What Type of Care Do You Need?
San Francisco Health Plan strives to deliver the best care possible for our Medi-Cal members – because we care about the health and well-being of our community. Whether you need help accessing providers, finding specialists for your health conditions, or getting the right care at the right time, we’re here for you.
Primary Care Provider (PCP)
Visit your Primary Care Provider* (PCP) if you have not had a recent health check-up or have not met with your PCP. Learn who to contact in your care network.
When to Visit Your PCP:
- Routine check-ups to prevent future health issues
- Treating sudden or short-term health problems
- Managing long-term conditions or diseases like diabetes
You should be able to get an appointment within:
- 10 business days for PCP appointments that are not urgent.
If you need help finding the phone number of your PCP, please call SFHP Customer Service at 1(415) 547-7800 weekdays from 8:30am – 5:30pm.
*Your Primary Care Provider is the doctor, nurse practitioner, or physician assistant who is in charge of your health care.
Specialist
Visit a specialist if you need expert advice or treatment for a specific problem. Find out how to get an appointment with a specialist.
Some examples of when to visit a specialist:
- Asthma
- Diabetes
- Heart problems
You should be able to get an appointment within:
- 15 business days for specialist care that is not urgent.
Contact your PCP about what specialists you may need to see. If you need help finding the phone number of your PCP, please call SFHP Customer Service at 1(415) 547-7800, TTY 1(888) 883-7347 weekdays from 8:30am – 5:30pm.
Behavioral and Mental Health Services
You can get mental health services through specialists from Carelon Behavioral Health. Talk with your PCP if you think you may have symptoms of any mental health issues. Most people get better with treatment. This can be medicine, counseling, or talking with a Behavioral Health Specialist.
Mental health services can treat anxiety, depression, or behavioral health problems.
You can get outpatient mental health services at no cost with SFHP.
Some examples of when to talk with a Behavioral Health Specialist:
- Mental health screening and treatment
- Psychological testing to check your mental health condition
- Lab work, drugs, and supplies
- Psychiatric assessment and medicine if needed
- Screening, counseling, and referral to treatment
You should be able to get an appointment within:
- 10 business days. Carelon Behavioral Health will reach out to you. A Behavioral Health Specialist can give you a mental health screening if you have mental health needs that are not urgent.
You do not need a referral to get Mental Health Services. You can call Carelon Behavioral Health to learn more or get an appointment at 1(855) 371-8117, or visit carelonbehavioralhealth.com.
After-Hours & Urgent Care
Urgent Care is available when you need to be seen by a provider right away.
Some examples of when to get urgent care:
- Cold, flu, fever
- Infections (skin, eye, ear, etc.)
- Stomach problems (pain, vomiting, diarrhea)
You should be able to get an appointment within:
- 48 hours for urgent appointments with your PCP.
- 96 hours for urgent appointments with a specialist.
Urgent Care Centers
You can go to an urgent care center if your PCP is not available and you want to get care in person. Check your medical group and which centers you can go to:
- ZSFG Adult & Pediatric Urgent Care Centers
- Acute Care Clinic
- UCSF Pediatric Urgent Care Clinic
- Visit one of the many Dignity Health-GoHealth centers located across San Francisco.
- Visit one of the many Dignity Health-GoHealth centers located across San Francisco.
Members of San Francisco Health Network, Community Clinic Network, or North East Medical Services with San Francisco Health Network:
Members of University of California, San Francisco (UCSF):
Members of North East Medical Services and Chinese Community Health Care Association:
Members of Jade Health Care, Hill Physicians, or Brown & Toland Physicians:
Teladoc:
You can call a provider by phone or video if your PCP is not available and you want to get care for simple health problems.
Some examples of when to use Teladoc:
- Colds/Flu
- Vomiting & Diarrhea
- Skin Rashes
Visit teladoc.com/sfhp or call 1(800) 835-2362.
Nurse Advice Line:
You can talk to a nurse 24/7.
Some examples of when to use the nurse advice line:
- If you need to see a doctor.
- If your symptoms get worse.
- If you have questions on how to start feeling better at home.
Call the nurse advice line at 1(877) 977-3397.
Emergency Care
Visit a hospital emergency room only if you have a medical emergency.
Some examples of medical emergencies:
- Hard time breathing and/or shortness of breath
- Chest or upper stomach pain, or feel pressure in your chest
- Sudden numbness or weakness in the face, arm, or leg
If you think your health issue is life-threatening or will get worse on the way to the hospital, call 911 and have local emergency medical services come to you.
Vision Services with VSP Vision Care
Whether you have noticed changes in your vision or just need a regular check-up, you can access quality vision care through VSP. Benefits include:
- One routine eye exam every 24 months. For members with conditions like diabetes, more frequent eye exams may be needed
- Eyeglasses (frames and lenses covered)
- Medically necessary contact lenses
- And more
Depending on your vision care needs, you may need to see an optometrist or ophthalmologist.
Optometrists (ODs) are not medical doctors. They can help you with:
- Glasses or contact lenses
- Basic eye health and routine exams
To find an optometrist, visit vsp.com or call
Ophthalmologists are medical doctors who can do eye surgery. They can help you with:
- Eye surgery and procedures
- Skin issues near your eyes, like moles or skin tags
- Treatment for complex eye health conditions, like cataracts
Talk to your PCP to see if you need to visit an ophthalmologist for your eye health.
To learn more about vision benefits for adults and children, and how to schedule a visit through VSP, visit our Vision Services page.
Medi-Cal Dental Services
SFHP Medi-Cal members can access dental care with Medi-Cal Dental.
Medi-Cal Dental covers many dental health services, including:
- Dental exams
- X-rays
- Teeth cleaning
- Partial and full dentures
- Teeth removal
- Emergency service
Visit our Dental Services page to view the full list of covered services for adults and children.
To find or change your dentist:
- Visit Medi-Cal Dental and search the Provider Directory
- Or call
1(800) 322-6384 (toll free), or1(800) 735-2922 (TTY).
To access member resources like your Medi-Cal Dental Handbook, find answers to common questions, and more, visit smilecalifornia.org.
Not an SFHP member yet?
Learn about your health care options and see if you can get Medi-Cal at sfhp.org/qualify.