Medi-Cal

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)
  • Preventive care – such as health exams, screenings, tests, immunizations and other office visits with a primary care doctor
  • Dental care is covered by Denti-Cal

Cost

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.

Apply

Call the County of San Mateo Human Services Agency, Health Benefits Information line at 1-800-223-8383.

For more information: