Medical/dental care provided at an IHS or tribal health care facility is called Direct Care. The PRC Program is for medical/dental care provided away from an IHS or tribal health care facility. PRC is not an entitlement program and an IHS referral does not imply the care will be paid. If IHS is requested to pay, then a patient must meet the residency requirements, notification requirements, medical priority, and use of alternate resources.
All AI/AN should be aware of the following requirements each time he/she is referred or requests IHS to pay for medical care away from an IHS or tribal health care facility.
- Patient responsibility to comply with PRC requirements
- Purchased/Referred Care (PRC) is not an entitlement program
- PRC Eligibility Requirements
- PRC Notification Requirements
- PRC Patient Process for Authorization for Payment Diagram [PDF - 251KB]
- Medical/Dental Priority of Care
- Use of Alternate Resource
(Medicare, Medicaid, VA, Private Insurance, charity, etc.)
- Appeal Process for Denial of PRC
- Patient Rights & Responsibilities
- Directory for an IHS or tribal health care facility near your location
The Frequently Asked Questions (FAQ) section gives answers to the most commonly asked questions regarding the PRC program.
The PRC program requirements are based on specific legislation, Federal regulations, policy, and guidelines to maintain the needs of AI/AN.
Read the Understanding the Purchased/Referred Care (PRC) Program: Parts 1-6 on the Director's Blog.
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