Medi-Cal | HPSM Members

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class="card matchheight p-1 border border-danger text-center"> <div class="p-1"> <h5 class="mt-1 mb-2 card-title text-navy">HPSM's Updated Privacy Practices</h5> <a class="btn btn-primary btn-sm" href="/docs/default-source/member-notices/hpsm_notice_of_privacy_practices_english.pdf?sfvrsn=cbbeeadd_73">Read now</a> </div> </div> </div> <div class="my-1 col-md-4 col-sm-12"> <div class="card matchheight p-1 border border-danger text-center"> <div class="p-1"> <h5 class="mt-1 mb-2 card-title text-navy">Monkeypox information</h5> <span class="btn-group"><a class="btn btn-primary btn-sm" href="/member/emergency-message/monkeypox-information">Members</a><a class="btn btn-secondary btn-sm" href="/provider/urgent-messages/monkeypox">Providers</a></span> </div> </div> </div> <div class="my-1 col-md-4 col-sm-12"> <div class="card matchheight p-1 border border-danger text-center"> <div class="p-1"> <h5 class="mt-1 mb-2 card-title text-navy">Power Outages</h5> <span class="btn-group"><a class="btn 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href="#sideNav" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent=".accordian-menu"></i> </span> <div class="list-group panel" id="sideNav"> <a href="https://www.hpsm.org/member/medi-cal/eligibility" class="list-group-item strong "> Eligibility </a> <a href="https://www.hpsm.org/member/medi-cal/benefits" class="list-group-item dropdown-item collapsed "> Benefits & Services <i href="#group-154f66d73-5412-4ae0-8f4d-dd62957bd892" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-1022e58b3-d61e-4552-989f-46fd9ec9dd73"></i> </a> <div class="collapse" id="group-154f66d73-5412-4ae0-8f4d-dd62957bd892"> <a href="https://www.hpsm.org/member/medi-cal/benefits/enhanced-care-management" class="list-group-item strong "> Enhanced Care Management (ECM) </a> <a href="https://www.hpsm.org/member/medi-cal/benefits/community-supports" class="list-group-item strong "> Community Supports </a> </div> <a href="https://www.hpsm.org/member/medi-cal/costs" class="list-group-item strong "> Member Costs </a> <a href="https://www.hpsm.org/member/medi-cal/doctors-specialists" class="list-group-item strong "> Doctors & Specialists </a> <a href="https://www.hpsm.org/member/medi-cal/medi-cal-rx" class="list-group-item dropdown-item collapsed "> Prescriptions & Pharmacies <i href="#group-194a1dbf6-aa2f-4b3b-8884-0fd83f559ccd" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-1022e58b3-d61e-4552-989f-46fd9ec9dd73"></i> </a> <div class="collapse" id="group-194a1dbf6-aa2f-4b3b-8884-0fd83f559ccd"> <a href="https://www.hpsm.org/member/medi-cal/medi-cal-rx/id-cards" class="list-group-item strong "> Your New ID Cards </a> <a href="https://www.hpsm.org/member/medi-cal/medi-cal-rx/your-pharmacy" class="list-group-item strong "> Find a Pharmacy </a> <a href="https://www.hpsm.org/member/medi-cal/medi-cal-rx/drug-list" class="list-group-item strong "> List of Covered Medicines </a> <a href="https://www.hpsm.org/member/medi-cal/medi-cal-rx/appeals-and-complaints" class="list-group-item strong "> Appeals and Complaints </a> <a href="https://www.hpsm.org/member/medi-cal/medi-cal-rx/helpful-contact-information" class="list-group-item strong "> Helpful Contact Information </a> </div> <a href="https://www.hpsm.org/member/medi-cal/hpsm-dental" class="list-group-item strong "> HPSM Dental </a> <a href="https://www.hpsm.org/member/medi-cal/where-can-i-get-care" class="list-group-item dropdown-item collapsed "> Where Can I Get Care? <i href="#group-126fd7936-aab2-416d-86c5-11f54183f5dd" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-1022e58b3-d61e-4552-989f-46fd9ec9dd73"></i> </a> <div class="collapse" id="group-126fd7936-aab2-416d-86c5-11f54183f5dd"> <a href="https://www.hpsm.org/member/medi-cal/where-can-i-get-care/emergency-medical-care" class="list-group-item strong "> Emergency Medical Care </a> </div> <a href="https://www.hpsm.org/member/medi-cal/get-your-initial-health-assessment" class="list-group-item strong "> Initial Health Assessment </a> <a href="https://www.hpsm.org/member/medi-cal/continuity-of-care" class="list-group-item strong "> Continuity of Care </a> <a href="https://www.hpsm.org/member/medi-cal/whole-child-model" class="list-group-item dropdown-item collapsed "> Whole Child Model <i href="#group-114390f98-fab6-40ea-8ec5-67e4740693ff" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-1022e58b3-d61e-4552-989f-46fd9ec9dd73"></i> </a> <div class="collapse" id="group-114390f98-fab6-40ea-8ec5-67e4740693ff"> <a href="https://www.hpsm.org/member/medi-cal/whole-child-model/qualifying-conditions" class="list-group-item strong "> Qualifying Conditions </a> </div> <a href="https://www.hpsm.org/member/medi-cal/ride-benefit" class="list-group-item strong "> Ride Benefit </a> <a href="https://www.hpsm.org/member/medi-cal/language-services" class="list-group-item strong "> Language Services </a> <a href="https://www.hpsm.org/member/medi-cal/resources" class="list-group-item dropdown-item collapsed "> Member Materials <i href="#group-15a440ed8-78c1-4c02-a475-7a3bf2d5b9a3" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-1022e58b3-d61e-4552-989f-46fd9ec9dd73"></i> </a> <div class="collapse" id="group-15a440ed8-78c1-4c02-a475-7a3bf2d5b9a3"> <a href="https://www.hpsm.org/member/medi-cal/resources/manuals" class="list-group-item strong "> Member Manuals </a> <a href="https://www.hpsm.org/member/medi-cal/resources/member-forms" class="list-group-item strong "> Member Forms </a> <a href="https://www.hpsm.org/member/medi-cal/resources/member-notices" class="list-group-item strong "> Member Notices </a> <a href="https://www.hpsm.org/member/medi-cal/resources/member-newsletters" class="list-group-item strong "> Member Newsletters </a> </div> <a href="https://www.hpsm.org/member/medi-cal/medi-cal-quick-start-guide" class="list-group-item dropdown-item collapsed "> Quick-Start Guide <i href="#group-188a80ea2-1e01-406e-a1a5-66bf11c5b5ff" class="fa fa-caret-down collapsed" data-toggle="collapse" data-parent="group-1022e58b3-d61e-4552-989f-46fd9ec9dd73"></i> </a> <div class="collapse" id="group-188a80ea2-1e01-406e-a1a5-66bf11c5b5ff"> <a href="https://www.hpsm.org/member/medi-cal/medi-cal-quick-start-guide/welcome-to-hpsm" class="list-group-item strong "> Welcome to HPSM </a> <a href="https://www.hpsm.org/member/medi-cal/medi-cal-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/medi-cal/medi-cal-quick-start-guide/know-your-id-cards" class="list-group-item strong "> Know Your ID Cards </a> <a href="https://www.hpsm.org/member/medi-cal/medi-cal-quick-start-guide/hpsm-benefits" class="list-group-item strong "> HPSM Benefits </a> <a href="https://www.hpsm.org/member/medi-cal/medi-cal-quick-start-guide/other-programs-services" class="list-group-item strong "> Other Programs & Services </a> <a href="https://www.hpsm.org/member/medi-cal/medi-cal-quick-start-guide/dont-lose-your-medi-cal" class="list-group-item strong "> Don't Lose Your Medi-Cal </a> </div> <a href="https://www.hpsm.org/member/medi-cal/problems-and-complaints" class="list-group-item strong "> Problems and Complaints </a> <a href="https://www.hpsm.org/member/medi-cal/nondiscrimination-notice" class="list-group-item strong "> Nondiscrimination Notice </a> <a href="https://www.hpsm.org/member/medi-cal/contact-us" class="list-group-item strong "> Contact Us </a> </div> </div> </div> <div class="related-items">  <div class="card"> <h3> </h3> <div class="name-and-phone-list"> <h5> </h5> <div > <div class="sfContentBlock sf-Long-text" ><h3 style="margin-left: 20px">Member Handbooks</h3></div> </div> <div class="handbooks"> <div class="media"> <div class="media-left"> <span class="fa fa-file-pdf-o"> </span> </div> <div class="media-body notranslate"> <a class="sf-title" href="https://www.hpsm.org/docs/default-source/member-manuals/medi-cal_provider_directory.pdf?sfvrsn=86cc3c4f_540" target="_blank">Medi-Cal Provider Directory</a> <span class="small nowrap">(7584 KB)</span> </div> </div> <div class="media"> <div class="media-left"> <span class="fa fa-file-pdf-o"> </span> </div> <div class="media-body notranslate"> <a class="sf-title" href="https://www.hpsm.org/docs/default-source/member-manuals/medi-cal-member-handbook-english.pdf?sfvrsn=fa21ef70_58" target="_blank">Medi-Cal Member Handbook / Evidence of