Purchased/Referred Care (PRC)

Address: 9605 Grand Ronde Road Grand Ronde, OR 97347 | Phone: 503-879-2080 | Toll Free: 800-775-0095 | Fax: 503-879-2228

Hours: Monday - Friday 8:00am - 12:00pm, 1:00pm - 5:00pm | Holiday Closures

Mission Statement: 

Purchased Referred Cares mission is to provide funding for Grand Ronde Tribal Members and eligible Descendants; allowing them to receive high quality health care beyond what is available through IHS and Tribal Health facilities.

Registration Form:


 


WHO IS ELIGIBLE FOR P/RC?

  • You must be an enrolled Grand Ronde Tribal Member or a direct minor descendant (under age 19) of a P/RC eligible member, residing within the 6 county service delivery area. Those counties are as follows: Marion,Polk, Yamhill, Multnomah, Tillamook & Washington counties. Certain exceptions may apply. Please contact program staff for details.
  • A non-Indian woman pregnant with a P/RC eligible member’s child. Rules and restrictions apply. Please contact program staff for details.
  • Be enrolled in college or academic institution, vocational program or related training. NOTE: A student must first be eligible for P/RC PRIOR to leaving the service delivery area for school.
  • A foster child who is placed in foster care outside of the Grand Ronde service delivery area by court order and who is eligible for P/RC at the time of the court order. Such children continue to be eligible for P/RC while in foster care, or turn 19 years of age.
  • Members that are incarcerated are not eligible for P/RC coverage.
  • A refusal to apply for alternate resources will result in a denial of payment.

FREQUENTLY ASKED QUESTIONS:

WHY DO I HAVE TO APPLY FOR ALTERNATE RESOURCES?

This is required by 42 C.F.R. 136.61, Payer of last resort. Approval of P/RC payment for services is considered after all other Alternate Resources (AR) are applied. Any patient who is potentially eligible is required to apply for or an alternate resource.

 


WHAT IS AN “ALTERNATE RESOURCE”?

Medicaid, Medicare, Employer Coverage, Private Insurance. Skookum (Shasta) is not insurance.
Click here for information about Oregon health Plan (OHP)

 


WHAT SERVICES ARE COVERED BY P/RC?

Most medical services, dental, optical, mental health, chemical dependence and some outside pharmacy and durable medical equipment services.

 


WHAT IS NOT COVERED BY P/RC?

Non-emergency ER services, chiropractic, massage, naturopaths, personal care items, cosmetic services, luxury or over the counter prescriptions as well as unapproved prescriptions filled at a pharmacy other than Grand Ronde Pharmacy.

*This may not be a full list of non-covered services. Please contact your P/RC Representative with questions.*

The Purchased/Referred Care program is federally funded under P.L.93-638 by Congress for the Grand Ronde Tribe. To receive services through this program, one must meet the Purchased/Referred Care Service eligibility requirements outlined above. All routine medical care, including follow-up visits, must have prior approval.

Some extra benefits for Tribal Members out of the service area, may be available. Please contact Grand Ronde P/RC if you are out of the 6 county service area, but need funding assistance for the following services: vision, dental, hearing aid or chemical dependency residential treatment.

Click here for the Notice of Privacy Practices for the Grand Ronde Health & Wellness Center