Healthcare Assistance Program (HCAP)

Purpose

Access to health care reduces long term medical and social costs. An effective health care system must retain local health care efforts, stimulate local innovations for meeting particular health needs, and use existing resources to expand health care options, especially for those citizens unable to pay for their own care. Each individual county in the state of New Mexico is responsible for ambulance transportation, hospital care, or the provision of health care to indigent patients domiciled in the respective county, as determined by resolution of the board of county commissioners, in addition to providing support for the state's Medicaid program. (NMSA 1978 §27-5-2A).

Pursuant to NMSA 1978 §27-5-6E, the Otero County Health Care Assistance Fund must comply with the standards of the Health Insurance Portability and Accountability Act (HIPPA).

The Healthcare Service program previously known as Indigent Fund is the payer of "last resort" and is a claims-based program. A patient must have received services from one of our contracted providers.

Claim Limits

The maximum amount per assistance claim is $10,000, with an annual cap of $30,000 for medical expenses. The maximum amount for ambulance assistance is $500 per year.(§104-13(D)) All claims for assistance will be denied when caps are reached until the next fiscal year.

Program will not pay:

  • Elective surgery or procedures
  • Private Physician Services in office
  • Private Physician contracted with GCRMC (unless billed directly through GCRMC)
  • No Physician payments after insurance
  • Deductibles and co-payments

Please do not hesitate to apply for assistance. We will look at each individual and unique circumstance to assist in any way as allowed by State Statute and County Ordinance.

Time Limits for Filling

Pursuant to Otero County Ordinance §140-12(A), you have 75 days from the date of discharge or once a bill has occurred with any of the contracted medical providers to file for assistance. You have 30 days to provide any and all paper work required and requested. Time may be extended upon request and approval for up to one year for paper work needed to complete the process of your claim(s) (§140-12(F)(2)(b)).