Patient & Visitor Information

Roosevelt County Medical Assistance Program

(Indigent Program)

Do you need help with your hospital and ambulance bill? The Roosevelt County Indigent program may be able to help. Funding for the program comes from the county's indigent fund.

  • A Hospital claim must be submitted within 90 days of service.
  • Ambulance bills must be submitted within 90 days of service.

Who is eligible for the assistance program?

  • Residents of Roosevelt County who have lived a minimum of three months prior to the date of medical services provided.
  • County residents living in households receiving benefits from one of the following: Food Stamps,TANF, GA, Homeless

The following documentation must be provided with the completed Program Application (click here to download):

  • Proof of residency: A notarized statement by landlord or neighbor, a rental lease agreement, utility bill or driver's license
  • Proof of Income: Check stubs for the last two months. If applicant is unemployed, two notarized letters stating how their expenses are covered
  • Federal income tax return
  • Gross receipts sales tax form
  • Award letters for benefits
  • Bank statements

For more information contact:
Erminia Chavez
Roosevelt General Hospital
42121 US Hwy 70
Portales, NM 88130
Phone: 575.356.3410
Fax: 575.356.9200

Click here to view the official Roosevelt County page for more information.

Carol Acosta-Flores
Roosevelt County Indigent Administrator
109 W 1st Street Room B-5
Portales, NM 88130
Phone: 575.356.5307
Fax: 575.356.8307