Medi-Cal is a state and federally funded health insurance program.
Who is eligible
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.
To check your eligibility or Medi-Cal application status, call the San Mateo County Human Services Agency at 1-800-223-8383. Additional information is available on the Covered California website.
For information about your child's Medi-Cal eligibility and enrollment, contact the Health Coverage Unit at 650-616-2002.
What is covered
- Doctor visits
- Hospital care
- Prescription drugs are covered by Medi-Cal Rx
- Physician Administered Drugs (PADs) - drugs administered in an office or clinic setting
- Diabetes supplies
- Eye and hearing tests
- Skilled nursing care
- Community-Based Adult Services (CBAS)
- Care Planning and Management Benefit
- Preventive care – such as health exams, screenings, tests, immunizations and other office visits with a primary care doctor
- Dental care is covered through HPSM Dental
- Mental health care
- Doula services
Learn more about getting started with mental health care.
Co-pays for Services
- Medi-Cal providers may charge a $1 co-pay for some services
- Hospitals can charge a $5 co-pay for emergency visits for non-emergency care
- Most HPSM providers do not charge HPSM members any co-pays
Share-of-Cost (SOC) payments
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.
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.
If you have HPSM Medi-Cal and Medicare
You can join HPSM’s CareAdvantage plan! CareAdvantage makes make your health care easier with a single card and phone number for all your benefits!