You can give legal permission to have someone represent you
You can choose a relative, friend, or other trusted person to act on your behalf to contact CareAdvantage with questions,
or to make a complaint or make an appeal about a coverage decision. You may already have an appointed representative to act for you.
How to Appoint a Legal Representative
Complete, sign, and mail the Appointment of Representative Form to Health Plan of San Mateo or call the
to request to have a copy mailed to you.
You and your appointed representative need to sign this form.
Mail the Completed Appointment of Representative Form
Health Plan of San Mateo
701 Gateway Blvd., Suite 400
South San Francisco, CA 94080
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