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San Francisco Health Plan

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About Medi-Cal Health Coverage

Medi-Cal is a health insurance program for low-income residents of California. As your local health plan, San Francisco Health Plan offers an excellent and large selection of doctors, hospitals, and clinics. The following are examples of people who may qualify for Medi-Cal health coverage:

People who live in San Francisco County;

People who are a parent, child, adults without children, older adults or disabled;

People under the age of 26, regardless of their immigration status;

People who meet the income guidelines

Find Out if You Qualify for Medi-Cal

Find out if you or your child qualifies for one of our programs.

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Based on your selections you or your child may qualify for Medi-Cal health insurance.

Contact Our Enrollment Team

Contact our Enrollment Team by calling 1(888) 558-5858 Monday – Friday, 8:30am to 5:30pm. Asking a member of our Enrollment Team is the best way to know for sure if you qualify for one of our health care coverage programs.

  • We have several programs and will help you find the right one
  • Your children may qualify even if they are not legal residents
  • If you are not sure if you or your child qualifies for Medi-Cal, contact our Enrollment Team by calling 1(888) 558-5858 Monday – Friday, 8:30am to 5:30pm.

Based on your selections you do not qualify for Medi-Cal health insurance.

Contact Our Enrollment Team

Contact our Enrollment Team by calling 1(888) 558-5858 Monday – Friday, 8:30am to 5:30pm. Asking a member of our Enrollment Team is the best way to know for sure if you qualify for one of our health care coverage programs.

  • We have several programs and will help you find the right one
  • Your children may qualify even if they are not legal residents
  • If you are not sure if you or your child qualifies for Medi-Cal, contact our Enrollment Team by calling 1(888) 558-5858 Monday – Friday, 8:30am to 5:30pm.

Medi-Cal Benefits & Services for Your Health Needs

Medi-Cal provides coverage benefits for your health needs including, medical, dental, and vision services. Your covered services are free as long as they are medically necessary and provided by an in-network provider. Your health plan may cover medically necessary services from an out-of-network provider. But you must ask SFHP or your medical group for this. SFHP offers services such as:

X-ray and Diagnostics
Diagnostic X-ray and
Laboratory Services

Therapeutic radiological services, ECG, EEG, mammography, other diagnostic laboratory and radiology tests, laboratory tests for the management of diabetes.

Member Pays: No co-payment

Emergency Health Coverage

24-hour care for emergency services including psychiatric screening, examination and treatment, injury or condition requiring immediate diagnosis in and out of the Plan.

Member Pays: No co-payment

Family Planning

Counseling, surgical procedures for sterilization, contraceptives, elective abortion.

Member Pays: No co-payment

Home Health Services
Home Health Services

Medically necessary skilled care (not custodial); nursing care, home visits, physical, occupational, and speech therapy.

Member Pays: No co-payment

Mental Health Services

SFHP covers outpatient laboratory, drugs, supplies and supplements in connection with mental health services.

Member Pays: No co-payment

Perinatal/Maternity Care

Prenatal and postnatal care, inpatient, newborn nursery care while the mother is hospitalized and for the first month and the following month of life. Genetic testing is covered for PKU only.

Member Pays: No co-payment

Transportation Icon
Transportation

Emergency transportation such as ambulance, when medically necessary. Non-emergency medical transportation such as ambulance, litter van or wheelchair when you cannot get to your medical appointment by car, bus, train or taxi. For members under 21 years of age, non-medical transportation such as car, taxi, or bus to get to a medical appointment covered under the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program.

Member Pays: No co-payment

Regular Check-ups and Immunizations (shots)

Immunizations, periodic health exams, well-child visits, STD tests, cytology exams, prenatal care.

Member Pays: No co-payment

Vision Services

Vision care is covered through your Vision Service Plan. Vision benefits for children under the age of 21 years include eye exams from an Optometrist once every 24 months. Frames and lenses are covered. Vision benefits for adults age 21 years and older include eye exams from an Optometrist once every 24 months. Frames and lenses are not covered.

Member Pays: No co-payment

How to Apply for Medi-Cal

Visiting Our Service Center

The SFHP Service Center continues to provide the highest quality enrollment services for you and your family. During this challenging time of COVID-19, we are doing everything we can to meet the health care needs of San Franciscans – we’re doing it all by in-person and phone.

Our Enrollment Team offers information and application assistance for Medi-Cal.

In-person appointments are available on:
Tuesday and Thursday 8:30am – 5:00pm
Wednesday 8:30am – 4:00pm

Phone appointments are available on:
Monday to Friday 8:30am – 5:00pm
Saturday 8:30am – 12:00pm

Our team is happy to assist you with health coverage needs at a time that works best for you!

To schedule an in-person or phone appointment, please contact us at 1(415) 777-9992 or 1(888) 558-5858.

Visit our Service Center page for more information »

Need to Renew Your Medi-Cal Insurance?

As a Medi-Cal member, your eligibility will be reviewed every year. The steps below will apply for most Medi-Cal members.

  • The Medi-Cal office will review the information in your case file.
  • They will review the information in their systems to see if you are still eligible for Medi-Cal. Watch for a letter. The letter will tell you if you are still eligible for the Medi-Cal program.
  • Additional information may be requested. If there is not enough information to determine if you are still eligible, the Medi-Cal program may ask you to provide additional information.

Call the Medi-Cal office at 1(415) 863-9892 for more information.

Contact Us

Learn more about your health care options and get your Medi-Cal application started today.

For more information, contact us at:

  • Phone: 1(415) 777-9992 or 1(888) 558-5858
  • Fax: 1(415) 547-7820
  • Phone Hours: Monday–Friday, 8:30am – 5:00pm