Doctors & Specialists
In general, HPSM will only cover services you receive from Medi-Cal providers in HPSM’s network. You are covered for services from a non-network provider in the United States only for medical emergencies, for urgent care outside of the plan’s
service area or when HPSM pre-approves coverage for a visit to non-network provider.
Prior authorization of referrals are not required if your doctor refers you to a specialist within the HPSM network. If you need to be referred outside the HPSM provider network, your doctor needs to request approval of coverage before you receive services.
Search for a provider
Use the online provider search form to find the latest information for in-network primary care providers (PCP), specialists, pharmacies, clinics or hospitals. This directory is updated weekly. You may need a referral from your PCP before making an appointment with a specialist for non-emergency care. Call your PCP to find out if a referral is required.
Doctor's visits by phone or video anytime
Many providers can give you advice over the phone or see you by video. Telephone and video visits are fully covered by HPSM. Call your primary care provider (PCP) to check if they provide telephone or video visits.
If your do not have PCP, or if your PCP does not offer phone or video appointments, you may be able to use Teladoc®, one of HPSM's newest service partners. Learn more.
Continuity of Care
If you are a new member, you may request permission to continue getting medical care from a doctor or hospital who is not in HPSM's network if you were receiving this care before enrolling in HPSM and if you meet certain conditions. To learn more, see the HealthWorx HMO Evidence of Coverage.
Download the Provider Directory
For more information about HealthWorx doctors and specialists, refer to section 4 of the HealthWorx HMO Evidence of Coverage. To order a printed EOC, email CustomerSupport@hpsm.org or call Member Services.
Request a Printed Copy
If you would like a provider directory mailed to you, please send an email to email@example.com with the following information:
- Your first and last name
- Daytime phone number (in case we need to call you about your request)
- Mailing address
- Which directory you want (CareAdvantage or Medi-Cal)
The provider directory is updated every week; however there may be incorrect or new information about a provider that has not yet been updated. If you find an error, please send us the correct information by using the Provider Directory Error Report Form.