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CareAdvantage D-SNP 2024 | HPSM Members

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Benefit </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/drug-coverage" class="list-group-item dropdown-item collapsed "> Medicine Coverage <i href="#group-149023254-0bf5-4cb7-88a5-c1869cfd060b" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-1e371f23a-076a-4bfc-bac6-4adba5efa651"></i> </a> <div class="collapse" id="group-149023254-0bf5-4cb7-88a5-c1869cfd060b"> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/drug-coverage/costs" class="list-group-item strong "> Medicine Costs </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/drug-coverage/drug-transition-policy" class="list-group-item strong "> Medicine Transition Policy </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/drug-coverage/determination" class="list-group-item strong "> Coverage Determination </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/drug-coverage/redetermination" class="list-group-item strong "> Coverage Redetermination </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/drug-coverage/mtm" class="list-group-item strong "> Medication Therapy Management </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/drug-coverage/90-day-rx" class="list-group-item strong "> Fill Your Prescription for 90 Days </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/drug-coverage/pharmacy-services" class="list-group-item strong "> Pharmacy Services </a> </div> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/hpsm-dental" class="list-group-item strong "> HPSM Dental </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/preventive-services" class="list-group-item strong "> Preventive Services </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/behavioral-health-care" class="list-group-item strong "> Behavioral Health Care </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/fitness-membership-program" class="list-group-item strong "> Fitness Membership Program </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/ride-benefit" class="list-group-item strong "> Ride Benefit </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/language-services" class="list-group-item strong "> Language Services </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/member-materials" class="list-group-item dropdown-item collapsed "> Member Materials <i href="#group-18cff6985-a3ba-42b4-8157-444b05809d01" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-1e371f23a-076a-4bfc-bac6-4adba5efa651"></i> </a> <div class="collapse" id="group-18cff6985-a3ba-42b4-8157-444b05809d01"> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/member-materials/member-manuals" class="list-group-item strong "> Member Manuals </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/member-materials/member-forms" class="list-group-item strong "> Member Forms </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/member-materials/member-newsletters" class="list-group-item strong "> Member Newsletters </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/member-materials/notices" class="list-group-item strong "> Member Notices </a> </div> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/quick-start-guide" class="list-group-item dropdown-item collapsed "> Quick-Start Guide <i href="#group-19f3ec623-265b-41b1-bac4-9d7f521f0bb9" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-1e371f23a-076a-4bfc-bac6-4adba5efa651"></i> </a> <div class="collapse" id="group-19f3ec623-265b-41b1-bac4-9d7f521f0bb9"> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/quick-start-guide/welcome-to-hpsm" class="list-group-item strong "> Welcome to HPSM </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/quick-start-guide/six-steps-to-a-healthy-start" class="list-group-item strong "> Six Steps to a Healthy Start </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/quick-start-guide/your-member-id-cards" class="list-group-item strong "> Your Member ID Cards </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/quick-start-guide/careadvantage-benefits" class="list-group-item strong "> CareAdvantage Benefits </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/quick-start-guide/other-programs-services" class="list-group-item strong "> Other Programs &amp; Services </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/quick-start-guide/dont-lose-your-medi-cal" class="list-group-item strong "> Don&#39;t Lose Your Medi-Cal </a> </div> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/problems-and-complaints" class="list-group-item strong "> Problems and Complaints </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/end-my-membership" class="list-group-item strong "> End My Membership </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/nondiscrimination-notice" class="list-group-item strong "> Nondiscrimination Notice </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/contact-careadvantage" class="list-group-item strong "> Contact CareAdvantage </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/join-careadvantage" class="list-group-item strong "> Join CareAdvantage </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/grove-san-mateo" class="list-group-item strong "> Grove San Mateo </a> <a href="https://www.hpsm.org/member/my-health-plan/careadvantage-2024/careadvantage-2025" class="list-group-item strong "> CareAdvantage 2025 </a> </div> </div> </div> <div class="related-items"> <!-- Have a Question? --> <div class="card"> <h3> </h3> <div class="name-and-phone-list"> <h5> </h5> <div > <div class="sfContentBlock sf-Long-text" ><h3>Member Handbooks</h3></div> </div> <div> <div class="media"> <div class="media-left"> <span class="fa fa-file-pdf-o">&nbsp;</span> </div> <div class="media-body notranslate"> <a class="sf-title" href="https://www.hpsm.org/docs/default-source/member-manuals/hpsm_directory_ca-dsnp-2024_202312040909.pdf?sfvrsn=3bb5f723_94" target="_blank">CareAdvantage D-SNP 2024 Provider Directory</a> <span class="small nowrap">(6724 KB)</span> </div> </div> <div class="media"> <div class="media-left"> <span class="fa fa-file-pdf-o">&nbsp;</span> </div> <div class="media-body notranslate"> <a class="sf-title" href="https://www.hpsm.org/docs/default-source/member-manuals/h6019_sob2024_m-en.pdf?sfvrsn=ffbec2cc_12" target="_blank">CareAdvantage D-SNP 2024 Summary of Benefits</a> <span class="small nowrap">(1855 KB)</span> </div> </div> <div class="media"> <div class="media-left"> <span class="fa fa-file-pdf-o">&nbsp;</span> </div> <div class="media-body notranslate"> <a class="sf-title" href="https://www.hpsm.org/docs/default-source/member-manuals/careadvantage-2024-member-handbook.pdf?sfvrsn=7248966f_20" target="_blank">CareAdvantage D-SNP 2024 Member Handbook</a> <span class="small nowrap">(3405 KB)</span> </div> </div> </div> <div > <div class="sfContentBlock sf-Long-text" ><hr></div> </div> <div > <div class="sfContentBlock sf-Long-text" ><h3 class="mt-4">New address or contact information?</h3><p>If you move and/or change your contact information (phone number, email), you must tell both HPSM and either the San Mateo County Human Services Agency at <span class="phone">1-800-223-8383</span> or Social Security Administration at <span class="phone">1-800-772-1213</span>. This will ensure that you continue to get important information about your Medi-Cal coverage status.</p><p>To report your new information with HPSM, you can <a target="_blank" href="/member-portal-login">log in to the Member Portal</a> or call the number below if you need assistance.</p><p class="my-4"><a class="btn btn-primary btn-wide" target="_blank" href="/member-portal-login">Log in to the Member Portal</a></p></div> </div> <div > <div class="sfContentBlock sf-Long-text" ><h3 id="call-ca-unit">CareAdvantage Unit</h3><p class="mt-2"><span class="nobreak">Toll free:</span>&nbsp;<span class="phone">1-866-880-0606</span> <br>Local:&nbsp;<span class="phone">650-616-2174</span> <br>TTY: <span class="phone">1-800-735-2929</span> or dial <span class="phone">7-1-1</span></p><p class="mt-2"><span class="nobreak">Phone hours: Monday–Sunday</span> <span class="nobreak">8:00 a.m. to 8:00 p.m.</span><br>Office hours: Monday–Friday&nbsp;8:00 a.m. to 4:00 p.m.