Medi-Cal

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 (5283 KB)

Download the list of covered drugs

 Download the formulary

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

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)

Notices and Announcements

 
Ride benefit provides free rides to health care visits (313 KB)
 
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 Newsletter

 
HEALTHmatters Spring 2021 (4563 KB)

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