Rio Arriba County Indigent Program
ESPANOLA, NEW MEXICO 87532
TELEPHONE: 505 753-2992
Fax: 505 753-9397
Email: smvigil@rio-arriba.org
Hours of Operation
Monday - Friday, 8AM-5PM
1122 INDUSTRIAL PARK ROAD
PHONE: 505 753-2992
OFFICE HOURS: 8:00-5:00 CLOSED FROM NOON TO 1PM
(CALL TO SCHEDULE AN APPOINTMENT)
Welcome to the Rio Arriba County Indigent Claims Administration. This department was created by the county to carry out the mandates and intent of the New Mexico State Law contained in Chapter 27, Article 5 NMSA 1978 cited as the “Indigent Hospital and County Health Care Act”. The purpose of the Indigent Hospital and County Health Care Act [27-5-1 NMSA 1978] is:
To recognize that Rio Arriba County in the state of New Mexico is also responsible for supporting indigent patients by providing local revenues to match federal funds for the state Medicaid Program, including the provision of matching funds for payments to sole community provider hospitals and the transfer of funds to the county-supported Medicaid Fund pursuant to the Statewide Health Care Act [27-10-1 NMSA 1978]; and
Before assistance can be provided, certain requirements will have to be met and the applicant must attend an interview in person and must be prepared to provide personal information.
DOCUMENTS NEEDED TO PROCESS AN APPLICATION
Indigent Application
Indigent Burial Application
- Copy of Income Tax with w2s for previous year or Social Security Check Indigent Burial Application (If applicable)
- Proof of Residency (Property Tax Receipt) rent or lease agreement if you do not own property (Mexican Nationalist will need verification of legal citizenship in the US)
- Utility Bills (Light, Gas or Butane)
- Picture Identification (Driver’s License)
- Hospital Bill
INCOME QUALIFICATIONS
1- Dependent $21,660.00 6-Dependents $59,060.00
2 - Dependents $29,140.00 7- Dependents $66,540.00
3 - Dependents $36,620.00 8- Dependents $74,020.00
4 - Dependents $44,100.00
5 - Dependents $51,580.00
for family units of more than 8 members add $3,740.00 for each additional member
PROVIDERS COVERED
- Española Hospital
- St. Vincent's Hospital
- Los Alamos Medical Center
SERVICES PROVIDED
- In-Patient (must be admitted)
- Emergency Room (out Patient)
- Scheduled Surgery (a letter from doctor prior to surgery is required)
- Physical Therapy
- Home Health Care from Hospital
- Ambulance
- Presbyterian Physicians
- Anesthetist
- Radiology
- MRI
- CAT Scan
- Burial Assistance (county will pay $200.00 to DeVargas Funeral Home and Rivera Funeral Home) will need a copy of statement from mortuary and death certificate before payment is made to mortuary.
ADDITIONAL REQUIREMENTS
- Patient needs to be a RESIDENT of Rio Arriba County 90 days prior to date of service, Patient needs to contact the County Indigent Office or Hospital after being discharged
- Rio Arriba County will pay only from $500 TO $5,000.00 PER ADMISSION for qualifying patients.
- Drug and Alcohol Abuse patients have a $5,000.00 Life Time Limit