New Mexico is now the only state that makes insurers pay for diabetic foot care

New law took effect Jan. 1

New Mexico now requires private health insurance plans to cover specialized equipment for treating diabetic foot ulcers.

The law took effect Jan. 1, 2026, making New Mexico the first state in the nation to mandate this kind of coverage on state-regulated plans, according to the American Diabetes Association (ADA).

Gov. Michelle Lujan Grisham signed House Bill 233 on April 7, 2025. Reps. Joshua Hernandez, Liz Thomson, Eleanor Chavez, and Kathleen Cates sponsored the bill.

Equipment and therapies the law covers

The law requires insurers to cover durable medical equipment for active diabetic foot ulcers, including topical oxygen therapy.

It also covers podiatric appliances designed to prevent foot problems from diabetes, like therapeutic molded shoes, depth-inlay shoes, custom orthotics, replacement inserts, and shoe modifications.

Treatment must be prescribed by a health care practitioner with prescribing authority. The goal is to catch foot problems early, before they turn into something far worse.

Not everyone qualifies for coverage

The mandate applies to people on state-regulated private health insurance, including individual and group policies, health maintenance organizations, and nonprofit health care plans. But it does not cover Medicare or Medicaid patients.

Short-term travel, accident-only, and limited disease policies are also excluded.

Some state lawmakers have talked about expanding Medicaid to include these treatments down the road, but no legislation has moved forward yet.

Diabetes hits New Mexico hard

About 217,400 adults in New Mexico have a diabetes diagnosis, roughly 13% of the state’s adult population, according to the state Department of Health. About 9,800 adults get a new diagnosis each year.

The disease hits some communities harder than others. African Americans, Hispanic Americans, and Native Americans face higher rates.

Among people 65 and older, more than 22% of women and close to 25% of men have diabetes.

Foot ulcers can turn deadly fast

Diabetic foot ulcers are open sores that form when minor cuts or blisters on the feet don’t heal properly. Nerve damage called neuropathy, poor blood flow from peripheral artery disease, or both can cause them.

What starts as a small wound can lead to infection, hospitalization, loss of mobility, or even amputation.

The ADA estimates that foot ulcers affect roughly 15% to 25% of people with diabetes at some point in their lives.

Amputations happen at a staggering rate

The numbers are hard to ignore. About 160,000 people with diabetes lose a limb to a non-traumatic amputation in the United States each year, according to the ADA.

That works out to roughly one amputation every three and a half minutes. Diabetes complications cause about 80% of all non-traumatic lower-limb amputations.

People who go through a diabetes-related amputation have a lower five-year survival rate than people with coronary artery disease, breast cancer, or colorectal cancer.

Lack of insurance leads to emergency rooms

Before this law, many insurers in New Mexico simply didn’t cover specialized foot ulcer treatments. That left a lot of people without options.

People with diabetes who lack insurance have about 60% fewer doctor visits and get about 52% fewer prescriptions, but they end up in the emergency room about 168% more often.

The ADA has said every dollar spent on podiatric care saves the health care system between $27 and $51 for commercially insured patients.

Topical oxygen therapy explained

Topical oxygen therapy delivers concentrated oxygen directly to a wound to help it heal. It’s different from hyperbaric oxygen therapy, which requires sitting in a pressurized chamber.

Multiple peer-reviewed studies have linked topical oxygen therapy to higher healing rates for diabetic foot ulcers when combined with standard wound care.

Before HB 233 passed, most insurers in New Mexico would not pay for the treatment, leaving many patients to cover the cost themselves or go without.

Stigma keeps other states behind

So why hasn’t any other state done this? The ADA points to stigma around diabetes and foot health as a major barrier.

Policymakers generally haven’t understood how big the problem is.

Amputations are more common among people of color and people with lower incomes, according to the ADA. And waiting more than six weeks to see a doctor for a foot ulcer raises the chance that it ends in amputation.

Awareness has been slow to build.

Medicare and Medicaid patients still left out

The law doesn’t help everyone. Medicare and Medicaid patients are not covered, and New Mexico’s Medicaid program still doesn’t pay for these specialized treatments.

Self-insured employer plans, which the federal government regulates, are also excluded. People on those plans need to check directly with their insurer to find out what foot care options they have.

That leaves a big gap, especially for lower-income patients who face the highest amputation risk.

Other states could follow New Mexico’s lead

No other state has introduced similar legislation as of early 2026, but the ADA has signaled interest in pushing for it.

The ADA’s 2026 Standards of Care in Diabetes now includes expanded guidance on advanced therapies for diabetic foot ulcers, including topical oxygen therapy.

If New Mexico’s law leads to fewer amputations and lower costs, it could serve as a model. For now, New Mexico stands alone.

What residents should do right now

If you have diabetes and carry a state-regulated private insurance plan in New Mexico, call your insurer and ask about updated coverage for foot ulcer treatment.

Anyone with diabetes who notices a sore, cut, or blister that isn’t healing should see a doctor right away. The law requires coverage when a practitioner with prescribing authority orders treatment.

People on Medicare or Medicaid should ask their providers what foot care options their current plan covers.

This article was created with AI assistance and human editing.

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