A Complete Guide to San Francisco Health Plan Services: Coverage, Mental Health Access, and How to Get Started

If you're a San Francisco resident looking for comprehensive healthcare coverage through Medi-Cal, San Francisco Health Plan (SFHP) offers extensive services to over 160,000 low- and moderate-income families throughout the city. Understanding what's covered and how to access care—especially mental health services through Carelon Behavioral Health—can help you make the most of your benefits.

What is San Francisco Health Plan?

San Francisco Health Plan is a community-based nonprofit health plan that provides affordable Medi-Cal coverage to San Francisco residents. With a network of more than 7,000 healthcare providers and 7 hospitals across San Francisco and San Mateo counties, SFHP ensures members have access to quality care close to home.

Comprehensive Medical Services Covered by SFHP

San Francisco Health Plan offers a wide range of medical services at no cost to members, including:

Primary and Preventive Care

Members receive routine checkups, preventive screenings, immunizations, and wellness visits to help maintain good health and catch potential issues early.

Specialist Care

SFHP covers visits to specialists including surgeons, cardiologists, dermatologists, orthopedists, and other medical experts when needed for your care.

Emergency and Hospital Services

Twenty-four-hour emergency care is available, including psychiatric screening, examination, and treatment. Hospital stays for surgery, childbirth, or medical treatment are fully covered.

Prescription Medications

Members have access to prescription drug coverage for medications prescribed by their healthcare providers.

Dental, Vision, and Hearing

Comprehensive dental services, vision care including eye exams and glasses, and hearing services including hearing aids are all included in SFHP coverage.

Additional Services

SFHP also covers laboratory tests, diagnostic imaging, home health care, hospice services, family planning services including counseling and contraceptives, and even transportation to medical appointments at no cost to members.

Mental Health Services Through Carelon Behavioral Health

One of the most valuable aspects of San Francisco Health Plan is its partnership with Carelon Behavioral Health (formerly Beacon Health Options), which manages mental health and behavioral health therapy benefits for all SFHP Medi-Cal members.

What Mental Health Services Are Covered?

Carelon Behavioral Health provides coverage for mild-to-moderate mental health conditions, including:

• Individual and group psychotherapy - Talk therapy with licensed mental health professionals
• Mental health assessments and treatment - Comprehensive evaluations and ongoing care
• Psychological testing - Available with prior authorization when clinically appropriate
• Psychiatric consultations - Medication management with psychiatrists
• Outpatient services - Including lab work, medications, and supplies related to mental health treatment
• Behavioral Health Treatment (BHT) - For members under 21, including Applied Behavior Analysis (ABA) for autism and behavioral issues

How to Access Mental Health Care: No Referral Needed

Here's important information that many members don't know: you do not need a referral from your primary care doctor to access mental health services through Carelon Behavioral Health. This means you can reach out directly to get the support you need.

Making an Appointment with Carelon Behavioral Health

To schedule an appointment with a licensed mental health professional such as a psychiatrist, psychologist, or therapist, you have several options:

Call Carelon Behavioral Health:

• Phone CARELON: 1-855-371-8117 (toll-free)
• TDD/TTY: 1-800-735-2929
• Available 24 hours a day, 7 days a week

Online: Visit carelonbehavioralhealth.com to search for providers in your area and schedule appointments directly.

The 24/7 phone line means you can get help whenever you need it, including evenings and weekends.

**Online referral to UniHealth: complete this online form to request an appointment with a behavioral health psychotherapist at our practice, UniHealth: click here. 

Specialty Mental Health Services

For members dealing with more serious mental health conditions or substance abuse issues, San Francisco Health Plan also connects you with specialty services. If you need care for severe mental illness or addiction services, you should contact:

San Francisco Behavioral Health Services:

• Phone: 1-415-255-3737 or 1-888-246-3333

These services provide intensive treatment and support for complex mental health needs.

**Online referral to UniHealth: complete this online form to request an appointment with a behavioral health psychotherapist at our practice, UniHealth: click here. 

Who Qualifies for San Francisco Health Plan?

SFHP serves San Francisco residents who qualify for Medi-Cal based on income and other eligibility requirements. If you live in San Francisco and meet the Medi-Cal criteria, you can access this comprehensive coverage at no or low cost.

Getting the Most from Your Benefits

To maximize your San Francisco Health Plan coverage:

1. Choose a primary care provider who can coordinate your overall healthcare
2. Schedule preventive visits to stay healthy and catch problems early
3. Don't hesitate to access mental health services - remember, no referral is needed through Carelon
4. Use transportation services if getting to appointments is difficult
5. Keep Carelon's 24/7 number handy (1-855-371-8117) for when you need mental health support

Why Mental Health Access Matters

Mental health is just as important as physical health, and San Francisco Health Plan recognizes this by making mental health services easily accessible through Carelon Behavioral Health. Whether you're dealing with depression, anxiety, stress, relationship issues, or other mental health concerns, help is available without barriers or long waits for referrals.

Take the Next Step

If you're an SFHP member and need mental health support, don't wait. Call Carelon Behavioral Health today at 1-855-371-8117 to connect with a mental health professional who can help. With no referral required and 24/7 access, getting the care you need has never been easier.

San Francisco Health Plan's partnership with Carelon Behavioral Health ensures that quality mental health care is accessible, affordable, and available when you need it most. Take advantage of these comprehensive benefits and prioritize your mental wellness today.

Online referral to UniHealth: complete this online form to request an appointment with a behavioral health psychotherapist at our practice, UniHealth: click here.