Coverage</a> <span class="small nowrap">(2125 KB)</span> </div> </div> <div class="media"> <div class="media-left"> <span class="fa fa-file-pdf-o"> </span> </div> <div class="media-body notranslate"> <a class="sf-title" href="https://www.hpsm.org/docs/default-source/member-manuals/medi-cal_guide_for_new_members_english.pdf?sfvrsn=78d3d4d5_56" target="_blank">Medi-Cal Benefits Quick-Start Guide</a> <span class="small nowrap">(1927 KB)</span> </div> </div> </div> <div > <div class="sfContentBlock sf-Long-text" ><hr></div> </div> <img class="centered responsive" src="/images/default-source/logos/ncqa-4-star-accredited.tmb-thumb200.png?sfvrsn=ead3c47d_2" title="NCQA Accredited" alt="NCQA Accredited" /> <div > <div class="sfContentBlock sf-Long-text" ><h3 style="margin-bottom: 4px">NCQA Accredited</h3></div> </div> <div > <div class="sfContentBlock sf-Long-text" ><p>HPSM’s Medi-Cal program received Accreditation from the <a href="http://www.ncqa.org/" class="external" target="_blank">National Committee for Quality Assurance (NCQA)</a> on January 17, 2020. NCQA is a not-for-profit organization dedicated to improving health care quality. NCQA Accreditation is widely considered the health care industry’s “seal of approval,” and having it shows that HPSM meets the highest quality standards.</p></div> </div> </div> <div class="name-and-phone-list"> <h5> <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-member-services">Member Services</h3><p class="mt-1"><span class="nobreak">Toll free:</span> <span class="phone">1-800-750-4776</span> <br>Local: <span class="phone">650-616-2133</span> <br>TTY: <span class="phone">1-800-735-2929</span> or dial <span class="phone">7-1-1</span></p><p class="mt-1"><span class="nobreak">Phone hours: Monday–Friday</span> <span class="nobreak">8:00 a.m. to 6:00 p.m.</span> <br>Office hours: Monday–Friday 8:00 a.m. to 4:00 p.m.<br>Email: <a href="mailto:MemberServicesSupport@hpsm.org">MemberServicesSupport@hpsm.org</a></p></div> </div></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 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>Medi-Cal </h1><p>Medi-Cal is a state and federally funded health insurance program. </p></div> </div> <div > <div class="sfContentBlock sf-Long-text" ><div id="mc-renew" class="callout callout-danger"><div class="row mx-0 align-content-center"><div class="col-md-9 col-sm-12"><h3 class="my-1 mx-sm-auto"><span class="text-danger">Don't lose your Medi-Cal </span></h3><p>Has your address changed?  Report changes at <a target="_blank" href="https://www.mybenefitscalwin.org/#/home"><strong>mybenefitscalwin.org</strong></a> for fastest service or call San Mateo County HSA at <span class="phone">1-800-223-8383</span>. </p></div><div class="col-md-auto col-sm-12"><p class="my-auto ml-md-auto mx-sm-auto text-md-right"><a class="btn btn-info btn-sm my-auto" href="https://mybenefitscalwin.org">Report changes</a></p></div></div></div></div> </div> <div > <div class="sfContentBlock sf-Long-text" ><h2>Who is eligible</h2><p>Medi-Cal covers low-income adults, families with children, seniors, persons with disabilities, pregnant women, children in foster care and former foster youth up to age 26.</p><p>To check your eligibility or Medi-Cal application status, call the San Mateo County Human Services Agency at <span class="phone">1-800-223-8383</span>. Additional information is available on the <a class="external" href="https://www.coveredca.com/medi-cal/" target="_blank">Covered California website</a>.</p><p>For information about your child's Medi-Cal eligibility and enrollment, contact the Health Coverage Unit at <span class="phone">650-616-2002</span>.</p></div> </div> <div > <div class="sfContentBlock sf-Long-text" ><h2>What is covered</h2><ul><li>Doctor visits </li><li>Hospital care </li><li>Prescription drugs are covered by <a href="/member/medi-cal/medi-cal-rx">Medi-Cal Rx</a></li><li>Physician Administered Drugs (PADs) - medicines administered in an office or clinic setting</li><li>Diabetes supplies </li><li>Eye and hearing tests</li><li>Skilled nursing care </li><li>Community-Based Adult Services (CBAS)</li><li>Care Planning and Management Benefit</li><li>Preventive care – such as health exams, screenings, tests, immunizations and other office visits with a primary care doctor </li><li>Dental care is covered through <a href="/member/hpsm-dental">HPSM Dental</a></li><li>Mental health care</li><li>Doula services</li></ul><div class="callout callout-info"><p><a target="_blank" href="/member/health-tips/mental-health/get-mental-health-care"><strong>Learn more</strong></a> about getting started with mental health care.