CareAdvantage Dual Eligible Special Needs Plan (D-SNP) 2023
Worldwide Emergency Benefit
CareAdvantage covers up to $25,000 a year for emergency services and transportation received anywhere in the world
You shouldn't have to worry about what would happen if you get sick or hurt while far from home. With CareAdvantage, you can enjoy peace of mind knowing that your emergency health care costs are covered no matter where you go. You're covered whether you’re driving cross-country or flying around the world!
The worldwide emergency benefit covers services when:
- Your life is at risk if treatment is not provided immediately.
- Your abilities are at risk of losing maximum capacity (for example, if your arm was hurt and without treatment you could lose the arm).
- Emergency services are provided by a health care professional at a health care facility.
- Not previously scheduled or coordinated.
To get reimbursement for emergency services, you must provide the following documentation:
- Copies of your medical record identifying the services received and stating that they were provided in response to an emergency. Services that were already scheduled are not covered under this benefit.
- An itemized bill or invoice showing all services received.
- Proof of payment (one of the following):
- Bank statement.
- Credit card statement.
- (For cash payment) receipt signed by provider.
- A completed Direct Member Reimbursement Form.
- Proof of travel (such as a plane ticket, flight/cruise itinerary or passport stamp).
Submit your information in one of two ways:
1. Email: firstname.lastname@example.org
2. Mail: Health Plan of San Mateo
801 Gateway Blvd., Suite 100
South San Francisco, CA 94080
After you submit a reimbursement request
- HPSM will start the review process as soon as your request and all required documentation is received.
- HPSM will issue a written response based on the information you provide, including payment (if applicable), within 30 calendar days from the day we received your request.
- If you have questions about your request, please contact our CareAdvantage Unit at 650-616-2174 or 866-880-0606 (TTY: 800-735-2929 or 7-1-1): office hours are Monday through Sunday from 8:00 a.m. to 8:00 p.m.
Toll free: 1-866-880-0606
TTY: 1-800-735-2929 or dial 7-1-1
Monday–Sunday 8:00 a.m. to 8:00 p.m.
CareAdvantage Dual Eligible Special Needs Plan (D-SNP) is a health plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to enrollees. Limitations and restrictions may apply. For more information, call the CareAdvantage Unit or read the CareAdvantage 2023 Member Handbook.
Benefits and co-pays may change on January 1 of each year.
If you speak other languages other than English, language assistance services, free of charge, are available to you. Call 1-866-880-0606 (TTY: 1-800-735-2929 or dial 7-1-1). ( Download this statement in multiple languages.)
Page updated October 1, 2022