Eligibility

Native & Non-Native Spouse Prescription Program

Native Americans:

Prescription drug assistance for Native Americans and non-Native American spouses with active private or Medicare Part D prescription insurance is available through the Chickasaw Nation Refill Center (federally recognized tribes only). For enrollment approval, prescription insurance coverage is required. Prescriptions are subject to insurance approval and will be made available by mail or pick-up at the Chickasaw Nation Refill Center.

Once enrolled, participants may have prescriptions sent to the Chickasaw Nation Refill Center to be reviewed and processed. Completed prescriptions will be available to patients via mail or to be picked up in the drive-thru at the Chickasaw Nation Refill Center. As refills are needed, participants may call the Chickasaw Nation Refill Center directly or utilize our website, email, smartphone application or interactive telephone service to process refill requests.

Non-Native Spouses:

Non-Native spouses must submit a current marriage license with the application in addition to the required documentation listed on the enrollment application.

Chickasaw Citizens:

Uninsured Chickasaw citizens younger than 19 years of age living outside of the Chickasaw Nation boundaries may contact the Chickasaw Nation Refill Center for alternative eligibility requirements for prescription assistance.

Non-covered items include:

• Investigational Drugs
• IV medications and IV drug administration devices
• Over-the-counter (OTC) medications
• Compounded medications

All controlled substance medications must be picked up at the Chickasaw Nation Refill Center.

All participants must provide:

• Completed Application (each participant must submit a separate application)
• Copy of CDIB Card
• Copy of Tribal Citizenship Card
• Copy of Prescription Insurance Card (front and back of insurance card)
• Copy of Marriage License
• Signed Acknowledgement of Receipt of Notice of Privacy Practices form

Forms:

To view and download forms please visit apply