These Items Will Be Needed For This Online Application:

• Proof of Tribal Enrollment or Descendancy (official letter from the tribe)
• Birth Certificate
• Social Security Card
• 1 Item for proof of residency (electric bill, rent/lease receipt, valid MT Driver's license with your current physical address or a voter registration card with your current address and/or residential phone bill dated within the last 30 days).
• Medicaid, Medicare and/or HMK Card OR letter of denial (copy both sides of the card)

Pregnant women also need to submit:

• Statement from your OB-GYN with Due Date

College Students also need to submit the following:

• Student status verification (official letter/official transcripts from the institute verifying full-time student status and duration of attendance)
• Contract Health Service eligibility letter from home reservation

If all required documents are NOT submitted with your application your eligibility status will be "Direct Care Only".  An Eligibility Determination for "Purchase Referred Care" cannot be made until your application is complete. This means there will be no medical services paid by THPC medical treatment received outside of our facility.