Frequently Asked Questions regarding Indian Health Services
Q: I am part Indian, am I eligible for health benefits from the Indian Health Service?
A: The most common standard applied for eligibility for health services from the Indian Health Service is that the individual is an enrolled member of a Federally recognized Tribe. The IHS Indian Health Manual (IHM) provides the exact policy concerning eligibility.
Q: What is a federally recognized tribe?
A: A federally recognized tribe is an American Indian or Alaska Native tribal entity that is recognized as having a government-to-government relationship with the United States, with the responsibilities, powers, limitations, and obligations attached to that designation, and is eligible for funding and services from the Indian Health Service & Bureau of Indian Affairs . Furthermore, federally recognized tribes are recognized as possessing certain inherent rights of self-government (i.e., tribal sovereignty) and are entitled to receive certain federal benefits, services, and protections because of their special relationship with the United States. At present, there are 573 federally recognized American Indian and Alaska Native tribes and villages.
Q: Is Muscogee Creek a federally recognized tribe?
A: Yes, The Muscogee (Creek) Nation is a federally recognized tribe of Muscogee people, also known as the Creek, based in the U.S. state of Oklahoma.
Q: What is Indian Health Service?
The Indian Health Service https://www.ihs.gov/aboutihs/, an agency within the Department of Health and Human Services , is responsible for providing federal health services to American Indians and Alaska Natives.
Q: What are Tribal Operated 638 Programs?
A: Tribal Contract or Compact Health Centers (also called a 638 contract or compact) are operated by Tribes or Tribal organizations and Urban Indian Health Centers are outpatient health care programs and facilities that specialize in caring for American Indians and Alaska natives.
Q: What’s the difference between an outpatient vs. inpatient clinic?
Outpatient care, also called ambulatory care, is anything that doesn’t require hospitalization.
Inpatient is someone admitted to the hospital to stay overnight.
Q: Is medical insurance needed?
No, you must present your citizenship enrollment card.
Q: Where is my closest IHS Health Care Facility?
A: Depending on where you live there may be an IHS facility close or far. Utilize the spreadsheet I created for the family Indian Health Facilities or you can use the IHS Find Health Care website to locate your closest facility.
Q: What’s covered?
A: Medical, Dental, Behavioral (Depending on the location.)
Q: I am eligible for health care from the Indian Health Service, but the local Service Unit will not pay for the [surgery, health care, medicine] that I need? Why?
A: The Indian Health Service is funded each year through appropriations by the U.S. Congress. The Indian Health Service is not an entitlement program, such as Medicare or Medicaid. The Indian Health Service is not an insurance program. The Indian Health Service is not an established benefits package.
Direct health care services are services provided at an IHS/Tribal/Urban facilities/Purchased/Referred Care (PRC) are services that the IHS is unable to provide in its own facilities. PRC are provided by non-IHS health care providers and facilities. PRC payments are authorized based on clearly defined guidelines and are subject to availability of funds. The Indian Health Service cannot always guarantee that funds are always available. Funds appropriated by the U.S. Congress currently cover an estimated 60% of health care needs of the eligible American Indian and Alaska Native people.
Unfortunately, that means that services obtained under PRC must be prioritized, with life-threatening illnesses or injuries being given highest priority. The patient medical referral is reviewed by PRC to determine if the medical need is within the available funding at that time. It also means that the IHS formulary (the list of drugs and medicines available from IHS pharmacies) may not include all drugs and medicines, but will include most of the ones that have proven to be beneficial and cost-effective.
Q: Can I go to any of the clinics listed?
A: Yes, any tribe member can go to any of the locations listed.
Q: How long will it take?
A: Tribal citizens take priority. Depending on the location you visit. If you are located in the Creek Nation area you have priority. Tribes take their members 1st depending on the funding.
Q: What is needed to transfer my medical record?
A: A Hippa Release Form.
Q: What is a Hippa form?
