Just for members

From paying your bill to adding people to your plan, it's all here.

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  • Get care
  • Types of care
  • Manage your plan
  • Forms
  • File a grievance
  • Pharmacy and prescription drugs

Get care

Get the care you and your family need to be happy and healthy. Covered care options can be different, depending on the plan you purchased. Check your Member Handbook for an explanation of your benefits. You'll find your Member Handbook on our SharpConnect portal. Please log into your account for coverage details.

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Get care

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Get the care you and your family need to be happy and healthy. Covered care options can be different, depending on the plan you purchased. Check your Member Handbook for an explanation of your benefits. You'll find your Member Handbook on our SharpConnect portal. Please log into your account for coverage details.

Talk to a nurse

Sharp Nurse Connection's specially trained registered nurses can talk with you about your illness or injury, help you decide where to seek care and provide advice on any health concerns you may have. 

Call 1.800.359.2002 to talk to a nurse after hours.

Out-of-area care

Outside of San Diego? We've got you covered. Find everything you need to know about getting referrals through AssistAmerica®. Call 800.872.1414 (inside the U.S.) or 609.986.1234 (outside the U.S.). Here's the reference number for Sharp Health Plan Members: 01-AA-SHP-09073.

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Types of care

With Sharp you can get health care and services for every stage of life. Explore the types of care we cover for you or a loved one. Covered care options change depending on the plan you purchased, please log into your account for your coverage details.

Not seeing what you're looking for?

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Types of care

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With Sharp you can get health care and services for every stage of life. Explore the types of care we cover for you or a loved one. Covered care options change depending on the plan you purchased, please log into your account for your coverage details.

Women's wellness

From menopause treatment to breast cancer screenings, get the comprehensive care you need from compassionate nurses and doctors.

Learn more

Children’s care

Your children deserve the best possible care. Get answers about eligibility, immunizations, and finding the right pediatrician.

Learn more

Mental health care

Find the compassionate care you need to restore balance in your life or that of a loved one.

Learn more

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Manage your plan

We have a separate, secure login for individual and family plan members to manage their account. This is your shortcut to the most popular member actions. From paying your bill, to adding and removing people to your plan it's all here.

Not seeing what you’re looking for? Go to the account management center.

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Manage your plan

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We have a separate, secure login for individual and family plan members to manage their account. This is your shortcut to the most popular member actions. From paying your bill, to adding and removing people to your plan it's all here.

Change your coverage

You can make changes to your coverage during open enrollment, November 1 – January 31. The only time you can make a change outside this time period is when you have a "qualifying life event" in the past 60 days.

Learn More

Renew your plan

When your Sharp Health Plan coverage year is ready to renew review our renewal information and learn all about your renewal options.

Sharp Advantage members

Get plan and benefit information for your employer group here.

Not seeing what you’re looking for? Go to the account management center.

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Forms

Member forms and resources, all in one place. You can get the information and care that you need quickly with these commonly-requested forms and resources.

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Forms

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Member forms and resources, all in one place. You can get the information and care that you need quickly with these commonly-requested forms and resources.

Get reimbursed for medical services or prescription drugs

Sometimes you may be required to pay in advance for healthcare services, for example, when you have an emergency while traveling. Find out if you qualify for a reimbursement and learn how to submit a request. Check out the "Medical bills and reimbursements" section of the FAQ.

View FAQ

Share your health information with others

You may want us to disclose your protected health information to someone else, like your partner or child. Here are the information and forms you'll need to authorize the release of that information.

Download form

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File a grievance

Let us know if you’re having any problems with your current plan or plan provider so we can help. File a formal complaint or appeal and learn more about the grievance process.

Fill out form

File a grievance

Let us know if you’re having any problems with your current plan or plan provider so we can help. File a formal complaint or appeal and learn more about the grievance process.

How to file a complaint

To start the grievance process, fill out the form, or download and print a paper form, and describe your situation in detail. Don’t forget to include specific information, such as where and when it happened, and what you believe Sharp Health Plan can do to resolve the concern.

How we'll respond

We will send you a letter to let you know that we received your grievance within five days and a decision letter within 30 days. If your grievance involves an imminent and serious threat to your health, including, but not limited to, severe pain, potential loss of life, limb or major bodily function, we will provide you with a decision within 72 hours.

How to contact us

Call us at 1.858.499.8300 or toll-free at 1.800.359.2002

Pharmacy and prescription drugs

Always show your Member ID card at the pharmacy. Ask the pharmacy if any of your medications aren’t covered. If the drug is covered by Sharp Health Plan, you are responsible only for the applicable copayment, and you will never pay more than the retail price. There may also be a deductible. In which case, you may be responsible for the full cost.

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Pharmacy and prescription drugs

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Always show your Member ID card at the pharmacy. Ask the pharmacy if any of your medications aren’t covered. If the drug is covered by Sharp Health Plan, you are responsible only for the applicable copayment, and you will never pay more than the retail price. There may also be a deductible. In which case, you may be responsible for the full cost.

See covered medications

Review the drug list to find out if your medication is covered by Sharp Health Plan.

Learn more

Prior authorization for certain medications

Some medications require prior authorization. Your doctor will need to make a special request, then we will review the request to see if it meets the criteria for coverage.

Learn more

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Make a payment

If you purchased your plan independently instead of through an employer, you can quickly make a payment here.
Doctor's visits

Doctor’s visits

For non-urgent and emergency services, you can contact your doctor directly to make an appointment. Sharp Rees-Stealy (SRS) members can call 858.499.2600 and both SRS and non-SRS members can find the number on their health insurance ID card.
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Public Policy Committee

We want to hear from you. Join our committee to help us serve you better and improve member satisfaction overall.
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Make a payment

If you purchased your plan independently instead of through an employer, you can quickly make a payment here.
Doctor's visits

Doctor’s visits

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Public Policy Committee

Be a part of Sharp Health Plan's Public Policy Committee

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