HPSM Benefits
HPSM gives you access to a full range of health care benefits and services. Below is an overview of what you get, along with links to more details.
Health Care Services
HPSM’s Medi-Cal plan covers many health care services, including;
- Appointments with HPSM network providers
- Preventive care (such as health exams, screenings and more)
- Urgent care
- Skilled nursing facility care
- Hospital services
- Adult day care through Community Based Adult Services (CBAS)
- Care through the Multipurpose Senior Services Program (MSSP)
- Medical emergencies: call 9-1-1 or go to the nearest emergency room
Prescription medicines
Medicines prescribed by your doctor are covered. Some medicines may require prior authorization: talk to your doctor. Some over-the-counter medicines may also be covered, but must be prescribed by your doctor.
Costs
Co-pays: Medi-Cal providers and pharmacies may charge a $1 co-pay for some services and prescription medicines. However:
- Medi-Cal providers and pharmacies may charge a $1 co-pay for some services and prescription medicines.
- Hospitals can charge a $5 co-pay for non-emergency care provided at an emergency room. Check with your provider or pharmacy to see whether they charge a co-pay for services or medicinces.
Share-of-cost (SOC) payments: Some Medi-Cal members must pay a monthly fee towards their health care expenses. The County of San Mateo Human Services Agency determines if you must pay SOC based on your earnings. Call their Health Benefits Information line at 1-800-223-8383 to learn more.
Nurse Advice Line
If you are worried about your health, HPSM has a nurse advice line open 24 hours a day, 7 days a week at no cost to our members. Call 1-833-846-8773 if your healthcare provider is not available. Registered nurses are on hand to answer questions about your symptoms.
Care Management program
Helps get your doctors and HPSM all working to give you the focus and support you need to stay healthy. Your personal Care Manager helps you set health goals and make a plan for achieving them.
For more information, visit our Care Management page or call 650-616-2060
Wellness Programs and Services
The HPSM Health Promotion Unit supports members with general health information, tips and resources to stay healthy. This unit cannot offer medical advice. This unit connects to wellness programs and services at no-cost to members. Health topics include
- Diabetes and pre-diabetes
- High blood pressure
- Pregnancy
- Quitting tobacco
- Exercise and nutrition services
For more information about these programs, call HPSM’s Health Promotion Unit at 650-616-2165. For general health information, tips and resources, visit www.hpsm.org/health-tips.
Free rides to health care appointments, the pharmacy, and other health care services
For members who don’t have other means of transportation to health care services. To schedule a ride, call American Logistics (AL) at 1-877-356-1080 at least two (2) business days before your appointment (AL is open Monday through Friday). If you have an urgent appointment, call as soon as you can.
Free interpreter services
If your doctor does not speak your language, interpreter services are available by phone and video. Just ask your doctor to call an interpreter during your visit. In special cases, an interpreter can go to the visit with you.
Doctor’s visits by phone or video
Many providers can give you advice over the phone or see you by video. Telephone and video visits are fully covered. Call your primary care provider (PCP) to check if they provide telephone or video visits.