ACE Participants

San Mateo County ACE Program

ACE payments

Copays

Copays are your out-of-pocket expenses for certain benefits, usually at the time of an appointment. In general, doctor’s appointments cost $15 and prescriptions cost $7. The maximum amount of copays per benefit year is $640. After that, you don’t need to pay any more copays for the rest of the benefit year. Keep track of your copays so you will know when you have reached this limit.

See the ACE Copays List for more information.

Annual Participation Fee

ACE Participants must pay a $360 non-refundable annual Participation Fee in order to receive services. With copays, the most you will pay in out-of-pocket expenses per benefit year is $1,000. 

You can either pay the full amount up front at once or in monthly payments.

  • If you pay the full $360 up front, you will receive $45  in San Mateo County ACE Bucks that you can use toward copays
  • Otherwise, HPSM will send you a monthly invoice until your annual Participation Fee is paid off 

There are two ways you can pay your annual Participation Fee:

  1. We accept payments via check or money order. You can pick up a pre-paid envelope (BRE) to mail your payment at the Health Plan of San Mateo office. Our office is open to assist walk-in members Monday through Friday, from 8:00 a.m. to 4:00 p.m. Please remember to bring your ACE Participant ID card with you.

 Health Plan of San Mateo
801 Gateway Blvd., Suite 100
South San Francisco, CA 94080

We are available Monday–Friday 8:00 a.m. to 4:00 p.m.
Our office is ADA-compliant and wheelchair accessible.

  1. Mail a check or money order to the address below

Health Plan of San Mateo
Attn: ACE Program Annual Participation Fee
PO BOX 51048
Los Angeles, CA 90051-9867

HPSM does not accept cash, credit or debit cards. Please include your HPSM ID on the check or money order for processing.

Fee Assistance

You can request Fee Assistance to reduce the amount of your ACE Participation Fee. You can get a form from a Community Health Advocate at your Primary Care Provider clinic location or from your community application assistor. You may also contact the Health Coverage Unit at 650-616-2002. If you are approved for Fee Assistance, you will still be responsible for copays. 

If you have questions about the Participation Fee, call HPSM’s Member Services:

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

For more information about ACE Program payments, refer to section 7 of the San Mateo County ACE Participant Handbook. To order a printed ACE Participant Handbook, email MemberServicesSupport@hpsm.org or call Member Services.