<br>Email:&nbsp;<a href="mailto:CareAdvantageSupport@hpsm.org">CareAdvantageSupport@hpsm.org</a></p></div> </div> </div> <div class="name-and-phone-list"> <h5> </h5> </div> <div class="name-and-phone-list"> <h5> </h5> </div> </div> </div> </div> <div class="col-xs-12 col-sm-8 col-sm-pull-4"> <div class="content-area container-fluid-margin"> <div > <div class="sfContentBlock sf-Long-text" ><p class="plan-name mb-4">CareAdvantage Dual Eligible Special Needs Plan (D-SNP) 2024<br></p></div> </div><div class="sf_cols" data-sf-element="Row"> <div class="sf_colsOut sf_1col_1_100"> <div id="Contentplaceholder_TACCE306D001_Col00" class="sf_colsIn sf_1col_1in_100" data-sf-element="Column 1"> <div > <div class="sfContentBlock sf-Long-text" ><h1 style="font-size: 3.5rem">CareAdvantage</h1><h2 class="text-primary mt-1">by Health Plan of San Mateo</h2></div> </div> <div > <div class="sfContentBlock sf-Long-text" ><p>CareAdvantage is a health insurance program that combines Medicare and Medi-Cal into one comprehensive, convenient plan. It also provides extra benefits and is available to eligible HPSM Medi-Cal members.</p></div> </div> <div > <div class="sfContentBlock sf-Long-text" ><h2 class="mt-4">Who is eligible</h2> <p>You can join CareAdvantage if you:</p> <ul class="fa-ul"> <li><span class="fas fa-map-marker-alt text-success fa-fw mr-2"></span>Live in San Mateo County</li> <li><span class="fas fa-medkit text-success fa-fw mr-2"></span>Have Medicare Parts A &amp; B and</li> <li><span class="fas fa-id-card text-success fa-fw mr-2"></span>Have full-scope Medi-Cal through the Health Plan of San Mateo</li> </ul></div> </div> <div > <div class="sfContentBlock sf-Long-text" ><h2 class="mt-4">What is covered</h2><div class="row"><div class="col-lg-6 col-md-12"><div class="media mt-3" id="a1"><div class="media-left media-middle"><img src="/images/default-source/icons/cmc-copay.tmb-thumb80.png?sfvrsn=21af3827_4" style="max-width: 4rem" title="cmc-copay" data-displaymode="Thumbnail" alt="cmc-copay" class="img-fluid"></div><div class="media-body media-middle my-auto"><h4 class="my-auto"><span class="text-primary">No copays, premiums or deductibles for</span></h4></div></div><div class="pl-6 mb-3"><ul class="fa-ul"><li><span class="fa fa-check-circle-o fa-fw"></span>&nbsp;Doctor and hospital visits</li><li><span class="fa fa-check-circle-o fa-fw"></span>&nbsp;Shots and lab tests</li><li><span class="fa fa-check-circle-o fa-fw"></span>&nbsp;Chiropractor and acupuncture visits<br>... and more!</li></ul></div><div class="media mt-3" id="a2"><div class="media-left media-middle"><img src="/images/default-source/icons/cmc-network.tmb-thumb80.png?sfvrsn=9e59b1e9_3" style="max-width: 4rem" title="cmc-network" data-displaymode="Thumbnail" alt="cmc-network" class="media-object"></div><div class="media-body media-middle my-auto"><h4 class="my-auto"><span class="text-primary">Large provider network to choose from</span></h4></div></div><div class="pl-6 mb-3"><ul class="fa-ul"><li><span class="fa fa-check-circle-o fa-fw"></span>&nbsp;5,700 doctors</li><li><span class="fa fa-check-circle-o fa-fw"></span>&nbsp;150 dentists</li><li><span class="fa fa-check-circle-o fa-fw"></span>&nbsp;20 hospitals</li></ul></div><div class="media mt-3" id="a3"><div class="media-left media-middle"><img src="/images/default-source/icons/care-coordination.png?sfvrsn=e355dad7_6" style="max-width: 4rem" title="Care Management" data-displaymode="Original" alt="Care Management" class="media-object"></div><div class="media-body media-middle my-auto"><h4 class="my-auto"><span class="text-primary">Care Management</span></h4></div></div><div class="pl-6 mb-3"><p class="mt-1 mb-0">You will be matched with a Care Manager who is your one point of contact for all your health care needs. Your Care Manager works with you to create a care plan that coordinates all aspects of your care. They also help you:</p><div class="pl-2"><ul class="fa-ul"><li><span class="fa fa-li fa-check-circle-o fa-fw"></span>&nbsp;Find doctors and specialists</li><li><span class="fa fa-li fa-check-circle-o fa-fw"></span>&nbsp;Make health care appointments</li><li><span class="fa fa-li fa-check-circle-o fa-fw"></span>&nbsp;Set up no-cost rides to health care visits</li><li><span class="fa fa-li fa-check-circle-o fa-fw"></span>&nbsp;Help you transition smoothly back home after a hospital stay</li><li><span class="fa fa-li fa-check-circle-o fa-fw"></span>&nbsp;Get follow-up care after doctor's visits, hospital stays and outpatient surgery</li><li><span class="fa fa-li fa-check-circle-o fa-fw"></span>&nbsp;Connect you with programs such as home health care, housing supports, meal programs and more<br></li></ul></div></div></div><div class="col-lg-6 col-md-12"><div class="media mt-3" id="a4"><div class="media-left media-middle"><img src="/images/default-source/icons/cmc-prescriptions.tmb-thumb80.png?sfvrsn=50a9071d_3" style="max-width: 