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
- Diabetes supplies
- Eye and hearing tests
- Mental health care
- 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 the Denti-Cal Program
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
Co-pays for prescription drugs
- Pharmacies may charge a $1 co-pay for some prescription drugs
- Most HPSM pharmacies do not charge HPSM members any co-pays
- Both generic and brand-name drugs prescribed by your doctor are covered by the plan
Check with your provider or pharmacy to see whether you will be charged a $1 co-pay for the services or medications you receive.
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.