NCQA Accredited
HPSM’s Medi-Cal program received Accreditation from the National Committee for Quality Assurance (NCQA) on January 17, 2020. NCQA is a not-for-profit organization dedicated to improving health care quality. NCQA Accreditation is widely considered the health care industry’s “seal of approval,” and having it shows that HPSM meets the highest quality standards.
New address or contact information?
If you move and/or change your contact information (phone number, email), you must tell both HPSM and either the San Mateo County Human Services Agency at 1-800-223-8383 or Social Security Administration at 1-800-772-1213.
This will ensure that you continue to get important information about your Medi-Cal coverage status.
To report your new information with HPSM, you can log in to the Member Portal or call the number below if you need assistance.
Member Services
Toll free: 1-800-750-4776
Local: 650-616-2133
TTY: 1-800-735-2929 or dial 7-1-1
Phone hours: Monday–Friday 8:00 a.m. to 6:00 p.m.
Office hours: Monday–Friday 8:00 a.m. to 4:00 p.m.
Email: MemberServicesSupport@hpsm.org
New address or contact information?
If you move and/or change your contact information (phone number, email), you must tell both HPSM and either the San Mateo County Human Services Agency at 1-800-223-8383 or Social Security Administration at 1-800-772-1213. This will ensure that you continue to get important information about your Medi-Cal coverage status.
To report your new information with HPSM, you can log in to the Member Portal or call the number below if you need assistance.
Member Services
Toll free: 1-800-750-4776
Local: 650-616-2133
TTY: 1-800-735-2929 or dial 7-1-1
Phone hours: Monday–Friday 8:00 a.m. to 6:00 p.m.
Office hours: Monday–Friday 8:00 a.m. to 4:00 p.m.
Email: MemberServicesSupport@hpsm.org
Medi-Cal
Medi-Cal is California’s Medicaid program. It provides health coverage at no cost or low cost to qualified adults, families with children, seniors, persons with disabilities, pregnant people, children in foster care and former foster youth up to 26.
Who qualifies for Medi-Cal?
Residents of California who meet eligibility criteria and income guidelines may be able to get Medi-Cal. HPSM manages the healthcare coverage of people who qualify for Full-Scope Medi-Cal in San Mateo County. People who need health benefits can apply for Medi-Cal anytime throughout the year.
How much does Medi-Cal cost?
Most Medi-Cal members pay $0 for care.
Do I need to pay co-pays?
- Most HPSM providers do not charge HPSM members any co-pays
- Medi-Cal providers may charge a $1 co-pay for some services
- Hospitals can charge a $5 co-pay for going to the emergency room for non-emergency care
What is share-of-cost (SOC)?
Some Medi-Cal members must pay a monthly fee towards their healthcare expenses. This is called share-of-cost (SOC) and is like paying a deductible in a private health plan. These payments are not co-pays.
To find out if you must pay SOC, contact the San Mateo County Human Services Agency
What is Fee-For-Service (FFS) Medi-Cal?
Between 2026 and 2028 Medi-Cal will undergo a series of changes. Some people may no longer qualify for Full-Scope Medi-Cal (which HPSM manages) and may be moved to FFS Medi-Cal. People with FFS Medi-Cal may have to pay a small fee each time they get care. Learn about FFS Medi-Cal from www.dhcs.ca.gov.
How can I apply for Medi-Cal?
- Online: Visit the BenefitsCal website to complete the online application and upload documents
- Phone: Call the San Mateo County Human Services Agency (HSA) Call Center at 1-800-223-8383 to apply by phone or request a paper application be mailed to you
- Mail: Visit the HSA website and download, print and follow the directions to mail the application
How do I keep my Medi-Cal coverage?
Opening your mail, updating your contact information and reporting changes right away can help prevent delays or loss of coverage. Learn how to keep your benefits.
Don't lose your Medi-Cal
Has your address changed? Report changes at benefitscal.com for fastest service or call San Mateo County HSA at 1-800-223-8383. Report changes
Clicking on these links will direct you to a website or document that is external to www.hpsm.org. The Health Plan of San Mateo (HPSM) accepts no responsibility for the content, policies or accessibility of the external websites or external documents linked to on this website.
If you have HPSM Medi-Cal and Medicare
You can join HPSM’s CareAdvantage plan! CareAdvantage makes make your health care easier with a single card and phone number for all your benefits!