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HPSM Medi-Cal

Member Materials

Handbooks and Directories

 
Nutritional Supplements for Medical Conditions Formulary (63 KB)
 
Medi-Cal Member Handbook / Evidence of Coverage (2183 KB)
 
Medi-Cal Guide for New Members (9350 KB)
 
Medi-Cal Provider Directory (5242 KB)

Download the list of covered drugs

 Download the formulary

The formulary includes covered medications. See the last section for an alphabetical index.

View all Medi-Cal Member Manuals

Forms

 
Health Risk Assessment (HRA) Form (709 KB)
 
Confidential Member Complaint Form (178 KB)
 
Appointment of Representative Form (93 KB)
 
Advanced Health Care Directive (240 KB)
 
Protected Health Information Request Form (153 KB)
See All Member Forms

Notices and Announcements

 
Notice of Privacy Practices (69 KB)
 
Provisional Postpartum Care Extension Program (English) (91 KB)
 
Provisional Postpartum Care Extension Program (Tagalog) (93 KB)
 
Provisional Postpartum Care Extension Program (Chinese) (141 KB)
 
Provisional Postpartum Care Extension Program (Spanish) (93 KB)
 
Frequently Asked Questions about the Transition (435 KB)
 
Member Nondiscrimination Notice - Large Print (436 KB)
 
Member Rights in the Complaint Process (252 KB)
View All Medi-Cal Member Notices

Member Newsletter

 
HEALTHmatters Summer 2020 (5473 KB)
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801 Gateway Blvd., Suite 100South San Francisco, CA 94080

Phone: 650-616-0050
Fax: 650-616-0060
TTY:  1-800-735-2929
or dial 7-1-1

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Helping San Mateo County’s vulnerable and underinsured residents live the healthiest lives possible.



Ⓒ 2021 Health Plan of San Mateo