Let us know about other health insurance
You can use this form to let us know if you have any other health insurance coverage, including Medicare, in addition to your coverage with Sharp Health Plan.
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Electronic signatures are required
By completing and submitting this form you certify that all information provided in this form is complete and accurate to the best of your knowledge, and you authorize Sharp Health Plan to verify the information provided in this form.
Thank you for taking time to complete this form. If you have any questions or need to update information provided previously, please call Customer Care at
1-800-359-2002.