Purchase Referred Care (PRC) ANSWERS TO FREQUENTLY ASKED QUESTIONS
IN ORDER TO MINIMIZE YOUR EXPOSURE THROUGHOUT THE SAULT TRIBE HEALTH CENTER DURING COVID-19
WE WOULD LIKE TO ASK YOU:
IF YOU ARE ENTERING THE BUILDING TO REQUEST SERVICES FROM PURCHASE / REFERRED CARE (PRC) OR TO DROP
OFF PAPERWORK OR BILLS, PLEASE LEAVE THEM IN THE BOX LOCATED AT FIRST FLOOR OF STHC (SCREENING AREA).
PLEASE CALL YOUR PATIENT CARE COORDINATOR AT (906) 632-5220 FOR YOUR VOUCHER REQUESTS FOR YOUR
REFERRED CARE OR FOR URGENT / EMERGENT VOUCHER, AND OR PRC APPLICATIONS WHICH CAN BE FAXED TO 906-632-5248 OR EMAIL TO This email address is being protected from spambots. You need JavaScript enabled to view it.
IF YOU NEED IMMEDIATE ASSISTANCE FROM PRC FOR REASONS OTHER THAN DESCRIBED ABOVE, PLEASE CALL PRC MANAGER AT (906) 632-5225.
The PRC application asks for current income, either the current Federal 1040 tax return, or if income changed from that time, the last 3 pay stubs for working persons residing in household. Is there an income guideline to be eligible for the program?
No there is no income guideline or over-income to be eligible for PRC. Income is used only to determine eligibility for alternate resources, such as Medicaid. If a person meets the income
guide lines for Medicaid we have staff available to assist you in applying for those funds and PRC may be used for services not covered by Medicaid.
I work and my family is covered by my employee sponsored health insurance, because I have insurance does that make my family in-eligible for the PRC program?
No, as long as you use our Tribal Health Clinic Providers and are referred for Specialty Care/Service that cannot be provided within the health center, you may be able to obtain an authorization to assist with that service secondary to your primary insurance as long as service is within the Priority of care PRC is covering. You must contact your Patient Care Coordinator at PRC at 906-632-5220 prior to your referred appointment to request a voucher for that date of service.
I was seen at the Tribal health center and they referred me and said I was all set, is there anything I need to do?
Yes, if you wish for financial assistance in paying for that referred service you must contact PRC Program to request an authorization (voucher) for every visit outside of our health centers. You may be requested from that specialty provider to come back for a second, or third visit, you must contact PRC for a voucher every time for each date of service.
What if my Referred provider sends me over to the hospital for a test, such as EMG, or MRI, is that covered by my voucher?
No, you must contact your PCC at PRC to let them know you had that test done by the hospital so that there is a voucher added for that particular test and there is PRC dollars obligated for that service.
I was seen at the Tribal Health center and referred out for specialty care, but I live below the bridge, am I covered by PRC?
No, PRC eligibility criteria specifies only those members who reside within the 7 county service area are eligible. Those counties include: Chippewa, Mackinac, Luce, Schoolcraft, Alger, Delta, and Marquette.
Are there certain circumstances when a member may be covered should they leave the area for work (transient) or students attending college/trade school, or going to warmer climate for the winter months?
Yes, you may be covered as long as you have an active application with PRC before leaving the Area and notification to PRC has been made. You may have to show proof if you are attending college full time and not working with a transcript copy of classes and or letter from college stating you are a full time student. Transient workers leave the area, or the state for work, but always return back to their home where they permanently reside. The same with Snow birds as We call them who reside within the service area who may leave for the winter months and return in the spring.
My Tribal Provider wrote a prescription that is not available at the health center, do I need to pay for this myself at an outside pharmacy or my own copay since I have health insurance?
No, please contact your Patient Care Coordinator (PCC) at PRC to ask that question. PRC is contracted with certain pharmacies within each county. They will assist you in obtaining the prescription at the most reasonable cost for PRC Program. Depending on cost, it may be Special Ordered thru our Tribal Clinic Pharmacy at 340b Pricing.
