Health Care Assistance Program

The Sandoval County Health Care Assistance Program (HCAP) assists eligible county residents with medical, ambulance, and prescription costs as follows (income restrictions apply):

Service Maximum per Claim Maximum per Year
Ambulance
75% of Tariff Rate or $400, whichever is less
$400 $800
Hospitalization
75% of billed charge or $2500, whichever is less
$2,500 $5,000
Outpatient Behavioral Health $150 $600
Outpatient Primary Care
Includes lab tests
$150 $600
Oral health Care
(Exams, X-rays, Cleaning)
$200 $200
Pharmacy* $800 $800
Indigent Burial
(Cremation)
$600 $600

*Eligible prescriptions and medications are based on the Medicaid formulary. All Schedule 2 medications and special $4.00 prescriptions are excluded.

Sandoval County Indigent Hosptial and Health Care Ordinance

Sandoval County Health Care Assistance Payment Plan Resolution

Sandoval County HCAP Provider Forms

To access the HCAP forms, please use the links below.

Sandoval County HCAP Checklist

Sandoval HCAP Application

HCAP Residency Verification Form

If you have questions about the program or need assistance with the application, call 505-867-2291 extension 1704.

Other Health Care Assistance Options

Please access information about other health care assistance options at the links below.

Insurance Options for New Mexico Residents

State Coverage Insurance (NM Department of Health Web Site)

New Mexico MedBank Prescription Program