Dear providers,
Some Health Plan of San Mateo (HPSM) members with certain immigration statuses will no longer be eligible for full-scope Medi-Cal starting July 1, 2026. This will impact their dental benefit, as California’s Medi-Cal program will stop covering dental services for these members except during emergencies. New HPSM members will likely be impacted each month, as any member with certain immigration statuses turning 19 will lose their full-scope dental coverage.
We are sending you this notification because this is a network-wide change that will impact many members – including your patients, possibly. This notification is to provide you with the information you may need in case a member has questions about their benefit. If they have questions or need help understanding their:
- Eligibility or immigration status, refer them to San Mateo County Human Services Agency at 650-802-6470 Monday through Friday between 8:00 a.m. to 5:00 p.m..
- Medi-Cal healthcare benefits, have them call HPSM Member Services at 1-800-750-4776 Monday through Friday between 8:00 a.m. and 6:00 p.m.
- Rights, have them email [email protected] or call 1-888-452-8609.
Affected members can use their HPSM Dental benefit for non-emergency services until June 30, 2026. Starting July 1, 2026, members can find a Medi-Cal Dental provider near them by visiting: https://dental.dhcs.ca.gov/find-a-dentist/home.
Some members who fall into this category will not be impacted. Exceptions to this rule include:
- People younger than 19 years of age will not be affected by this change.
- People 19 years and older with certain immigration statuses will continue to be eligible for non-emergency dental services through Medi-Cal Dental (fee-for-service) if they are:
- Pregnant, and up to one year after pregnancy.
- Between 19-26 and were in foster care on their 18th birthday.
For the full list of exceptions, or if a member wants to find out if this change applies them, have them visit: https://www.dhcs.ca.gov/Medi-Cal/Pages/immigration-status-categories.aspx
Thank you,
The Health Plan of San Mateo