Health and Wellness Center
Health and Wellness Center
Purchased/Referred Care Program
What is the Purchased Referred Care Program?
The Purchased/Referred Care Program is hospital, physician, pharmacy, dental, optometry services that cannot be provided at the Stockbridge-Munsee Health and Wellness Center.
What do I have to do to get these services?
The patient must be referred by an on-site provider at the Stockbridge Munsee Health and Wellness Center. The referral MUST be signed by PRC staff and the patient and then hand carried to the appointment.
The patient must obtain a new referral form for each visit outside of the S/M Health and Wellness Center. This referral also covers prescription medication at the S/M Health and Wellness Center that are prescribed by the outside provider.
Reimbursement for pharmaceuticals from emergencies will be made when the S/M Health and Wellness Clinic is closed, if more than $10.00. Ages 55 and older or disabled will be reimbursed at 100% of the cost when the receipt and prescription information is brought in to the PRC department.
*If you are referred by the authorizing PRC staff to apply for these types of assistance, documentation of the denial/approval of the programs are required before PRC Funds are obligated. It should be clearly understood that residency within the Stockbridge-Munsee Purchased Referred Care Delivery Area (PRCDA), Shawano and Menominee Counties. Noncompliance with these requests will result in a denial from the PRC department.
Who is eligible for the Purchased Referred Care Program?
An enrolled member of the Stockbridge-Munsee Tribe who resides within the Purchased/Referred Care Delivery Area (PRCDA).
A direct descendant (first generation) of an enrolled member of the Stockbridge-Munsee Tribe who resides within the PRCDA.
A second generation descendant of an enrolled member of the Stockbridge-Munsee Tribe who resides within the PRCDA.
Any individual who has not attained the age of 19 and is the natural or adopted child, stepchild, legal ward or orphan of an enrolled member of the Stockbridge-Munsee Tribe who resides within the PRCDA.
A full time student at a vocational, technical or other academic institution who is an enrolled member of the Stockbridge-Munsee Tribe whose permanent address was within the PRCDA prior to attending the educational institution, not to exceed 180 days after completion of their study.
A non-Indian woman who is pregnant with an enrolled Stockbridge-Munsee member's child, but, only during the period of her pregnancy and postpartum (generally about six weeks after delivery).
**Note: Eligible patients will be asked to verify residency every 3 years**
Purchased/Referred Care funds are to be used ONLY after it has been established that NO other resources are available to the person requiring PRC services. It should be clearly understood that residency within the Stockbridge-Munsee Purchased Referred Care Delivery Area (PRCDA), Shawano and Menominee Counties creates no legal entitlement to Contract Health Services but only potential eligibility for services.
Emergency Room Visit Hotline:
**The Purchased/Referred Care Program must be advised within 72 hours of the ER visit.**
(Exceptions for Elderly and Disabled)
Medical Benefits Outreach Specialist
Tribal Health Fund Specialist