CareAdvantage Benefits

CareAdvantage gives you access to a full range of health care benefits and services. Below is an overview of what you get, along with links to more details.

cmc-network

Health Care Services

CareAdvantage covers many health care services, including;

prescriptions

Prescription Drugs

CareAdvantage covers medications prescribed by your doctor. In general, CareAdvantage only covers prescriptions that are filled at network pharmacies. HPSM contracts with major chain pharmacies which are located throughout the country.

Costs

Costs

You have no-pays for: 

  • Doctor visits
  • Preventive services
  • Vision care
  • Hospital care
  • ER visits / Urgent care
  • Mental health services
  • Skilled nursing facility care
  • Hospital services
  • Physical & occupational therapy
  • Long-term nursing home care
  • Rides to healthcare appointments

Prescription drug co-pays:

  • Depend on your income
  • Increase every January 1st
  • Current co-pays range from:
    • $0, $1.35 or $3.95 for generic drugs
    • $0, $4.00 or $9.85 for brand-name drugs

There is no co-payment for:

  • Drugs you get at a nursing home facility or hospital
  • Some prescribed over-the-counter drugs covered through your Medi-Cal coverage
Nurse Advice Line

Nurse Advice Line

This toll-free phone hotline is open 24 hours a day, 7 days a week. Just call 1-833-846-8773.

Registered nurses are on hand to answer questions about your symptoms. They can tell you how urgently you need to see a doctor and may give you advice for self-care at home.

Learn more

care coordination

Care Coordination program

Helps get your doctors and HPSM all working to give you the focus and support you need to stay healthy. Your personal Case Manager helps you set health goals and make a plan for achieving them.

For more information, visit our Care Coordination page or call 650-616-2060

Health Education

Health Education Unit

Provides information on a range of topics such as:

  • How to quit tobacco and other similar products
  • Managing your diabetes, asthma, blood pressure and more

For more information, visit our Health Information pages or call 650-616-2165

Transportation

Free rides to health care appointments, the pharmacy, and other health care services

For members who don’t have other means of transportation to health care services. To schedule a ride, call American Logistics Company (ALC) at 1-844-856-4389 at least two (2) business days before your appointment (ALC is open Monday through Friday). If you have an urgent appointment, call as soon as you can.

Learn more

care coordination

Free interpreter services

If your doctor does not speak your language, interpreter services are available by phone and video. Just ask your doctor to call an interpreter during your visit. In special cases, an interpreter can go to the visit with you.

Learn more

Telemedicine

Doctor’s visits by phone or video

Many providers can give you advice over the phone or see you by video. Telephone and video visits are fully covered. Call your primacy care provider (PCP) to check if they provide telephone or video visits.

Learn more