Northern Valley Indian Health Services, a branch of the U.S. Department of Health and Human Services, has set the guidelines on who qualifies for Purchased/Referred Care. Generally, in order to be eligible you must:
PROVIDE PROOF OF CALIFORNIA NATIVE AMERICAN DESCENT
You must provide proof of California Native American descent such as a letter from your tribe, a tribal enrollment or BIA card, or the birth certificate of self, a parent, or grandparent showing proof of your lineage to a verified Native American. If your name has changed, you will also be asked to provide legal documentation of the name change.
PROVIDE PROOF THAT YOU RESIDE WITHIN OUR DELIVERY AREA
You must provide proof that you reside within our delivery area. This may be a recent utility bill with your name and address listed. Our delivery area includes communities within Yolo, Butte, Glenn, Tehama and Colusa counties. If you are a member of one of our consortium tribes, you are considered to have met residency requirements if you reside within one of our 5 counties.
See “ELIGIBLE DELIVERY AREAS” section below.
HAVE A VALID REFERRAL
You must have a valid referral to the outside provider from an NVIH provider. The referral must be for a PRC covered service and coverage must be approved by our PRC Department.
APPLY FOR AND USE ALL OTHER ALTERNATE RESOURCES AVAILABLE TO YOU
You must first apply for and use all other alternate resources that are available to you, such as your private medical insurance, Medi-Cal, or Medicare. If you have no alternate resources, you must apply for Medi-Cal and provide NVIH with the Determination Letter. If you need assistance applying, please contact
a PRC Representative.
Some exceptions may be made to the above requirements (such as eligibility for a student away from home and a non-Native woman pregnant with a Native American child). Please contact a PRC Representative to determine your eligibility.
