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Health Insurance

Overview

Health Insurance

Insurance keeps you healthy and financially covered when you need it most.

Health coverage can be complicated. That's why we offer free assistance to help you apply. We can let you know which programs you may qualify for, explain how they work, what it may cost, and then help you apply.

Schedule a health coverage screening appointment even if you think you might not qualify or if you have private, non-employer sponsored insurance. Legal immigration status is not required to access free or low-cost health insurance in San Mateo County. If you are under age 26 and currently not employed, but covered by a parent’s private insurance plan, you might qualify for subsidized coverage through Medi-Cal.

Insurance keeps you healthy and financially covered when you need it most.

Health coverage can be complicated. That’s why we offer free assistance to help you apply. We can let you know which programs you may qualify for, explain how they work, what it may cost, and then help you apply.

Schedule a health coverage screening appointment even if you think you might not qualify or if you have private, non-employer sponsored insurance. Legal immigration status is not required to access free or low-cost health insurance in San Mateo County. If you are under age 26 and currently not employed, but covered by a parent’s private insurance plan, you might qualify for subsidized coverage through Medi-Cal.

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Do You Need Help Paying for Health Care?

Federal, state, and county health coverage programs can help you pay for services. Our Health Coverage Unit will help you find a program right for you.

How to Apply

You can apply by phone or make an appointment to apply in person. Drop-ins are welcome. Call (650) 616-2002.

Hours
  • Monday – Wednesday, Friday: 8:30 AM – 5:00 PM
  • Thursday*: 10:00 AM – 5:00 PM

*We close at 2:30 PM the 2nd Thursday of each month.

Locations

Coastside Clinic
225 S. Cabrillo Hwy., 100A, Half Moon Bay
Open Mondays only

Daly City Clinic
380 90th Street, Daly City

Human Services Agency
2500 Middlefield Road, Redwood City

San Mateo Medical Center
222 West 39th Ave, San Mateo
1st floor, SMMC Business Office, 2nd floor,
Nursing Wing, outside 2AB

Where to Get an Application

  • Apply online
  • Go to one of our offices
  • Call (650) 616-2002 and we will mail it to you
  • Application available at no charge in English, Chinese, Spanish, and Tagalog

How to Apply Online or by Phone

Connect with us so we can get you access to the best plan for you and your family. Enrollment counselors are available to help you.

All information shared in health coverage applications is confidential.

For free health coverage help, you can apply online or on the phone:

What You Need to Apply

  • Proof of home address in San Mateo County (recent utility bill, billing statement, or ID with your address)
  • Proof of income (if you have income – recent paystub, government check stub, or tax forms from the previous year)
  • Proof of identity (any state ID card, ID from your country of origin, or passport)
  • Social Security Number or Tax ID Number (if you have one)
  • Residency card (if you have one)
  • Work Permit (if you have one)

Income Levels to Qualify 

Maximum Monthly Income to Qualify for Health Programs for Adults
Effective 1/1/2023 – 12/31/2023

Household Size 0 – 100% FPL MAGI MC (Caretaker/Relative)
0 – 109% FPL
ACE FW, MAGI MC     0 – 138% FPL

ACE
138-200% FPL

MAGI MC (Pregnant Women)
0-213% FPL

ACE Excess Income
200-225% FPL

MCAP (Pregnant Women, Newborns)
213-322% FPL
DHC, CC APTC
138-400% FPL
CC APTC – State Subsidy
400-600% FPL
1 $1,215 $1,324 $1,677 $2,430 $2,588 $2,734 $3,913 $4,860 $7,290
2 $1,644 $1,792 $2,269 $3,288 $3,502 $3,699 $5,294 $6,576 $9,864
3 $2,072 $2,259 $2,860 $4,144 $4,414 $4,662 $6,672 $8,288 $12,432
4 $2,500 $2,725 $3,450 $5,000 $5,325 $5,625 $8,050 $10,000 $15,000
5 $2,929 $3,193 $4,043 $5,858 $6,239 $6,590 $9,432 $11,716 $17,574
6 $3,357 $3,660 $4,633 $6,714 $7,151 $7,553 $10,810 $13,428 $20,142
7 $3,785 $4,126 $5,224 $7,570 $8,063 $8,516 $12,188 $15,140 $22,710
8 $4,214 $4,594 $5,816 $8,428 $8,976 $9,482 $13,570 $16,856 $25,284
9 $4,642 $5,060 $6,406 $9,284 $9,888 $10,445 $14,948 $18,568 $27,852
10 $5,070 $5,527 $6,997 $10,140 $10,800 $11,408 $16,326 $20,280 $30,420
11 $5,499 $5,994 $7,589 $10,998 $11,713 $12,373 $17,707 $21,996 $32,994
12 $5,927 $6,461 $8,180 $11,854 $12,625 $13,336 $19,085 $23,708 $35,562
Add for each additional person $429 $468 $593 $858 $914 $965 $1,382 $1,716 $2,574

Maximum Monthly Income to Qualify for Health Programs for Children
Effective 1/1/2023 – 12/31/2023

