Alternative Access Standards (AAS)
It is our goal to make sure all members can see network providers and specialists near their home or work. We follow time and distance standards set by the state based on zip code.
Standards for San Mateo County by Provider Type
California law requires health plans to provide timely access to care . This means that there are limits on how long you have to wait to get health care appointments and telephone advice. See the table below for the standards for San Mateo County.
Type of provider
Appointment available within
Time and distance within
Primary Care
Adult, Pediatric and OB/GYN
10 business days
10 miles or 30 minutes
Specialty Care
Adult, Pediatric and OB/GYN
15 business days
15 miles or 30 minutes
Hospital
Not applicable
15 miles or 30 minutes
Pharmacy
72-hour supply of covered medicines during emergency situations
10 miles or 30 minutes
Mental Health
Adult and pediatric non-psychiatric outpatient services
10 business days
15 miles or 30 minutes
Ancillary Services
15 business days
Not applicable
Time and distance standards do not apply to Multipurpose Senior Services Program, Skilled Nursing Facilities or Intermediate Care Facilities because services are provided at the residence.
Type of provider
Appointment available within
Skilled Nursing Facility
5 business days
Intermediate Care Facility
Developmentally Disabled (ICF-DD)
5 business days
Call center
Wait time within
HPSM Medi-Cal Member Services
10 minutes from the time the call is placed
Alternative Access Provider List
The approved Alternative Access Standards Provider List can be used to find out if your area is impacted by any time and distance challenges for certain provider types. If your zip code and provider type are listed, HPSM must help you find an appointment.
If the provider you are looking for is further than the required distance from your home, you can do any of the following:
- Choose any network provider from HPSM's directory and contact them directly to schedule an appointment
- Call HPSM Member Services or CareAdvantage Unit for help in finding the nearest available network provider who meets your needs. We can even make the appointment for you!
If HPSM cannot find you an appointment with a closer provider, HPSM will help with arranging transportation to see the specialist.
Is transportation a challenge for you?
If you need help getting to your appointment and back home, you can get a ride at no cost. Learn more about the HPSM Ride Benefit.
CareAdvantage members
Call 1-866-880-0606 or 650-616-2174 Monday–Sunday 8:00 a.m. to 8:00 p.m.
TTY: 1-800-735-2929 or dial 7-1-1
Email: [email protected]
Medi-Cal and HealthWorx members and ACE Program participants
Call 1-800-750-4776 or 650-616-2133 Monday–Friday 8:00 a.m. to 6:00 p.m.
TTY: 1-800-735-2929 or dial 7-1-1
Email: [email protected]