A: A HIPAA authorization form gives covered entities permission to use protected health information for purposes other than treatment, payment, or health care operations. The HIPAA Privacy Rule requires that an individual provide signed authorization to a covered entity, before the entity may use or disclose certain protected health information.
Q:Where can I get a Hippa Release Form?
A: From your primary care physician or your dentist.
Free Medical Records Release Authorization Form | HIPAA … (Health)
Partners Medical Records Release Form - Partners HealthCare (Dental)
Q: Am I required to get my prescriptions filled through an IHS pharmacy?
A: Patients are not required to get their medications filled through the IHS pharmacy. If you wish to purchase the medication at an external pharmacy, you can request a prescription or request that the prescription be electronically transferred to the requested pharmacy.
Your prescriber will enter the medication in your medical record even if the medication is filled at another pharmacy. This keeps your medication list up to date and prevents medication related errors. Please note that unless there are special circumstances, the patient will be expected to cover the costs of the medication filled by a non-IHS pharmacy.
There are some exceptions in which the patient may not take a prescription to an external pharmacy. These situations may include a patient who requires Directly Observed Therapy (DOT) where the facility staff is required to watch the patient take the medication. Another is when there is a pain contract or agreement in place where the patient has agreed to accept pain management treatment from one clinician and receive pain medications from one pharmacy
Q: How do I file a complaint, ask for more information, report a problem and/or that my privacy rights have been violated?
A: To exercise your rights under the HIPAA Privacy Rule you may file a written complaint with the Chief Executive Officer or the Service Unit Privacy official where you receive your health care; or you may file a written complaint with the Secretary, Health and Human Services, Washington, DC 20201 by accessing the link: http://www.hhs.gov/ocr/hipaa/ .
If you wish to email your complaint directly to the HHS Office of Civil Rights, download the Health Information Privacy Complaint Form in Microsoft Word format to your own computer, fill out and save the form using Microsoft Word. Use the Tab and Shift/Tab on your keyboard to move from field to field in the form. Then, you can email the form to OCR a [email protected].
Q: I am part Indian, am I eligible for health benefits from the Indian Health Service?
A: The most common standard applied for eligibility for health services from the Indian Health Service is that the individual is an enrolled member of a Federally recognized Tribe. The IHS Indian Health Manual (IHM) provides the exact policy concerning eligibility.
Q: What is a federally recognized tribe?
A: A federally recognized tribe is an American Indian or Alaska Native tribal entity that is recognized as having a government-to-government relationship with the United States, with the responsibilities, powers, limitations, and obligations attached to that designation, and is eligible for funding and services from the Indian Health Service & Bureau of Indian Affairs . Furthermore, federally recognized tribes are recognized as possessing certain inherent rights of self-government (i.e., tribal sovereignty) and are entitled to receive certain federal benefits, services, and protections because of their special relationship with the United States. At present, there are 573 federally recognized American Indian and Alaska Native tribes and villages.
Q: Is Muscogee Creek a federally recognized tribe?
A: Yes, The Muscogee (Creek) Nation is a federally recognized tribe of Muscogee people, also known as the Creek, based in the U.S. state of Oklahoma.
Q: What is Indian Health Service?
The Indian Health Service https://www.ihs.gov/aboutihs/, an agency within the Department of Health and Human Services , is responsible for providing federal health services to American Indians and Alaska Natives.
Q: What are Tribal Operated 638 Programs?
A: Tribal Contract or Compact Health Centers (also called a 638 contract or compact) are operated by Tribes or Tribal organizations and Urban Indian Health Centers are outpatient health care programs and facilities that specialize in caring for American Indians and Alaska natives.
Q: What’s the difference between an outpatient vs. inpatient clinic?
Outpatient care, also called ambulatory care, is anything that doesn’t require hospitalization.
Inpatient is someone admitted to the hospital to stay overnight.
Q: Is medical insurance needed?
No, you must present your citizenship enrollment card.
Q: Where is my closest IHS Health Care Facility?
