San Mateo County MCE Benefits & Costs
Medically necessary services received from MCE Primary Care Provider (PCP) clinics were covered. Services included consultation by phone and preventive health care such as immunizations and health education. General hospital services including nursing care, medications, surgery-related services, lab work, room and meals were covered. Prior authorization for hospital admission was required for coverage.
Urgent care was covered only at MCE Provider Clinics and the San Mateo Medical Center. Medical attention for a health problem that is not a medical emergency, but that is necessary to prevent the problem from getting worse, was covered only if received at MCE Provider sites.
Emergency Care was Covered at Any Emergency Room
If you were outside of San Mateo County and needed emergency care, or went to an emergency room in San Mateo County that was not an MCE Provider, your services were covered.
$0 Annual Fee and $0 Co-Pays
MCE Participants did not have to pay a fee for their coverage or co-pays for covered services, including prescriptions.
Payment was required for services only in these situations:
- You went to a Non-MCE provider for non-emergency medical care without a referral or prior authorization
- You received non-emergency medical care outside of San Mateo County
- You received services that were not covered by MCE
- You reached the coverage limit for a service