Traveling out of state? Learn about the Purchased Referred Care Travel Program
April 8, 2022ANMC Purchased Referred Care (PRC) offers limited benefits to eligible Alaska Native and American Indian beneficiaries to help with emergency medical care while traveling outside of Alaska.
Patients who meet ANMC’s eligibility criteria and residency requirements qualify. To meet residency requirements, the individual must not have been absent from Alaska for more than 180 days; and intend to live in Alaska indefinitely. Other criteria for eligibility include proof of Tribal enrollment or descent. Legal dependents of beneficiaries, including foster children, adopted children, and non-beneficiary women who are pregnant with an Alaska Native or American Indian man’s child are also eligible and additional documentation is required (birth certificate, marriage certificate or other document establishing paternity).
If you are moving, ANMC PRC is only able to provide coverage for emergent medical services for 180 days from the date you left Alaska.
There are exceptions for certain locations in Alaska, so please contact your local PRC office if your permanent or last place of residency is in the service areas of the Tanana Chiefs Conference, Ketchikan Indian Community, Metlakatla Indian Community or SouthEast Alaska Regional Health Consortium.
The traveler program may help patients cover the cost of emergency medical care while traveling outside of Alaska, including traveling outside of the United States. An emergency is defined as any medical condition for which immediate medical attention is necessary to prevent the death or serious impairment of the health of the individual. Services not covered include: non-emergent care, routine care, dental care, medications purchased while traveling, inpatient and outpatient mental health services or inpatient and outpatient substance abuse services.
What do I need to do prior to travel?
Prior to your travel verify if there is an Indian Health Service (IHS) or Tribal facility close to where you are traveling. If an IHS or Tribal facility is not available for emergencies, seek care at the closest medical facility. To find the nearest IHS facility, visit www.ihs.gov/locations.
PRC is payer of last resort. If you have health insurance coverage, it is your responsibility to provide that information to the provider and PRC. It is your responsibility to take care of routine medical needs such as immunizations, physicals and medication refills prior to travel.
The patient or the patient’s family has the responsibility to notify ANMC PRC within 72 hours, including weekends and holidays, after receiving medical treatment. If you are traveling out of the United States, you may be required to pay for the emergency medical care upfront. Notify ANMC PRC within 72 hours and provide the receipts.
From time of services, the patient has 30 days to submit supporting documents including medical bills, patient statements, medical records, flight itinerary or boarding pass, and proof of eligibility. It is the patient’s or their family’s ultimate responsibility to ensure PRC receives all claims and applicable health insurance information in a timely manner.
Your request for coverage will not be reviewed until all necessary documentation is received to determine if you are eligible for PRC services and care that meets the criteria for a medical emergency. Coverage may be approved or denied based on the documentation. Federal regulations mandate that PRC is the payer of last resort. You may be contacted for health benefits screening or to verify primary insurance coverage.
If you are moving outside of the state of Alaska, register and utilize the services available at the closest IHS or Tribal facility. There is no guarantee that you will be eligible to receive services at any of those facilities because each area has its own local eligibility policies.
For questions regarding ANMC PRC’s Traveler program or to provide your 72-hour notice, call the office at (907) 729-2470 or toll-free at 1-800-478-1636. If the office is closed, leave a detailed message and include the patient’s name, date of birth and contact phone number.
You may also go to https://anmc.org/patients-visitors/prc/#contact and submit an online message to ANMC PRC. For a full list of who and what is covered, please visit https://anmc.org/patients-visitors/prc/.