A: Depending on where you live there may be an IHS facility close or far. Utilize the spreadsheet I created for the family Indian Health Facilities or you can use the IHS Find Health Care website to locate your closest facility.
Q: What’s covered?
A: Medical, Dental, Behavioral (Depending on the location.)
Q: I am eligible for health care from the Indian Health Service, but the local Service Unit will not pay for the [surgery, health care, medicine] that I need? Why?
A: The Indian Health Service is funded each year through appropriations by the U.S. Congress. The Indian Health Service is not an entitlement program, such as Medicare or Medicaid. The Indian Health Service is not an insurance program. The Indian Health Service is not an established benefits package.
Direct health care services are services provided at an IHS/Tribal/Urban facilities/Purchased/Referred Care (PRC) are services that the IHS is unable to provide in its own facilities. PRC are provided by non-IHS health care providers and facilities. PRC payments are authorized based on clearly defined guidelines and are subject to availability of funds. The Indian Health Service cannot always guarantee that funds are always available. Funds appropriated by the U.S. Congress currently cover an estimated 60% of health care needs of the eligible American Indian and Alaska Native people.
Unfortunately, that means that services obtained under PRC must be prioritized, with life-threatening illnesses or injuries being given highest priority. The patient medical referral is reviewed by PRC to determine if the medical need is within the available funding at that time. It also means that the IHS formulary (the list of drugs and medicines available from IHS pharmacies) may not include all drugs and medicines, but will include most of the ones that have proven to be beneficial and cost-effective.
Q: Can I go to any of the clinics listed?
A: Yes, any tribe member can go to any of the locations listed.
Q: How long will it take?
A: Tribal citizens take priority. Depending on the location you visit. If you are located in the Creek Nation area you have priority. Tribes take their members 1st depending on the funding.
Q: What is needed to transfer my medical record?
A: A Hippa Release Form.
Q: What is a Hippa form?
A: A HIPAA authorization form gives covered entities permission to use protected health information for purposes other than treatment, payment, or health care operations. The HIPAA Privacy Rule requires that an individual provide signed authorization to a covered entity, before the entity may use or disclose certain protected health information.
Q:Where can I get a Hippa Release Form?
A: From your primary care physician or your dentist.
Free Medical Records Release Authorization Form | HIPAA … (Health)
Partners Medical Records Release Form - Partners HealthCare (Dental)
Q: Am I required to get my prescriptions filled through an IHS pharmacy?
A: Patients are not required to get their medications filled through the IHS pharmacy. If you wish to purchase the medication at an external pharmacy, you can request a prescription or request that the prescription be electronically transferred to the requested pharmacy.
Your prescriber will enter the medication in your medical record even if the medication is filled at another pharmacy. This keeps your medication list up to date and prevents medication related errors. Please note that unless there are special circumstances, the patient will be expected to cover the costs of the medication filled by a non-IHS pharmacy.
There are some exceptions in which the patient may not take a prescription to an external pharmacy. These situations may include a patient who requires Directly Observed Therapy (DOT) where the facility staff is required to watch the patient take the medication. Another is when there is a pain contract or agreement in place where the patient has agreed to accept pain management treatment from one clinician and receive pain medications from one pharmacy
Q: How do I file a complaint, ask for more information, report a problem and/or that my privacy rights have been violated?
A: To exercise your rights under the HIPAA Privacy Rule you may file a written complaint with the Chief Executive Officer or the Service Unit Privacy official where you receive your health care; or you may file a written complaint with the Secretary, Health and Human Services, Washington, DC 20201 by accessing the link: http://www.hhs.gov/ocr/hipaa/ .
If you wish to email your complaint directly to the HHS Office of Civil Rights, download the Health Information Privacy Complaint Form in Microsoft Word format to your own computer, fill out and save the form using Microsoft Word. Use the Tab and Shift/Tab on your keyboard to move from field to field in the form. Then, you can email the form to OCR a [email protected].