1. Healthy San Francisco
  2. For Participants

Covered Medical Services

HSF covers these medical services:

(Click on the services for more information.)

In a life-threatening emergency, call 9-1-1 or go to the hospital in your Medical Home Network. Healthy San Francisco (HSF) can ONLY cover the cost of care at the hospital in your Medical Home Network.

You can find the hospital in your Medical Home Network in the:

Medical emergencies include serious, life-threatening sicknesses, or injuries, such as:

  • Trouble breathing and/or shortness of breath
  • Chest or upper stomach pain, or feeling pressure in your chest
  • Fainting spells or sudden dizziness or weakness
  • Uncontrolled bleeding
  • Severe vomiting or diarrhea
  • Feelings that you want to hurt yourself or others

Ambulance services are covered ONLY for life-threatening emergencies and ONLY within San Francisco.

It is always best to get care from your Medical Home. If you need to see a doctor right away, reach out to your Medical Home about getting treated at their clinic.

You can get treatment from Urgent Care at the hospital in your Medical Home Network. HSF only covers the cost of care at the hospital in your Medical Home Network. Please see the listed urgent care location for each Medical Home in the Medical Home Directory.

Ambulance services are covered ONLY for:

  • Life-threatening emergencies, AND
  • Transportation within San Francisco

If you have a life-threatening emergency, call 9-1-1 to get an ambulance.

HSF only covers hospital care at the hospital in your Medical Home Network.

Unless there is an emergency, you must get a doctor or a specialist in your Medical Home Network to send you to hospital care.

HSF only covers the cost of care at the hospital in your Medical Home Network.

Find the listed hospital for your Medical Home Network in the:

Well-rounded health care treatment includes:

  • Care for ongoing health issues
  • Routine check-ups
  • Health testing

The care listed above is covered by Healthy San Francisco at your Medical Home.

Make appointments directly with your Medical Home for regular check-ups.

You can get prescription medicines through HSF. If you need them, your Medical Home doctor will order them for you.

HSF will pay for medications if they are:

  • Approved prescription drugs
  • Prescribed by your Primary Care Provider at your Medical Home

Each Medical Home has a specific pharmacy and resources to help you pick up your medicines.

To find your Medical Home’s pharmacy, check the Medical Home Directory and Participant Handbook.

To find your Medical Home, check out the Interactive Medical Home map.

Specialists are doctors who see patients with special health care conditions like asthma, diabetes, or heart problems. If needed, your Medical Home will send you to a specialist.

Some Medical Homes have specialists on staff who can treat you. Others will send you to specialists at one of the hospitals in your Medical Home Network. You can’t see a specialist without a referral from your provider at your Medical Home. If you see a specialist without a referral from your Medical Home, HSF will not pay for the care you get.

HSF Participants can get mental health care. You can get counseling for depression, anxiety, panic, or help with other emotional problems. Participants can get this care through their Medical Home. You can also get mental health support by reaching out to San Francisco Community Behavioral Health Services:

  • Local Callers: 1(415) 255-3737
  • Toll-Free Callers: 1(888) 246-3333
  • TDD/TTY for People who are Deaf, Hard-of-Hearing, or have Speech Disabilities: 1(888) 484-7200

You can get care for alcohol or other drug problems from San Francisco Community Behavioral Health Services.

Your communication with them is private.

  • Local Callers: 1(415) 255-3737
  • Toll-Free Callers: 1(888) 246-3333
  • TDD/TTY for People who are Deaf, Hard-of-Hearing, or have Speech Disabilities: 1(888) 484-7200

You can get medical or lab tests at your Medical Home, or at the hospital in your Medical Home Network.

Not all Medical Homes offer testing or laboratory work. To learn more, call your Medical Home or ask your doctor when the tests are ordered.

You can get family planning care at most HSF Medical Homes. Family planning includes:

  • Birth control
  • Pregnancy testing
  • Sexually transmitted infection (STI) testing

You can ask for a meeting for family planning care. Call your Medical Home to make an appointment for OB/GYN and other family planning services.

Durable Medical Equipment is equipment you would be prescribed, like a wheelchair or crutches.

To learn where to pick up your prescribed equipment, ask your Medical Home. You can find the contact information for your Medical Home on your HSF Participant ID Card or in the Medical Home Directory.

Healthy San Francisco is a limited health access program.

Healthy San Francisco does not provide some services. Below are some of the services that are NOT provided by Healthy San Francisco:

  • Acupuncture
  • Allergy Testing & shots
  • Chiropractic
  • Cosmetic
  • Dental
  • Gastric by-pass Surgery & Services
  • Genetic Testing & Counseling
  • Infertility
  • Long-term Care
  • Organ Transplants
  • Non-Emergency Transportation
  • Travel Immunizations
  • Vision
  • Hearing Aids

Healthy San Francisco does not provide gender affirming surgeries. However, participants interested in gender affirming surgical services may be able to access them through a separate program offered by the San Francisco Department of Public Health. You can get more information about the gender affirming surgery access program by clickinghere.