Health Care Assistance Program 

CONTACT INFO

109 W 1st Street
Portales, NM 88130
575.356.5307
575.356.8307 (fax) 

 Do I qualify for medical assistance?

Health Care Assistance Program Eligibility Criteria includes:
– Application must be submitted within 90 days of service
– Applicant must be a Roosevelt County resident (at least 90 days prior to service)

Income Criteria:

– Single, $12,000
– Married, $16,000
– Each dependent up to 4, $1,200
– Maximum, $20,800

Eligible Service Providers covered under HCAP include:

– Hospitals
– Ground Transport / Air Ambulance

Application and Instructions

Please print and completely answer all questions to expedite the application process.

Health Care Assistance Program (HCAP) Policy

FY21 Annual Health Care Assistance Report

FY20 Annual Health Care Assistance Report

FY19 Annual Health Care Assistance Report