COVID-19 Information for Members

Medi-Cal Presumptive Eligibility

Medi-Cal members may qualify for no-cost COVID-19 services 

Eligible Medi-Cal members who pay share-of-cost (SOC) can get services related to COVID-19 at no cost through HPSM’s Presumptive Eligibility (PE) program. These services include diagnostic testing and treatment related to COVID-19 provided at a doctor’s office, clinic or emergency room. 

SOC is a monthly fee that some Medi-Cal members pay towards their health care expenses. It is like paying a deductible in a private health plan. The County of San Mateo Human Services Agency determines who must pay SOC, and the amount is based on earnings. Members who are eligible for the PE program and need medical services due to COVID-19 do not need to pay their monthly SOC. 

  • A Qualified Provider must determine if you are eligible and enroll you in the program. See a list of Qualified Providers in San Mateo County. 
  • Enrollment in the program begins on the date that you apply and is valid for 60 days. You may re-enroll in the program if you need more services after your enrollment ends.
  • The provider will not bill you or HPSM for these services. They will bill Medi-Cal directly.

Learn more about the PE program at the Department of Health Care Services (DHCS) website. If you have additional questions, call Member Services.