Need Assistance?
CareAdvantage members
Call 1-866-880-0606 or 650-616-2174 Monday–Sunday 8:00 a.m. to 8:00 p.m.
TTY: 1-800-735-2929 or dial 7-1-1
Email: [email protected]
Medi-Cal and HealthWorx members and ACE Program participants
Call 1-800-750-4776 or 650-616-2133 Monday–Friday 8:00 a.m. to 6:00 p.m.
TTY: 1-800-735-2929 or dial 7-1-1
Email: [email protected]
Member Handbooks
Below are electronic copies of member materials and translated versions for each plan.
The name of your health plan can be found on your HPSM member ID card.
Member Handbooks / Evidence of Coverage
The Member Handbook / Evidence of Coverage tells members about the covered benefits for their plan. It also explains their rights and responsibilities as a member of HPSM.
Summary of Benefits
The Summary of Benefits is a brief overview of the benefits and services covered by the plan.
Formulary
The Formulary is a list of medicines that are covered under each HPSM plan's preferred medicine list. If a provider wants to prescribe an HPSM member a medicine that is not on this list, the provider must get prior authorization from before prescribing the medicine.
Provider Directory
The Provider Directory lists hospitals, clinics, pharmacies, PCPs, specialists, medical equipment providers and others that participate in the HPSM network. The Directory includes providers' names, addresses, phone numbers, business hours, languages spoken and more.
Viewing a PDF document requires the free version of Adobe Acrobat Reader or equivalent software.
The provider directory is updated every week; however there may be incorrect or new information about a provider that has not yet been updated. If you find an error, please call 650-616-2106 extension 5 (for TTY: 800-735-2929 or 711). You can also email HPSM Provider Services at [email protected].