CareAdvantage Cal MediConnect Plan (Medicare-Medicaid Plan) 2020

Preventive Services

Co-pay – $0

CareAdvantage covers the following preventative services. Some may require prior authorization. CareAdvantage also covers any additional preventive services approved by Medicare mid-year.

  • Annual physical exams
  • Alcohol misuse counseling
  • Cardiovascular screenings
  • Cardiovascular therapy
  • Cervical cancer screening
  • Colonoscopy
  • Depression screening
  • Diabetes screenings
  • Flexible sigmoidoscopy
  • HIV and STI screening
  • Immunizations
  • Mammogram
  • Nutrition therapy
  • Obesity screening
  • Osteoporosis screening
  • Prostate cancer screening
  • Tobacco cessation counseling

Medical Emergencies

CareAdvantage covers emergency services both in and outside of HPSM’s service area and our network of providers. You do not need approval or a referral for emergency care.

If you have a medical emergency, call 911 or go to the nearest emergency room. As soon as possible (preferably within 48 hours), call your PCP (or ask someone else to call). Your PCP’s phone number is on the front of your CareAdvantage CMC ID card.

Learn about getting care during a disaster

HPSM Nurse Advice Line

Call 1-833-846-8773 24 hours a day–7 days a week.

A Licensed Registered Nurse (RN) will give you medical advice when you think you need urgent medical attention, but you are not sure. A nurse will ask about your symptoms and tell you:

  • If you need to go to Urgent Care
  • If you can wait to see your doctor (within 24 hours, 3 days, or longer)
  • How to take care of your symptoms at home

Learn more about the Nurse Advice Line.

Quality Improvement Program

We want our members and community to have good health. We also want them to get the care they need. HPSM's Quality Improvement Program helps make sure our providers and staff deliver quality care and access to services by:

  • overseeing providers to make sure members get the care they need
  • reviewing quality of care issues
  • promoting member and provider education

Learn more about HPSM's Quality Improvement Programs.

CareAdvantage Cal MediConnect Plan (Medicare-Medicaid Plan) 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 CareAdvantage Member Handbook.

Benefits and co-pays may change on January 1 of each year.

If you speak other languages other than English, language assistance services, free of charge, are available to you. Call 1-866-880-0606 (TTY: 1-800-735-2929). (Download this statement in multiple languages.)

H7885_MMP_15129_01_20_EN Accepted

Page updated September 24, 2019