CareAdvantage Cal MediConnect Plan (Medicare-Medicaid Plan) 2021
Where Can I Get Care?
The CareAdvantage provider network includes doctors and medical facilities in San Mateo County and San Francisco. CareAdvantage covers your health care throughout the United States. If you need care outside of those areas, CareAdvantage may cover needed care you get from out-of-network providers.
Doctor's visits by phone or video anytime
Many providers can give you advice over the phone or see you by video. Telephone and video visits are fully covered by HPSM. Call your primary care provider (PCP) to check if they provide telephone or video visits.
If your do not have PCP, or if your PCP does not offer phone or video appointments, you may be able to use Teladoc®, one of HPSM's newest service partners. Learn more.
Continuity of Care
If you have recently joined CareAdvantage, you can keep seeing the doctors you go to now for a certain amount of time. You can keep your current providers from the time you enroll for up to 12 months for Medicare and Medi-Cal services if you meet all of the criteria described in the CareAdvantage Member Handbook. This is called continuity of care.
After the continuity of care period ends, you will need to see CareAdvantage network providers unless we make an agreement with your out-of-network doctor.
Getting care outside of the U.S.
CareAdvantage does not cover urgently needed care or any other care that you get outside the United States. Under your Medi-Cal benefit, you will only be covered if you need emergency service and are admitted to a hospital in either Canada or Mexico.
CareAdvantage does not cover any care outside of those areas and situations. If you travel outside of the United States, we recommend you buy supplemental travel insurance.
Search for a provider
Use the online provider search form to find the latest information for in-network primary care providers (PCP), specialists, pharmacies, clinics or hospitals. This directory is updated weekly. You may need a referral from your PCP before making an appointment with a specialist for non-emergency care. Call your PCP to find out if a referral is required.
Download the Provider Directory
Request a Printed Copy
If you would like a provider directory mailed to you, please send an email to firstname.lastname@example.org with the following information:
- Your first and last name
- Daytime phone number (in case we need to call you about your request)
- Mailing address
- Which directory you are requesting (HealthWorx HMO, ACE, CareAdvantage CMC, or Medi-Cal)
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 send us the correct information by using the Provider Directory Error Report Form.
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.)
Page updated December 28, 2020