Starting on September 1st, 2024, HPSM Medi-Cal members who qualify for CareAdvantage will be automatically enrolled in CareAdvantage as soon as they become eligible*. That is because the Department of Health Care Services (DHCS) has chosen HPSM as one of only three health plans in California to participate in the Medicare Advantage Default Enrollment Pilot.
Default CareAdvantage enrollment will improve Medi-Cal members’ healthcare by providing:
- Extra benefits and coverage that members don’t get with our Medi-Cal only plan — without having to go through the lengthy CareAdvantage enrollment process.
- Seamless continuity of care with the Medi-Cal providers they already see.
- Streamlined operational processes for enhanced member experience.
To learn more about default CareAdvantage enrollment, visit DHCS’s program webpage.
* To qualify for default enrollment, members must be 1: newly eligible for Medicare Advantage (they must have Medicare Parts A and B and be eligible for Medicare either due to age or qualifying disability), and 2: currently enrolled in HPSM’s Medi-Cal plan. (They must be full-benefit dual eligible beneficiaries 21 years of age or older who reside in San Mateo County). Qualified Medi-Cal members who want to join another Medicare plan will need to actively opt out of CareAdvantage.