An Excerpt from Chapa-De News: May 2025
Article by Sami Enos
Community Health Representative
May 8, 2025
Verified native patients are eligible to receive services Chapa-De provides in-house at no charge to them, due to Indian Health Services (IHS) paying the fees. However, there are procedures that are not available in-house that native patients are responsible for paying.
Having Medi-Cal or other type of insurance can help make sure you are not left paying these types of bills out of pocket:
- X-rays (imaging) – If you hurt your arm or foot, the doctor needs to know if it is broken or dislocated and the only way to know for sure is with imaging. It is not performed at Chapa-De, we have to send you out to get that done.
- Emergency – Whether you go to the emergency room or Urgent Care for illness or injury, any procedures, medications and care that they provide is the patient’s responsibility to pay.
- After hours – you need to be seen but our clinic is closed.
- Surgeries – including doctor fees, anesthesiologist fees, room fees, etc.
- Dental lab fees – in our dental department, if you need a crown or dentures, we send those items to an outside lab to get them made.
Telling Chapa-De about your insurance coverage allows us to receive more funding and does not cost you anything extra. When we use your insurance it does not increase your insurance rates and you do not have to pay any co-pays or deductibles at Chapa-De. IHS is given a yearly budget by Congress that only meets about half of the needs of American Indians and Alaska Natives, and it is not guaranteed. When we bill your insurance, it helps bring in more funding for up-to-date equipment, the latest technology and employees. We are also able to have more providers and services like our Optometry and Diabetes Departments.
Enrollment in health insurance can help bring more funding to Chapa-De to expand needed care options and helps make sure that health care is available to you when you need it. It protects you from high costs when something like illness or injury happens that requires you to be seen outside of Chapa-De.
Purchased and Referred Care (PRC)
Some natives qualify for the Purchased and Referred Care Program that can pay for some healthcare services outside of Chapa-De. However, only a small number of patients qualify for this program. To qualify, the patient must be verified, from a California Tribe, and live in an eligible county. PRC is payor of last resort. This means patient must use insurance first, and if they do not have insurance, they must prove they do not qualify for MediCal. They must also speak with the PRC Coordinator for all qualifications before the procedure or referral. Please see the Additional Benefits for California Natives article for additional Information in the May Newsletter.
Direct IHS Benefits
Patients that are verified with out of state (not California) tribe verification and/or do not live in an eligible county are not eligible for PRC*. That means they are eligible for IHS (Indian Health Services) funding and do not pay to receive services that we perform at Chapa-De. These patients are, however, responsible for everything outside of our office.
Resources
The Chapa-De Care Coordination Team is available to assist patients to get insurance. They can help you apply for Medi-Cal or Covered California. American Indians and Alaska Natives can sign up for these types of insurance plans all year and do not need to wait for open enrollment. Native people also qualify for higher rebates and financial assistance through Covered California.
AIAN have higher income limit to get financial assistance.
Contact the Care Coordination team at 530-537-2621 or ask to speak with one of us during your next visit.
*There are some exceptions
Read more of our May newsletter:
Chapa-De Indian Health Auburn Grass Valley | Medical Clinic
PASSIONATE PEOPLE. COMPASSIONATE CARE.
Chapa-De provides medical care, dental care, optometry, behavioral health, pharmacy services and much more.
Serving all American Indian, Low Income and Limited Income Community Members
