Health Plan of San Joaquin (HPSJ) streamlines access to benefits & prescriptions for any HPSJ members affected by California wildfires
(French Camp, CA) – Health Plan of San Joaquin (HPSJ) announced today that it has set up streamlined access to benefits and prescriptions for any of its members who may be impacted by the fires that have ravaged California. Communications have gone out to –
- Members of HPSJ’s Medi-Cal managed care plan.
- Participants of multiple San Joaquin County employee health plans administered by San Joaquin Health Administrators, the third-party administrator line of business operated by HPSJ.
Among members served by Health Plan of San Joaquin and San Joaquin Health Administrators are those who may live in the following counties affected by the wildfires: Butte, El Dorado, Humboldt, Lake, Madera, Napa, Nevada, Sacramento, San Bernardino, San Diego, Shasta, Solano, Tulare, Tuolumne, and Yolo. The two counties of HPSJ’s licensed service area (San Joaquin and Stanislaus counties) are not currently in the path of any of these fires.
“Since Governor Brown has declared a state of emergency, HPSJ is taking steps so that our members who may be impacted by these disasters are able to have ready access to medical services and prescriptions that they might need,” said HPSJ Vice President for External Affairs David Hurst. “While the majority of people served by our programs reside in San Joaquin and Stanislaus Counties, there are members who are traveling beyond their home community, dependents who may be out of area, as well as retired or current San Joaquin county employees whose health benefit plans are managed by San Joaquin Health Administrators and may live in one of the fire-impacted areas.”
For affected members served by HPSJ, the assistance provided will include:
- Ease of Access to Medications and Prescriptions
- HPSJ is contracted with nearly all pharmacies in California, including all major chains. Members may go to any of these pharmacies. In the rare instance that a pharmacy is not part of the network, HPSJ will reimburse the member for out of pocket charges.
- If members have had their prescriptions lost, damaged or destroyed due to fire or mandated evacuations, they may immediately refill them, even if they are not due to be refilled.
- HPSJ offers a three-day supply for medications, including controlled medications, that are part of a benefit, but may be subject to restrictions.
- Provider Access
- Members unable to be seen by their network or customary providers, including urgent care and hospitals, will be assisted in identifying alternative providers, including, if necessary, out-of-network physicians.
- Behavioral Health
- HPSJ’s partner, Beacon Health Strategies, will help members find mental health help if they cannot reach their usual source of care.
- Urgent Care
- If the fires cause members to need urgent care, they may go out of HPSJ’s network; if they have to pay for this, they will be reimbursed.
- Toll-free numbers for questions including loss of member ID card, access to prescription refills and appropriate out-of-network providers, or how to access nearby health care:
- HPSJ Customer Service number, 1-888-936-7526 (711 for hearing impaired members)
- San Joaquin Health Administrators, 1-888-876-7526 (711 for hearing-impaired participants)
- 24/7 Nurse Advice Line, 1-800-655-8294
HPSJ, a not-for-profit health plan, has been serving members and the community since 1996. Located in the heart of California’s multicultural Central Valley, HPSJ is the leading Medi-Cal Managed Care provider in San Joaquin and Stanislaus counties. HPSJ offers a broad network of providers and works closely with physicians to develop programs and services to ensure quality health care for over 300,000 members. With a staff of close to 300 employees in multiple regional sites, HPSJ strives to improve healthcare delivery for underserved families and individuals.
*The National Committee for Quality Assurance (NCQA) in June 2015 awarded HPSJ a Three-Year Health Plan Accreditation for its Medicaid/HMO line of business (Medicaid is known as Medi-Cal in California). The NCQA award recognizes HPSJ as “ACCREDITED for service and clinical quality that meet or exceed NCQA’s rigorous requirements for consumer protection and quality improvement.”
NCQA Accreditation Seal: Formats available here.
Media Contact:
David Hurst
Vice President, External Affairs
Health Plan of San Joaquin
Phone: 209-461-2241
Text: 916-802-3734
dhurst@hpsj.com