CareAdvantage Members

CareAdvantage Unit

Toll free: 1-866-880-0606
Local: 650-616-2174
TTY: 1-800-735-2929 or dial 7-1-1

Phone hours: Monday–Sunday 8:00 a.m. to 8:00 p.m.
Office hours: Monday–Friday 8:00 a.m. to 4:00 p.m.
Email: [email protected]

Grievance and Appeals Unit

Toll free: 1-888-576-7227
Local: 650-616-2850
Fax 650-829-2002

Monday–Friday 8:00 a.m. to 5:00 p.m.

Visit Us in Person

Health Plan of San Mateo
801 Gateway Blvd., Suite 100
South San Francisco, CA 94080 - map
Hours are 8:00 a.m. to 4:00 p.m. Monday though Friday

Members can drop by our office to speak with a CareAdvantage Navigator in-person. No appointment is necessary. To help us better assist you, bring your CareAdvantage Member ID card with you. Visitors only need to wear masks during private appointments. We have masks on hand for those who do not have them. Other health and safety precautions are in place as well. Our office is ADA-compliant and wheelchair accessible.

For more information about visiting HPSM’s office, call the HPSM Reception Desk at 650-616-0050.

New address or contact information?

If you move and/or change your contact information (phone number, email), you must tell both HPSM and either the San Mateo County Human Services Agency at 1-800-223-8383 or Social Security Administration at 1-800-772-1213. This will ensure that you continue to get important information about your Medi-Cal coverage status.

To report your new information with HPSM, you can log in to the Member Portal or call the number below if you need assistance.

Log in to the Member Portal

CareAdvantage Dual Eligible Special Needs Plan (D-SNP) 2026

Give Feedback On Your Care

If you have a concern about the medical care or service you received from your doctor's office or HPSM, we are here to resolve it quickly. Our grievance and appeals process ensures your issue is handled promptly.

Filing a complaint will not affect your benefits. Your provider (doctor) also cannot treat you differently because you raised a concern.

How to file a complaint

Call the CareAdvantage Unit promptly at 1-866-880-0606 or 650-616-2174. TTY: 1-800-735-2929 or 7-1-1. Office hours: Monday - Sunday, 8:00 a.m. to 8:00 p.m.

The CareAdvantage Unit will try to resolve your concern over the phone. If they do not resolve your complaint to your satisfaction within 24 hours, the Grievance and Appeals Unit will start a formal process to reach a solution. 

If you do not want to call (or called and were not satisfied), there are three other ways to file the complaint:

  • Complete the Member Complaint form online
  • Download, complete and print the member complaint form. This form can be sent to HPSM by
    • fax to 650-829-2002
    • mail to HPSM Grievance and Appeals
      801 Gateway Boulevard, Suite 100
      South San Francisco, CA 94080
  • Make an appointment to speak about your complaint in person by Calling the CareAdvantage Unit at 1-866-880-0606 >or 650-616-2174. TTY: 1-800-735-2929 or 7-1-1. Office hours: Monday - Sunday, 8:00 a.m. to 8:00 p.m.

Complaints about emergency situations

If your complaint involves an imminent and serious threat to your health (including but not limited to severe pain, potential loss of life, limb or major bodily function), you or your provider may request an expedited (fast-tracked) review. If your complaint qualifies, we will resolve it within three days of receipt.

How HPSM resolves your complaint

Within five (5) business days of receiving your complaint, an HPSM Grievance and Appeals Coordinator will call you to discuss your complaint and review HPSM's complaint process. We will resolve your complaint within 30 days and send you a letter explaining our decision. To ask about the status of an existing complaint, call our Grievance and Appeals Unit.

Any services that were authorized will continue to be provided until your complaint is resolved.

Other ways to file a complaint

You can send your complaint to Medicare. Medicare takes complaints seriously and will use this information to help improve the quality of the Medicare program.

You can call Medicare at 1-800-Medicare (1-800-633-4227) or click on the button below to complete a complaint form on the Medicare website:

Medicare Complaint Form

You can also contact the Cal MediConnect Ombudsman Program at 1-855-501-3077 for assistance.

Complaints about Medi-Cal Rx Pharmacy Benefits

Please note: Complaints related to Medi-Cal Rx pharmacy benefits are not subject to the HPSM grievance and appeals process. Members can submit complaints about Medi-Cal Rx pharmacy benefits by calling 1-800-977-2273 (TTY 1-800-977-2273 and press 5 or 7-1-1) or going to medi-calrx.dhcs.ca.gov. However, complaints related to pharmacy benefits not subject to Medi-Cal Rx may be eligible for an Independent Medical Review. DMHC’s toll-free telephone number is 1-888-466-2219 and the TTY line is 1-877-688-9891. You can find the Independent Medical Review/Complaint form and instructions online at the DMHC’s website: www.dmhc.ca.gov/.

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 D-SNP 2026 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.)

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