NATIVE AMERICAN BENEFITS

Chickasaw Nation Refill Center

GlobalHealth, Inc, and Chickasaw Nation Refill Center in Ada, OK, have teamed up to provide eligible GlobalHealth members and beneficiaries of Native American lineage certain prescription savings through this added value service. To qualify and participate in this tribal prescription program, please print and complete the enrollment form and affix a photocopy of your Tribal Membership card or CDIB card to the enrollment form. If you are enrolling based upon the Tribal Membership card or CDIB card of your spouse, attach a copy of your marriage license.

Please click on the links below for more information.

• Enrollment Form
• Notice of Privacy Practices
• Notice of Privacy Practices Acknowledgement Signature Form
• Chickasaw Nation Refill Center Website