</p></div></div> </div> <div > <div class="sfContentBlock sf-Long-text" ><h2>Cost</h2><h3>Co-pays for Services</h3><ul><li>Medi-Cal providers may charge a $1 co-pay for some services</li><li>Hospitals can charge a $5 co-pay for emergency visits for non-emergency care</li><li>Most HPSM providers do not charge HPSM members any co-pays</li></ul> <h3>Share-of-Cost (SOC) payments</h3><p>Some Medi-Cal members must pay a monthly fee towards their health care expenses. This is called share-of-cost (SOC) and is like paying a deductible in a private health plan. The County of San Mateo Human Services Agency determines if you must pay SOC. The amount is based on your earnings.</p></div> </div> <div > <div class="sfContentBlock sf-Long-text" ><h2>Apply</h2> <p>Call the County of San Mateo Human Services Agency, Health Benefits Information line at <span class="phone">1-800-223-8383</span>.</p> <p>For more information:</p> <ul> <li><a class="external" href="https://hsa.smcgov.org/" target="_blank">SMC Human Services Agency</a> </li> <li><a class="external" href="https://www.coveredca.com/" target="_blank">Covered California</a></li> </ul></div> </div> </div> </div> </div> <div > <div class="sfContentBlock sf-Long-text" ><p class="mt-4 small"><span class="external"> </span>Clicking on these links will direct you to a website or document that is external to www.hpsm.org. The Health Plan of San Mateo (HPSM) accepts no responsibility for the content, policies or accessibility of the external websites or external documents linked to on this website. </p></div> </div> <div > <div class="sfContentBlock sf-Long-text" ><h2 id="duals">If you have HPSM Medi-Cal and Medicare</h2><p><span>You can join HPSM’s CareAdvantage plan!</span> CareAdvantage makes make your health care easier with a single card and phone number for all your benefits! </p><p><a target="_blank" href="https://www.hpsm.org/member/my-health-plan/careadvantage-2025/join-careadvantage">Learn more about CareAdvantage</a></p></div> </div> <div > <div class="sfContentBlock sf-Long-text" ></div> </div> </div> <div class="container-fluid-margin"> </div> </div> </div> </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: <span style="color:#2e9947;">650-616-0050</span> <br />Fax: <span style="color:#2e9947;">650-616-0060</span> <br />TTY:  <span style="color:#2e9947;">1-800-735-2929</span> <br />or dial <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">Ⓒ 2024 Health Plan of San Mateo</small> </div> </div> </div> </footer>  <script src="/assets/_js/vendor/jquery.easing.1.3.js" type="text/javascript"></script> <script src="/assets/_js/vendor/bootstrap.min.js" type="text/javascript"></script> <script src="/assets/_js/vendor/jasny-bootstrap.js" type="text/javascript"></script> <script src="/assets/_js/vendor/enquire.min.js" type="text/javascript"></script> <script src="/assets/_js/vendor/jQuery.headroom.js" type="text/javascript"></script> <script src="/assets/_js/vendor/hoverIntent.js"></script> <script src="/assets/_js/vendor/jquery.matchHeight.js" type="text/javascript"></script> <script src="https://unpkg.com/scrollreveal/dist/scrollreveal.min.js"></script> <script src="/assets/_js/vendor/bootstrap-responsive-tabs.min.js" type="text/javascript"></script> <script src="/assets/vendor/cubeportfolio/js/jquery.cubeportfolio.min.js"></script>  <script src="/assets/_js/hs.core.js"></script> <script src="/assets/_js/hs.cubeportfolio.js"></script> <script src="/assets/_js/main.js" type="text/javascript"></script> <script src="/Frontend-Assembly/Telerik.Sitefinity.Frontend.Search/Mvc/Scripts/SearchBox/Search-box.min.js?v=MTMuMy43NjQwLjA%3d" type="text/javascript"></script> </body> </html>

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