Healthcare Plans, Programs & Members

Our four healthcare plans cover one out of five San Mateo County residents. We proudly serve those most in need of support: low-income individuals and families, seniors, people with disabilities, and children with complex medical conditions. This diverse and vibrant community includes people of all ages from many racial and ethnic backgrounds, half of whom speak a language other than English. We also offer programs to serve our members’ specific needs.

Healthcare plans	Description	Membership
Medi-Cal	State and federally funded health insurance program for low-income individuals and families	137,500+
CareAdvantage	Health insurance program for people with both Medicare and Medi-Cal	8,500+
HealthWorx HMO	A partnership between HPSM and San Mateo County to deliver coordinated care and services to eligible kids with complex medical conditions	1,300+
San Mateo County ACE Program	Locally funded plan administered by HPSM for low-income adults who do not qualify for other health insurance	2,600+

...

Healthcare programs	Description
HPSM Dental	California’s first and only dental plan for Medi-Cal members that is fully integrated with medical and mental health care benefits.
CalAIM	A statewide program by the California Department of Health Care Services (DHCS) that helps managed care plans like HPSM support high-risk, high-needs Medi-Cal members.
HomeAdvantage	Provides eligible CareAdvantage members with routine and urgent home visits, 24/7 phone access to providers, and transition support after a hospital visit.
Whole Child Model (WCM)	A partnership between HPSM and San Mateo County to deliver coordinated care and services to eligible kids with complex medical conditions.
Wider Circle	Helps older adults make new friends and develop healthy habits by attending fun social events in their community.