4rem" title="cmc-prescriptions" data-displaymode="Thumbnail" alt="cmc-prescriptions" class="img-fluid"></div><div class="media-body media-middle my-auto"><h4 class="my-auto"><span class="text-primary">Prescription medicine coverage managed by CareAdvantage</span></h4></div></div><div class="pl-6 mb-3"><ul class="fa-ul"><li><span class="fa fa-li fa-check-circle-o fa-fw"></span>&nbsp;$0 premium</li><li><span class="fa fa-li fa-check-circle-o fa-fw"></span>&nbsp;<a href="#asterisk" data-sf-ec-immutable="">Low or no copays*</a> <ul class="pl-4"><li>Generic medicines $0, $1.55 or $4.50</li><li>Brand-name medicines $0, $4.60 or $11.20</li></ul></li><li><span class="fa fa-li fa-check-circle-o fa-fw"></span>&nbsp;More than 500 over-the-counter (OTC) medicines at no cost</li><li><span class="fa fa-li fa-check-circle-o fa-fw"></span>&nbsp;Other medicines not normally covered by Medicare Part D including finasteride 1 mg (generic Propecia) for hair loss and tadalafil 5 mg (generic for Cialis) for erectile dysfunction.</li></ul></div><div class="media mt-3" id="a5"><div class="media-left media-middle"><img src="/images/default-source/icons/cmc-taxi.tmb-thumb80.png?sfvrsn=d079262a_3" style="max-width: 4rem" title="cmc-taxi" data-displaymode="Thumbnail" alt="cmc-taxi"></div><div class="media-body media-middle my-auto"><h4 class="my-auto"><span class="text-primary">No cost transportation</span></h4></div></div><div class="pl-6 mb-3"><div class="pl-2"><p class="my-1">to approved health care appointments and the pharmacy – <a href="/member/ride-benefit" target="_blank">learn more</a>&nbsp;</p></div></div><div class="media mt-3" id="a6"><div class="media-left media-middle"><img src="/images/default-source/icons/cmc-prescriptions.tmb-thumb80.png?sfvrsn=50a9071d_3" style="max-width: 4rem" title="cmc-prescriptions" data-displaymode="Thumbnail" alt="cmc-prescriptions" class="img-fluid"></div><div class="media-body media-middle my-auto"><h4 class="my-auto"><span class="text-primary">Dental care managed by HPSM</span></h4></div></div><div class="pl-8 mb-3"><p class="my-1">giving you more dentists to choose from – <a href="/member/hpsm-dental" target="_blank">learn more</a><br></p></div><div class="media mt-3" id="a7"><div class="media-left media-middle"><img src="/images/default-source/icons/cmc-prescriptions.tmb-thumb80.png?sfvrsn=50a9071d_3" style="max-width: 4rem" title="cmc-prescriptions" data-displaymode="Thumbnail" alt="cmc-prescriptions" class="img-fluid"></div><div class="media-body media-middle my-auto"><h4 class="my-auto"><span class="text-primary">Vision care</span></h4></div></div><div class="pl-8 mb-3"><p class="my-1">including a free annual exam and $175 towards glasses or contacts every year.</p></div><div class="media mt-3" id="a8"><div class="media-left media-middle"><img src="/images/default-source/icons/cmc-prescriptions.tmb-thumb80.png?sfvrsn=50a9071d_3" style="max-width: 4rem" title="cmc-prescriptions" data-displaymode="Thumbnail" alt="cmc-prescriptions" class="img-fluid"></div><div class="media-body media-middle my-auto"><h4 class="my-auto"><span class="text-primary">Outpatient behavioral health care</span></h4></div></div><div class="pl-8 mb-3"><p class="my-1">that includes referrals to therapists in HPSM’s network.</p></div></div></div></div> </div> <div > <div class="sfContentBlock sf-Long-text" ><h2 class="mt-4">Ready to Join?</h2></div> </div> <div > <div class="sfContentBlock sf-Long-text" ><div class="callout callout-success"> <h4 class="mb-2">For information, call a licensed CareAdvantage Medicare Specialist</h4> <p class="my-2"><span class="nobreak">Toll free:&nbsp;</span><span class="phone">1-888-252-3153</span> <span class="nobreak">Local:&nbsp;</span><span class="phone">650-616-1500</span></p> <p class="my-2">TTY: <span class="phone">1-800-735-2929</span> or dial <span class="phone">7-1-1</span></p> <p class="mt-2"><span class="nobreak">Hours: Monday–Friday</span> <span class="nobreak">9:00 a.m. to 6:00 p.m.</span></p> </div></div> </div> <div > <div class="sfContentBlock sf-Long-text" ></div> </div> <div > <div class="sfContentBlock sf-Long-text" ></div> </div> <div > <div class="sfContentBlock sf-Long-text" ><div class="space-1"><hr><p>CareAdvantage Dual Eligible Special Needs Plan (D-SNP) is a health plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to enrollees. Limitations and restrictions may apply. For more information, call the CareAdvantage Unit or read the <a href="/docs/default-source/member-manuals/careadvantage-2024-member-handbook.pdf?sfvrsn=7248966f_20" title="CareAdvantage D-SNP 2024 Member Handbook">CareAdvantage D-SNP 2024 Member Handbook</a>.