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.

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.

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.