Two types of services are provided by the Indian Health Service: (1) Direct health care services, which are provided by an IHS facility, or (2) contract health services (CHS), which are provided by a non-IHS facility or provider through contracts with the IHS. CHS are provided principally for members of federally recognized tribes who reside on or near the reservation established for the local tribe(s) in geographic areas called contract health service delivery areas (CHSDAs). The eligibility requirements are stricter for CHS than they are for direct care.
Health Care Options
A member of a Federally recognized tribe may obtain care at any IHS hospital
or clinic if the facility has the staff and capability to provide the medical
care. One of the additional requirements for CHS is that the patient must
reside in certain areas. One way to meet the residency requirement is to
live on the reservation of any Federally recognized tribe. Another way to
meet the residency requirement is to reside within the contract health service
delivery area (CHSDA) for the patient's tribe.
Many, or even most, people who move away from their home reservations are not eligible for CHS since they would be moving away from the CHSDA in which they have eligibility. Check with your home or local Service Unit about eligibility, since they will be the ones making all determinations and paying bills for approved care. Most CHS provided is for urgent or emergency needs, as defined by the local service unit, and requires prior approval for non-emergency care and notification within 72 hours for emergency care.
Home Health Care
Some programs or portions of programs are tribally operated instead of
being operated by the Federal Government through the IHS. Some tribally
operated hospitals or clinics restrict services to members of their own
tribe. Consequently, just because a patient is a member of a Federally recognized
tribe does not mean that they will be provided medical care at a tribally
operated hospital or clinic.
There are a few urban Indian health care facilities located in cities throughout
the United States. Check the Urban Indian Health Program listing to see
if there is an urban clinic located near you.