</p><p>Benefits and co-pays may change on January 1 of each year.</p><p>If you speak other languages other than English, language assistance services, free of charge, are available to you. Call <span class="phone">1-866-880-0606</span> (TTY: <span class="phone">1-800-735-2929</span> or dial <span class="phone">7-1-1</span>). ( <a target="_blank" title="Download this statement in multiple languages" href="/docs/default-source/member-notices/careadvantage-cmc-non-discrimination-notice.pdf?sfvrsn=b5887102_70">Download this statement in multiple languages</a>.)</p></div></div> </div> <div > <div class="sfContentBlock sf-Long-text" ><div class="mt-3 text-center"><div class="centered mx-auto"><p>H6019_Web2024_M&nbsp;</p><p>Page updated November 1, 2023</p></div></div></div> </div> </div> </div> </div> </div> <div class="container-fluid-margin"> <div > <div class="sfContentBlock sf-Long-text" ></div> </div> </div> </div> </div> </div> <!-- Container-End --> <div id="SpecialWidgetContent_T52A760D8037_Col00" class="sf_colsIn container container-fluid-margin" data-sf-element="Container"> </div> <div class="pre-footer reveal-fade-in"> <div class="container-fluid"> <div class="row"> <div class="col-sm-12"> </div> </div> </div> </div> </main> <footer> <div class="row pb-3"> <div class="col-xs-12 col-sm-3 col-md-3"> <div> <img style="width:150px;" role="presentation" src="/assets/_img/hpsm-logo.png" /> <p class="notranslate"><span class="block">801 Gateway Blvd., Suite 100</span><span class="block">South San Francisco, CA 94080</span></p> <p> Phone:&nbsp;<span style="color:#2e9947;">650-616-0050</span> <br />Fax:&nbsp;<span style="color:#2e9947;">650-616-0060</span> <br />TTY:&nbsp; <span style="color:#2e9947;">1-800-735-2929</span> <br />or&nbsp;dial&nbsp;<span style="color:#2e9947;">7-1-1</span> </p> <p class="mt-3"> <a style="margin-left:0.5rem;margin-right:1.0rem;" rel="noreferrer" target="_blank" href="https://www.facebook.com/healthplanofsanmateo"> <img style="display: inline;" width="24" height="24" src="https://www.hpsm.org/images/default-source/logos/facebook.svg?Status=Temp&sfvrsn=ac66c4ba_2" role="presentation" alt="facebook" /> </a> <a style="margin-left:1.0rem;" target="_blank" rel="noreferrer" href="https://www.instagram.com/healthplanofsanmateo/"> <img style="display: inline;" width="24" height="24" src="https://www.hpsm.org/images/default-source/logos/instagram.svg?Status=Temp&sfvrsn=d4ddac80_2" role="presentation" alt="instagram" /> </a> </p> </div> </div> <div class="col-xs-12 col-sm-3 col-md-3"> <div> <a id="MemberFooterLink" class="text-lg text-capitalize" title="Members" href="/member">Members</a> <a id="ProviderFooterLink" class="text-lg notranslate" title="Providers" href="/provider">Providers</a> <a id="HealthTipsFooterLink" class="text-lg" title="Health Tips" href="/health-tips">Health Tips</a> <a id="CareerFooterLink" class="text-lg" title="Careers" href="/job-seeker">Careers</a> <a id="AboutUsFooterLink" class="text-lg" title="About HPSM" href="/about-us">About HPSM</a> </div> </div> <div class="col-xs-12 col-sm-3 col-md-3"> <div> <ul style="line-height:1.5rem;"> <li class="nav-item"><a id="ContactFooterLink" href="/contact-us">Contact Us</a></li> <li class="nav-item"><a id="LanguageFooterLink" href="https://www.hpsm.org/docs/default-source/member-notices/language-assistance-tagline.pdf">Language Assistance</a></li> <li class="nav-item"><a id="PrivacyFooterLink" href="/privacy-policy">Privacy Policy</a></li> <li class="nav-item"><a id="NDNFooterLink" href="/non-discrimination-notice">Non-Discrimination Notice</a></li> <li class="nav-item"><a id="AccessibilityFooterLink" href="/help/accessibility">Accessibility Statement</a></li> <li class="nav-item"><a id="ComplianceFooterLink" href="/about-us/governance/compliance">Compliance</a></li> </ul> </div> </div> <div class="col-xs-12 col-sm-3 col-md-3"> <div> <div id="tagline"> <p>Helping San Mateo County’s vulnerable and underinsured residents live the healthiest lives possible.</p> </div> <br /><br /> <small class="notranslate">&#x24B8; 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