What kinds of medical costs can be covered in a New Mexico injury claim?

When someone else’s negligence caused your injury, New Mexico law allows you to seek compensation for economic damages. Economic damages commonly include:

• Past medical expenses (ER care, hospitalization, clinician visits, imaging, physical therapy, prescription drugs).
• Reasonable future medical treatment related to the injury (predicted cost of ongoing care).
• Related out‑of‑pocket costs (transportation to treatment, medical devices, home modifications when necessary).

To recover these you must prove the bills were reasonable, related to the accident, and medically necessary.

How does payment actually happen if I can’t afford care now?

There are several common ways medical care gets paid while your claim is pending:

1. Use existing health insurance or government benefits (Medicaid/Medicare). If you have private health insurance, Medicaid, or Medicare, those plans typically pay your immediate treatment costs. Later, they may seek repayment (subrogation) from any settlement or judgment. Contact the plan and keep good records.
2. Medical provider billing or lien while you wait for a claim outcome. Some hospitals or clinics will bill you or place a medical lien against your personal injury recovery. A lien gives the provider a legal claim to part of your settlement. Whether a provider can perfect a lien and how much they can recover depends on the provider’s policies and applicable law.
3. Auto insurance options. New Mexico does not require Personal Injury Protection (PIP) universally, but some auto policies include medical payments coverage (MedPay). If the at‑fault driver’s policy or your own policy has MedPay, it can pay immediate medical bills up to the policy limits regardless of fault.
4. Pay now, get reimbursed later. If you pay some bills out of pocket, you can include those costs as part of your claim and seek reimbursement.
5. Negotiate provider arrangements or lien reductions. Many providers will negotiate amounts, delay collection, or accept a reduced payment from settlement proceeds. An attorney experienced in injury claims often negotiates these liens.

What obstacles reduce the amount available to pay medical bills?

Several common factors can reduce what you receive and what providers can collect:

• Comparative fault. New Mexico applies comparative fault principles, so if you were partly at fault, your recovery for medical bills and other damages may be reduced in proportion to your fault.
• Insurance limits. If the at‑fault party’s liability insurance is low, there may be little money available to cover large bills.
• Liens and subrogation claims. Medicare, Medicaid, private health plans and ERISA plans can claim repayment from your settlement or judgment. Hospitals and providers may assert liens. Those claims can significantly reduce net recovery unless negotiated.
• Reasonableness disputes. Insurers or defense lawyers may dispute some bills as unnecessary or excessive; a court only awards reasonable charges supported by evidence.

What should I do step‑by‑step if I can’t afford medical bills after an accident?

1. Get medical care right away. Prompt care protects your health and creates the medical records needed to prove causation and costs.
2. Use available health insurance or public benefits. Apply for Medicaid if eligible (New Mexico Human Services Department can guide applications). Federal and state programs may cover treatment while you pursue a claim.
3. Tell providers there is a pending third‑party claim. Ask if they will delay collection or place a lien and get any agreement in writing.
4. Document everything. Keep all medical bills, itemized statements, appointments, and proof of payment or insurance payments.
5. Notify your auto insurer (if applicable) and the at‑fault party’s insurer. Provide timely notice to preserve your right to claim benefits or liability coverage.
6. Talk to a personal injury attorney early. Attorneys know how to handle liens, negotiate with insurers, and protect your net recovery. They can advise whether a structured settlement or lump sum better protects future care needs.
7. Do not sign away your rights to future claims without advice. Early, low settlement offers may not cover all future medical needs and can leave you stuck with unpaid bills.

Special concerns: Medicare, Medicaid and ERISA plans

If a government program or an employer‑sponsored plan paid your medical bills, it likely has subrogation or reimbursement rights. Federal law and program rules may require you to repay those programs from your recovery. Failing to address these claims can reduce your net recovery or expose you to legal action. Relevant resources:

• New Mexico Human Services Department (Medicaid): https://www.hsd.state.nm.us/
• Medicare (federal): https://www.medicare.gov/
• ERISA plan information (U.S. Department of Labor): https://www.dol.gov/agencies/ebsa

About New Mexico law and statutes that matter

New Mexico allows recovery of economic damages (like medical bills) and applies comparative fault rules when assessing recovery. For the authoritative New Mexico statutory code and chapter headings, see the New Mexico Legislature’s statutes index: https://www.nmlegis.gov/Legislation/Statutes. For help with Medicaid rules in New Mexico, see the Human Services Department: https://www.hsd.state.nm.us/.

Because lien, subrogation, and insurance questions depend on specific facts and contracts, an attorney can review how New Mexico law and your benefit plans apply to your case.

Helpful Hints

• Seek medical care immediately and follow your doctor’s recommendations—gaps in treatment can be used to argue your injuries aren’t serious or related to the accident.
• Keep a single folder (digital or paper) for all medical records, bills and treatment receipts.
• Tell every treating provider that you were in an accident and that a third‑party claim may follow; ask if they will assert a lien and get their contact for lien negotiations.
• Contact your health insurer to learn whether they will pay treatment now and whether they will seek repayment later.
• If an insurer or provider offers a lien reduction, get it in writing before you accept a settlement offer.
• Don’t accept a settlement without understanding outstanding liens, subrogation claims, and how much you will actually keep.
• Consider an attorney contingency fee arrangement if you cannot afford an upfront lawyer fee; most personal injury lawyers are paid only if you recover.