Eligibility

Eligibility

To be eligible for
Purchased / Referred Care

You are an enrolled member or descendant of the Ponca Tribe of Nebraska and reside within the Purchased/Referred Care Delivery Area (PRCDA).  
Full-time students who met Purchased/Referred Care (PRC) eligibility requirements before leaving for college, university, vocational, or technical school may remain eligible while attending school. Students must submit proof of full-time enrollment each semester to maintain eligibility. 
You are an eligible patient who temporarily leaves the community. Eligibility may continue for up to 180 days after leaving.  
You are a non-Indian woman who is pregnant with the child of an eligible Ponca Tribe of Nebraska member. Coverage continues throughout the pregnancy and the postpartum period.  
Children up to age 19 may be eligible if they are biological, adopted, foster, stepchildren, legal wards, or orphans of a Ponca Tribe of Nebraska member. 
Program Requirements

What you'll provide

Proof of tribal enrollment

Acceptable forms include:

  • Tribal enrollment card
  • Certificate Degree of Indian Blood (CDIB)

Apply for all alternate resources

Examples include but are not limited to:

  • Medicare
  • Medicaid / Children's Health Insurance Program
  • Private Insurance
Service Delivery Area

15-County PRCDA

You must provide proof of residency in the PHS Purchased/Referred Care Delivery Area (PRCDA).

View the proof of residency policy.

Nebraska

Boyd, Burt, Douglas, Hall, Holt, Knox, Lancaster, Madison, Platte, Sarpy, Stanton, Wayne

Iowa

Pottawatomi, Woodbury

South Dakota

Charles Mix

If denied

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:

Level 01

Reconsideration by the CEO

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

Level 02

Appeal to the Area Director

Appeal to the Area Director. If upheld, the person has 30 days to submit the appeal to the 3rd level.

Level 03

Final administrative appeal

Final administrative appeal to the Director, IHS