Household Size 0 – 100% FPL MAGI MC
0-160% FPL
MAGI MC
160-266% FPL
Kaiser Child Plan
0-300% FPL
CCHIP
266-322% FPL
CC APTC
322-400% FPL
CC APTC- State Subsidy
400-600% FPL
1 $1,215 $1,944 $3,232 $3,645 $3,913 $4,860 $7,290
2 $1,644 $2,631 $4,374 $4,932 $5,294 $6,576 $9,864
3 $2,072 $3,316 $5,512 $6,216 $6,672 $8,288 $12,432
4 $2,500 $4,000 $6,650 $7,500 $8,050 $10,000 $15,000
5 $2,929 $4,687 $7,792 $8,787 $9.432 $11,716 $17,574
6 $3,357 $5,372 $8,930 $10,071 $10,810 $13,428 $20,142
7 $3,785 $6,056 $10,069 $11,355 $12,188 $15,140 $22,710
8 $4,214 $6,743 $11,210 $12,642 $13,570 $16,856 $25,284
9 $4,642 $7,428 $12.348 $13,926 $14,948 $18,568 $27,852
10 $5,070 $8,112 $13,487 $15,210 $16,326 $20,280 $30,420
11 $5,499 $8,799 $14,628 $16,497 $17,707 $21,996 $32,994
12 $5,927 $9,484 $15,766 $17,781 $19,085 $23,708 $35,562
Add for each additional person $429 $687 $1,142 $1,287 $1,382 $1,716 $2,574

Available San Mateo County Health Coverage Programs 

More details about these programs are available here. Our Health Coverage Unit will help you find a program that’s right for you. Call (650) 616-2002 or e-mail info-hcu@smcgov.org.

Access and Care for Everyone (ACE)

  • Coverage for San Mateo County residents 19 years old or older without health insurance
  • $360 annual non-refundable application fee and co-payments for services
  • Income between 138% and 200% FPL

ACE Fee Waiver

  • Coverage for San Mateo County residents 26-49 years old without health insurance
  • No cost for services
  • Income at or below 138% FPL
  • Must also be enrolled in Restricted Scope Medi-Cal

Charity Care

  • Visits approved for Charity Care have no charge
  • Medications not covered
  • Income at or below 138% FPL

Discounted Health Care (DHC)

  • 65% discount off all services billed by San Mateo Medical Center
  • Income at or below 400% FPL

Available State and Federal Health Insurance and Coverage Programs 

Breast and Cervical Cancer Treatment Program (BCCTP)

  • Coverage for men and women with breast cancer and women with cervical cancer
  • Income at or below 200% FPL

Covered California

  • State’s health insurance marketplace
  • Premium assistance available to lower the cost of health care
  • Must file federal income tax return

Every Woman Counts (EWC)

  • Breast and cervical cancer screening for uninsured and underinsured women
  • Breast cancer screening for women age 40 and older
  • Cervical cancer screening for women age 21 and older
  • Income at or below 200% FPL

Family Planning, Access and Treatment Program (PACT)

  • Provides family planning services for individuals who are uninsured or underinsured
  • Income at or below 200% FPL

Medi-Cal

  • Coverage for children and adults with limited income and resources
  • No cost and low-cost health coverage

Other Payment Options 

Self-Pay Prompt Pay Discount

If you do not qualify for a health coverage program:

  • Pay 50% of your bill within 30 days of the date of the bill
  • We will waive the balance
  • Only available for services billed by San Mateo Medical Center

Extended Payment Plan

  • We can help with an interest-free payment plan based on your ability to pay.
  • Only available for services billed by San Mateo Medical Center

Questions About Your Bill

We never charge more than the amount generally billed for emergency services or other medically necessary care. If you have questions about your bill, please call our Business Services Department at (650) 573-2525.

Our Financial Assistance Policy is online at www.smchealth.org/health-care-costs.

San Mateo Medical Center Financial Assistance Program Application:
English and Spanish applications are available for download. 

Helpful Information and Additional Resources

Are health coverage programs available for everyone?

Health insurance is available regardless of immigration status, through a combination of Federal, State, and County programs. Contact 650-616-2002 or info-hcu@smcgov.org and enrollment counselors are available to talk through the best cost and coverage with each plan and find the right one for each person and family. 

Medi-Cal, California’s free health insurance available to those with low income, takes applications year-round. Children in low-income families are eligible for Medi-Cal regardless of their immigration status.

San Mateo County Health also provides free and low-cost health coverage programs for people who are low-income and do not qualify for Medi-Cal or tax credits through Covered California. This includes working families and immigrants regardless of immigration status. 

Already have health coverage?

If you have questions regarding your current health coverage, please call your health plan to help you use your health benefits. If you have full-scope Medi-Cal in San Mateo County, you are assigned to the Health Plan of San Mateo. Call them at 800-750-4776 or 650-616-2133 or visit https://www.hpsm.org.

If you’re not sure which program you’re currently enrolled in or how to receive help, contact the Health Coverage Unit at 650-616-2002 or e-mail info-hcu@smcgov.org.

Health coverage is renewed on an annual basis. Be sure to follow the instructions in the notice you receive in the mail. Health coverage helps you to stay healthy and have peace of mind that you and your family are covered for when you may need it the most.

Are you a small business?

If you are a small business, visit www.coveredca.com/forsmallbusiness. If you don’t offer health coverage to your employees, please provide them with the HCU flyer so they can learn what health program options are available. HCU Flyer Eng & Spn