D-SNP is a type of Medicare Advantage (MA) plan, also known as a Medi-Medi plan. D-SNP is only offered to “dual eligible” people (those who have both Medicare and Medi-Cal).

Using both Medicare and Medi-Cal can be hard and confusing. A D-SNP health plan combines Medicare and Medi-Cal into one plan, making it simpler to get benefits and care.

SFHP Care Plus gives the same coverage as Medicare and Medi-Cal, PLUS extra benefits and services, and personalized care, all at no extra cost to you.

Yes, SFHP Care Plus is an HMO D-SNP plan. This means you must get care from doctors and hospitals in the SFHP Care Plus network.

SFHP Care Plus partners with North East Medical Services (NEMS), a community health center serving diverse populations across the country. NEMS serves those who need it most, running 28 clinics and service delivery sites. They also have over 200 health care providers who specialize in many types of care.

NEMS offers health care services in many languages and dialects, including English, Cantonese, Mandarin, Toishan, Vietnamese, Burmese, Korean, Spanish, and Hindi.

If you need emergency care or out-of-area dialysis services, you can use providers outside of the SFHP Care Plus network. You can also get urgent care from out-of-network providers if you cannot access network providers within a reasonable time to address your urgent care needs.

If your providers (doctors, hospitals, pharmacies, etc.) are in the SFHP Care Plus network, you can keep seeing them and your care will be covered.

SFHP Care Plus partners with North East Medicare Services (NEMS). NEMS runs 28 clinics and service delivery sites and over 200 health care providers who specialize in many types of care. They offer health care services in many languages and dialects, including English, Cantonese, Mandarin, Toishan, Vietnamese, Burmese, Korean, Spanish, and Hindi.

If needed, we can help you switch to a new provider within NEMS’s network.

If you need urgent or emergency care or out-of-area dialysis services, you can use providers outside of the SFHP Care Plus network.

Once you finish your Health Risk Assessment (HRA), you and your care team will work together to create a personalized or individualized care plan (ICP). Together, we can make sure you get the support you need.

You will get care from a team of experts that is coordinated by SFHP. Your SFHP Care Plus care manager will help you navigate your plan, your providers, and your services. Their mission is to make sure you get what you need.

You will not pay any monthly premiums for your health coverage, including the Medicare Part B premium, because you have Medi-Cal.

There is no yearly deductible or cost sharing for medical care. You will not lose any of your current Medi-Cal benefits. As a member of SFHP Care Plus you will get additional, no-cost coverage and benefits.

Please note that for prescription drugs, you will have small copay for covered drugs. As a D-SNP member, you can get extra help to reduce costs for Part D drugs. Please refer to the member handbook for more information.