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Important changes are happening to Medi-Cal

Learn how to keep your Medi-Cal benefits and about the changes.

Your Medi-Cal healthcare Coverage Is Changing

Fee-for-Service Transition

This information may apply to you. Your letter is the best source of information about your individual coverage. If you are still unsure after reading this page, call us and have your letter with you.

If you received a letter from HPSM about a change to how you get medical care with Medi-Cal, this page explains when the change will happen, what coverage you will have, and how you need to prepare.

Your Medi-Cal eligibility is not ending because of this transition.

Starting January 1, 2027, affected members will get medical and dental care through Medi-Cal Fee-for-Service instead of through the Health Plan of San Mateo. This changes how to find and get care. It does not, by itself, end Medi-Cal eligibility.

Does this change affect me?

Not every Medi-Cal member will be affected. These changes are for all Medi-Cal members who are:

  • Undocumented
  • Green card holders (lawful permanent residents) who must wait five years for full Medi-Cal
  • Allowed to live in the U.S. but do not have official immigration status (PRUCOL)

If you received a letter about changes to your health care coverage, review the information in your notice carefully. Your letter is the best source of information about your individual situation.

To check if you have satisfactory immigration status and qualify for Full Scope Medi-Cal, review the Immigration Status and Changes to Medi-Cal Eligibility chart from the California Department of Health Care Services.

Important dates and activities

  • Now through December 31, 2026, Full healthcare coverage with HPSM

What to do:

  • Starting January 1, 2027, Some HPSM members will get their health care through Medi-Cal Fee-for-Service instead of through HPSM.

What to do:

What Is Medi-Cal Fee-for-Service?

Today, HPSM helps coordinate your care through our provider network. Beginning January 1, 2027, affected members will receive care through Medi-Cal Fee-for-Service (FFS).

Under Fee-for-Service:

  • You will no longer receive your medical benefits through HPSM.
  • You can get care from any doctor, clinic, or provider that accepts Medi-Cal Fee-for-Service.
  • You choose your own provider instead of being assigned to a health plan network

Fee-for-Service does not mean you pay for your care. Medi-Cal will continue to cover eligible services.

What Will Stay the Same?

Many important benefits and services will continue.

Prescription Medicines will continue to be covered through Medi-Cal Rx.

Mental Health and Substance Use Services will still be available.

  • Therapy, counseling, and psychiatric appointments will be available through Medi-Cal Fee-for-Service providers.
  • Specialty mental health services and substance use treatment will continue through county programs.

Medi-Cal Eligibility is not automatically affected. You must continue to:

  • Complete renewals when required
  • Report changes when requested
  • Respond to notices from Medi-Cal or your county office

For now, the most important step is making sure your contact information is up to date so you do not miss important notices. Log into BenefitsCal to make sure your contact information is up to date.

What Should I Do Before January 1, 2027?

Ask ALL your current healthcare and dental providers if they take Medi-Cal Fee-for-Service.

Keep Your Medi-Cal Benefits Identification Card (BIC)

After December 31, 2026 your HPSM member ID card will no longer be used for services. Starting January 1, 2027 your Medi-Cal Benefits Identification Card (BIC) will become your primary health care card.

  • Doctor visits
  • Pharmacy visits
  • Hospital visits
  • Other medical appointments

Lost or misplaced your Medi-Cal BIC card? Learn how to get a new one.

Watch for Important Notices

Read all letters, emails, and text messages from:

  • Medi-Cal (Department of Healthcare Services
  • San Mateo County Human Services Agency
  • HPSM

These notices may contain important information about your coverage and any actions you need to take.

Renew Your Medi-Cal On Time

This is very important! Renewing your Medi-Cal remains one of the most important ways to protect your coverage. Missing deadlines or failing to respond to requests for information could put your benefits at risk.

Make sure your contact information is up to date so you do not miss important notices. Log into BenefitsCal to make sure your contact information is up to date.

Find new healthcare providers and dentists

If your current doctor does not accept Medi-Cal Fee-for-Service, you can search for a participating provider or call the Medi-Cal Helpline for assistance. You can also call the Medi-Cal Helpline at 800-541-5555.

Need Help Understanding This Change?

Your coverage may be changing, but you do not have to navigate these changes alone. If you have questions:

  • Contact your San Mateo County Human Services Agency
  • Call the Medi-Cal Helpline at 800-541-5555
  • Contact HPSM Member Services

Learn more about

Changes to Dental Coverage

Work and Community Engagement Requirements

Updating Your Contact Information

Keeping Your Medi-Cal Coverage

Important: You are not losing your Medi-Cal coverage because of this change. Beginning January 1, 2027, some members will receive health and dental care through Medi-Cal Fee-for-Service instead of through HPSM.

The most important steps you can take now are to:

  • update your contact information,
  • renew your Medi-Cal on time, and
  • ask your current doctor if they accept Medi-Cal Fee-for-Service.

Medi-Cal Members

Call 1-800-750-4776 or 650-616-2133 Monday–Friday 8:00 a.m. to 6:00 p.m.

TTY: 1-800-735-2929 or dial 7-1-1

Email: MemberServicesSupport@hpsm.org

CareAdvantage Members

Call 1-866-880-0606 or 650-616-2174 Monday–Sunday 8:00 a.m. to 8:00 p.m.

TTY: 1-800-735-2929 or dial 7-1-1

Email: CareAdvantageSupport@hpsm.org