CareAdvantage Dual Eligible Special Needs Plan (D-SNP) 2025

CareAdvantage

by Health Plan of San Mateo

CareAdvantage is a health insurance program that combines Medicare and Medi-Cal into one comprehensive, convenient plan. It also provides extra benefits and is available to eligible HPSM Medi-Cal members.

Who is eligible

You can join CareAdvantage if you:

  • Live in San Mateo County
  • Have Medicare Parts A & B and
  • Have full-scope Medi-Cal through the Health Plan of San Mateo

What is covered

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No copays, premiums or deductibles for

  •  Doctor and hospital visits
  •  Shots and lab tests
  •  Chiropractor and acupuncture visits
    ... and more!
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Large provider network to choose from

  •  5,700 doctors
  •  150 dentists
  •  20 hospitals
Care Management

Care Management

You will be matched with a Care Manager who is your one point of contact for all your health care needs. Your Care Manager works with you to create a care plan that coordinates all aspects of your care. They also help you:

  •  Find doctors and specialists
  •  Make health care appointments
  •  Set up no-cost rides to health care visits
  •  Help you transition smoothly back home after a hospital stay
  •  Get follow-up care after doctor's visits, hospital stays and outpatient surgery
  •  Connect you with programs such as home health care, housing supports, meal programs and more
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Prescription medicine coverage managed by CareAdvantage

  •  $0 premium
  •  Low or no copays*
    • Generic medicines $0, $1.60 or $4.80
    • Brand-name medicines $0, $4.90 or $12.25
  •  More than 500 over-the-counter (OTC) medications at no cost
  •  Other medicine not normally covered by Medicare Part D including finasteride 1 mg (generic Propecia) for hair loss and tadalafil 5 mg (generic for Cialis) for erectile dysfunction.
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No cost transportation

to approved health care appointments and the pharmacy – learn more 

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Dental care managed by HPSM

giving you more dentists to choose from – learn more

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Vision care

including a free annual exam and $100 towards glasses or contacts every year.

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Outpatient behavioral health care

that includes referrals to therapists in HPSM’s network.

Ready to Join?

For information, call a licensed CareAdvantage Medicare Specialist

Toll free: 1-888-252-3153 Local: 650-616-1500

TTY: 1-800-735-2929 or dial 7-1-1

Hours: Monday–Friday 9:00 a.m. to 6:00 p.m.


CareAdvantage Dual Eligible Special Needs Plan (D-SNP) is a health plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to enrollees. Limitations and restrictions may apply. For more information, call the CareAdvantage Unit or read the CareAdvantage D-SNP 2025 Member Handbook.

Benefits and co-pays may change on January 1 of each year.

If you speak other languages other than English, language assistance services, free of charge, are available to you. Call 1-866-880-0606 (TTY: 1-800-735-2929 or dial 7-1-1). ( Download this statement in multiple languages.)

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Page updated November 1, 2024