    • Contact Us/Quote Request
Keystone Test
  • Home
  • About Us
    • Our History
    • Our Team
  • Services
    • FSA & LPFSA
    • Dependent Care
    • HRA
    • HSA
    • COBRA
    • Plan Benefit Card
  • Forms / Resources
  • 24/7 Account Access
  • OTAP Info.
  • FSA Store / HSA Store
  • Keystone Sponsorships
  • Contact Us/Quote Request

Otoe Missouria Tribal Extraordinary Assistance Program

Tribal Assistance Benefits Card Program

NOTE: Effective 4/3/2020, the Tribe has ruled to allow over the counter medications (Ibuprofen, cough medicine, etc.) as well as menstrual products under this plan. Your card WILL NOT function for these items. You will have to pay out of pocket and file a manual claim through your portal, mobile app, or via email/fax/mail for reimbursement. 


You are enrolled in the Tribal Assistance Benefits Card Program!  We’re now providing you with an easy way to access your Medical, Dental, and Vision funds. 


Your Benefits Card is pre-loaded each quarter of the year (1/1, 4/1, 7/1, 10/1) with $300 totaling an annual allotted amount of $1,200. Using your card helps you keep cash in your wallet and makes accessing your Tribal benefit funds easy. The card can be used, instead of cash, to pay for eligible expenses such as: Medical, Dental (including Orthodontia), and Vision.  


You’ll simply swipe your card each time you incur a qualified health care expense and the amount of your purchase will be deducted from your Tribal benefits plan automatically. You’ll have no claim forms to complete (unless your card does not function and you need to file manually) and you won’t have to wait to get a check in the mail. 


You can check balances or account details anytime via the online member portal (Link Below), through our mobile app, or with a quick phone call ( Toll Free: 1-866-680-8308 ). It’s that easy!  You will also find a downloadable version of a manual claim form below, as well as an Eligible/Ineligible list of the types of items that are covered under this plan.


**Reminder** 

  • Funds do not carry over from quarter to quarter. The $300 allotment has to be spent by the end of each quarter or the monies will be forfeited. 
  • Only the individual’s name that appears on the front of the card can use the monies associated with the card for eligible expenses such as: Medical, Dental (including Orthodontia), and Vision. 
  • The card will not work at gas stations or restaurants – only at health care related providers.
  • No Cosmetic Procedures are covered.
  • Do not throw away cards at year end. They are valid through the expiration date that appears on the front of the card. There is a $10.00 reissuing fee that coincides with ordering a new set.


 Link to Online Tribal Portal to Check Available Balance and Claim status 


Downloadable Forms

Otoe-Missouria Tribe Extraordinary Assistance MANUAL CLAIM FORM (pdf)Download
Tribal Assistance Benefits Card Eligible-Ineligible Fact Sheet (pdf)Download

Tribal Photo Gallery

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