TRIBAL MEMBER SERVICES

ReimbursementPrograms:

TheElder Benefit Program reimburses tribal elders 65 years and older up to$250 per fiscal year for out-of-pocket medical expenses. Out-of-pocket medicalexpenses that are reimbursable under this program are those that are medicallynecessary, but not covered by insurance or if no insurance coverage ispresent. Office visit co-pays(medical, dental, vision, chiropractic), prescription co-pays, medicalequipment (such as blood-glucose monitors, blood pressure monitors, etc.),eye-glasses, hearing aids, dentures are examples of the out-of-pocket medicalexpenses that can be reimbursed through this program.

The Disability ReimbursementProgram is a new program created for those tribal members who are betweenthe ages of 18 and 64 who are totally disabled. Like the Elder Benefit Program, thisprogram reimburses eligible tribal members for out-of-pocket medical expensesthat are medically necessary, that are not covered by insurance or if noinsurance coverage is present. Office visit co-pays (medical, dental, vision, chiropractic), prescriptionco-pays, medical equipment (such as blood-glucose monitors, blood pressuremonitors, etc.), eye-glasses, hearing aids, dentures are examples of theout-of-pocket medical expenses that can be reimbursed through this program.

To be eligible for this program,tribal members must meet the following definition of totally disabledas defined by the federal government:

(1) lacks the ability to engage in anysubstantial gainful activity;

(2) the incapacity isdue to one or more medically determinable physical or mental impairments; and

(3) the incapacity haslasted or can be expected to last for a continuous period of at least 12 monthsor to result in death

Important things to remember for the Elder Reimbursement Programand the Disability Reimbursement Program:

• Submit receipts, along with the reimbursement claim form, to be reimbursed for your out-of-pocket medical expenses to Charla Gibson, Office of Vital Records, to be eligible for reimbursement. Print the form Reimbursement Claim Form or one can be requested by calling the tribal office.

• FOR THE DISABILITY REIMBURSEMENT PROGRAM ONLY: In addition to the claim form and receipts, the written notification from the Social Security Administration that was received when it was determined that you were totally disabled must be submitted.

• These programs run on fiscal year, which begins October 1^st and ends September 30^th of each year. Receipts must be submitted for expenses incurred during the current fiscal year to be reimbursed.

• Claims for reimbursement can be made as expenses are incurred or after the full fiscal year benefit amount of $250 has been accumulated.

• Only actual receipts or a report from a provider (pharmacy or doctor's office) are eligible for reimbursement. Please do not submit copies of checks, cancelled checks, copies of money orders, receipts from the purchase of money orders for reimbursement under this program.

• $250 is the maximum benefit allowable per tribal member per fiscal year.

TribalMember Life Insurance:

All Miami Tribal Membersare insured for $1,000.00 payable upon death. A certified copy of the deathcertificate must be submitted to the Tribe before benefit is payable. This canbe paid to the next of kin, funeral home, estate, etc.