Purchased Referred Care is essential for improving access to health care, addressing health disparities, promoting tribal sovereignty, and ensuring that Native American communities receive the quality care they deserve.

NOTE: The PRC Program is neither an entitlement program nor an insurance program. By federal law and regulation, it is the payer of last resort. This means that if a PRC patient is also eligible for another health financial resource, they are required to take advantage of that program before PRC funds can be authorized to cover payment for outside services.

Eligibility:

• Enrolled Tribal Citizen of Samish Indian Nation
• Live within our ten-county service area: Skagit, Whatcom, Kitsap, Snohomish, King, Island, San Juan, Pierce, Jefferson and Clallam County.
• Register with the PRC office and abide by the Samish PRC program guidelines.

Services:

In general, PRC may pay for physician and other health professional services, dental services, prescriptions, vision care, physical therapy, hearing aids and mental health services.

Direct Care Services: For those citizens who live outside of the ten-county service delivery area, the hospitals and clinics of the Indian Health Services are available for services, often at no cost to you. However, the Indian Health Service facilities cannot always provide a full range of health care services. A referral by an Indian Health facility to a non-Indian Health facility does not constitute a commitment by the IHS or any tribal program to pay for any services.

Click here for more information about locating an Indian Health Service Area Office or facility near you.

Vision, Dental, and Orthodontics Assistance Maximums:

• For vision, each person is allotted $600 per calendar year, for exam and corrective hardware.
• For dental, each person is allotted $3,000 per calendar year.
• For orthodontics, each person is allotted $7,000 per lifetime, for evaluations, x-rays, models, etc.

If you are in need of accessing these services, please contact Purchased/Referred Care.

Tips for PRC

• Call and ask for an authorization number as soon as you know the date of an upcoming appointment. (Earliest: up to 90 days ahead of appointment date. Latest: day of appointment).
• Notification to PRC is required for each appointment with every appointment requiring a new authorization number. Always ask and keep a record of the authorization number, even if someone calls in for you (such as a nurse at the Clinic).
• Keep your authorization numbers on your calendar next to your appointment date and time.
• If you have insurance, PRC is not able to make a payment until after the insurance has either paid or denied the claim. The insurances might send you a statement (called an Explanation of Benefits (EOB) explaining what was paid and the balance that may still be due to the provider. If it is coming from the insurance directly, it will state somewhere on it “This is not a bill”. If it is from the provider, please contact the provider and have them bill directly.

If you have any questions regarding this decision or the PRC process, we would be happy to assist you by calling 360-899-5454.