HPSM Medi-Cal
Member Materials
Handbooks and Directories
Medi-Cal Benefits Quick-Start Guide
(1927 KB)
Medi-Cal Provider Directory
(6603 KB)
Forms
Direct Member Reimbursement Form
(126 KB)
Member Change of Address Form
(81 KB)
Health Risk Assessment (HRA) Form
(709 KB)
Confidential Member Complaint Form
(178 KB)
Advanced Health Care Directive
(240 KB)
Notices and Announcements
Attention Medi-Cal members: Starting January 1, 2022, your medication benefits will be managed by Medi-Cal Rx.
Notice of Privacy Practices
(69 KB)
DHCS Dental Transition Notice
(81 KB)
Member Newsletter
Quit tobacco newsletter
(525 KB)
Viewing a PDF document requires the free version of Adobe Acrobat Reader or equivalent software.