What to Do if You Need Urgent or Emergency Care

Emergency care

If you have an emergency medical condition, call “911” or go to the nearest hospital emergency room.

An emergency medical condition is defined as a medical condition, with symptoms of sufficient severity, including severe pain, that a reasonable lay person could reasonably expect the absence of immediate attention to result in placing the patient’s health in serious jeopardy, serious impairment of bodily functions, or serious dysfunction of any bodily organ or part.

Examples of emergency medical conditions include:

A follow-up visit, such as taking out stitches, is not an emergency and you should not go to the emergency room for this type of care. Call your primary care physician (PCP) for recommendations on what you should do for follow-up care.

Sometimes it is hard to decide if your injury or illness is really an emergency. If you aren’t sure whether it is an emergency, call your primary care physician (PCP). Your PCP will help you decide if it is an emergency.

You can also call Sharp Nurse Connection® for after-hours nurse advice telephone service. The specially trained registered nurses at Sharp Nurse Connection® are available from 5 pm to 8 am, Monday to Friday, and 24 hours a day on Saturday and Sunday. They can provide telephone advice and direction regarding any health care question or concern you may have. Just call Sharp Health Plan at 1-800-359-2002 and select the option to speak with a nurse.

You also have access to global emergency services through Assist America®. These services are available if you face a medical emergency while traveling 100 miles or more away from your permanent residence or in a foreign country - for San Diegans that can mean travel to Los Angeles or Mexico. Assist America will immediately connect you to doctors, hospitals, pharmacies and other health care services. Call 1-800-872-1414, identify yourself as a Sharp Health Plan member and provide Reference Number 01-AA-SHP-09073 to access global emergency services.

If you are hospitalized in an emergency, please notify your PCP or Sharp Health Plan within 48 hours or at the earliest time reasonably possible. This will allow your physician to share your medical history with the hospital and help coordinate your care.

Urgent care

Urgent conditions are not emergencies, but may need prompt medical attention.

Your PCP must authorize urgent care services if you are in Sharp Health Plan’s service area (San Diego and southern Riverside counties). Call your PCP first before going to urgent care. (Members who are assigned to Sharp Rees-Stealy Medical Group have direct access to Sharp Rees-Stealy urgent care centers. No call to your PCP is required.)

Out-of-area urgent care services do not require an authorization from your PCP. If you are traveling 100 miles or more away from your permanent residence or in a foreign country and need health care services, you can call Assist America for assistance. Call 1-800-872-1414, identify yourself as a Sharp Health Plan member and provide Reference Number 01-AA-SHP-09073 for telephone evaluation and referral to urgent care services.