HPSJ Expedites Access to Benefits & Prescriptions for Any HPSJ Medi-Cal Member Affected by California Wildfires & Smoke

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Health Plan of San Joaquin Expedites Access to Benefits & Prescriptions for Any HPSJ Medi-Cal Member Effected by California Wildfires & Smoke

  • Link to Wildfire Smoke Fact Sheet (2 pages) is below

(French Camp, CA) – Health Plan of San Joaquin (HPSJ) has set up streamlined access to benefits and prescriptions for any of its members who may be impacted by the fires now raging in Butte, Los Angeles, and Ventura counties.  HPSJ is reaching out to our Members who may be in impacted areas. Since Governor Brown has declared a state of emergency, HPSJ is taking these 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.  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, as well as dependents who may be out of area, and are in one of the fire-impacted areas.

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.

 For impacted 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.
  • Mental 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, at 1-888-936-7526 (711 for hearing impaired members)
  • HealthReach 24/7 Nurse Advice Line, at 1-800-655-8294

Additional Advisory sent to HPSJ Provider Network – For any further questions regarding this situation, including about prior authorizations, pre-certifications, or referrals, or regarding replacements of members’ medical equipment or supplies, as well as any other related matter – please contact our Customer Services Department at (209) 942-6320.

Health Plan of San Joaquin also is concerned about the health effects of smoke from the wildfires.  This link is to the two-page “Wildfire Smoke Fact Sheet”
https://hpsj4.wpengine.com/wp-content/uploads/2018/11/WebLink-Wildfires-Fact-Sheet.pdf .


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About HPSJ

Health Plan of San Joaquin, a not-for-profit, public health plan, has been serving members and the community since 1996. Located in the heart of California’s multicultural Central Valley, local HPSJ is the leading Medi-Cal managed care provider, serving over 91% of Medi-Cal recipients in San Joaquin County and over 65% in Stanislaus County. HPSJ offers a broad network of providers and works closely with doctors to develop programs and services to ensure quality health care for almost 350,000 members who are mostly working families and children, as well as seniors and disabled residents. About 178,000 HPSJ members are children, ages 0 to 19 years.

Jill Center, Health Plan of San Joaquin,
(209) 461-2372 (cell: 415-730-5958),

Posted on November 15th, 2018