Request continuity of care benefits

Keep the doctor you know and love while you finish treatments.
 

Enrolling in Sharp Health Plan gives you access to a large network of qualified nurses and doctors. But if you’re already being treated by a doctor outside of your Sharp Health Plan Network at the time of enrollment, then you may qualify for continuity of care benefits. This means that you may be authorized for additional visits with your current doctor to facilitate a safe transfer of care to a doctor within your Sharp Health Plan Network. Continuity of Care may also apply if you are a current Sharp Health Plan member and your health care provider is no longer contracted with Sharp Health Plan.

Please note that you do not qualify for this temporary continuity of care coverage:

  • If you are a newly enrolled member and you had the opportunity to enroll in a health plan with an out-of-network option.
  • If you had the option to continue with your previous health plan but instead voluntarily chose to change health plans.
  • If you have an Individual, Medicare, CalChoice, or CCSB (Covered California for Small Business) policy and had the ability to choose a plan that allowed you to stay with your doctor.

If you are unsure about your eligibility, please contact our Customer Care team at 858.499.8300.

 

Request additional visits with your current doctor

If you do not fall into one of the above categories and would like to request additional visits with your current doctor, Continuity of Care may be provided for the completion of care when a member is in an active course of treatment for the following conditions: (1) an acute condition; (2) a serious chronic condition; (3) a pregnancy; (4) a terminal illness; (5) a pending surgery or procedure that was previously scheduled; or (6) a child age 0-36 months.

If you would like to request continuity of care benefits, please complete the both sides of the Continuity of Care form so we can assist in the coordination of health care services. 

Download English form Download Spanish Form

Mail your completed form to:

Sharp Health Plan
8520 Tech Way, Suite 200
San Diego, CA 92123
or fax to 619.740.8111

One of our case managers will review the information you’ve provided, and contact you to assist with any needs.

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