Eligibility

To be eligible for Purchased/Referred Care, you must:

  • Enrolled Ponca Tribe of Nebraska member or descendent residing within the Purchase/Referred Care Delivery Area (PRCDA).
  • Students who meet eligibility guidelines at their permanent residence prior to leaving for school.  Students must supply purchased referred care service application with a copy of full-time student status each semester.
  • Eligible patient that leaves the community, may continue to be eligible for 180 days
  • Non-Indian women pregnant with an eligible Ponca member’s child for the duration of pregnancy through postpartum. 
  • Children of an eligible Ponca member, including non-Native and American Indian foster children, adopted children, stepchildren, legal wards or orphans, until age 19.

Program Requirements

  • Provide proof of tribal enrollment. Acceptable forms include:
    • Tribal enrollment card
    • Certificate degree of Indian Blood (CDIB)
  • Apply for and use all available alternate resources for care. Examples include but are not limited to:
    • Medicare
    • Medicaid/Children’s Health Insurance Program
    • Private Insurance
  • Provide Proof of Residency in the PHS Purchased/Referred Care Delivery Area (PRCDA). 15-County Service Delivery Area: Boyd, Burt, Douglas, Hall, Holt, Knox, Lancaster, Madison, Platte, Sarpy, Stanton, and Wayne Counties of Nebraska, Pottawatomi and Woodbury Counties of Iowa, and Charles Mix of South Dakota. View the Proof of Residency Policy.

Appeal Process

Any person to whom Purchased/Referred Care (PRC) are denied shall be notified of the denial in writing together with a statement of the reason for the denial. The notice informs the person that they have 30 days from the receipt of the notice to submit an appeal. The three level appeal process is as follows:

1st level: Request for reconsideration of the appeal by the CEO, if upheld the person has 30 days to submit the appeal to 2nd level.

2nd level: Appeal to the Area Director, if upheld the person has 30 days to submit the appeal to the 3rd level.

3rd level: Final administrative appeal to the Director, IHS.