Out-of-town coverage for children

If your dependent child is traveling for less than 90 consecutive days in the coming year, or is enrolling in college as full-time student, he or she may continue on your health insurance policy. In situations where your child is expected to be out of the service area, we want to be sure you know the options for accessing health care services.

Children must maintain their primary residence or work within Sharp Health Plan’s service area unless they are full-time students or in cases where coverage is provided under a medical support order. A child’s residence will no longer be considered a primary residence if: (a) the child moves out of the service area without intent to return or, (b) the child is absent from the residence for more than 90 consecutive days in any 12-month period and is not a full-time student.

Out of town coverage for children
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Basic care

Benefits outside of urgent care and emergency services are available only in Sharp Health Plan's service area and when approved by your Primary Care Physician (PCP).

CVS/MinuteClinic

When you're looking for convenient treatment for a minor illness or injury, you can visit MinuteClinic®. These are walk-in medical clinics located inside select CVS/pharmacy® stores nationwide. Most services will require a $40 copay (Medicare members will pay their urgent care copay) while flu shots have a $10 copay.

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Prescription benefits

Prescription drugs are covered the same as when home and easily accessed through a number of national chains.

After-hours hotline

Calling our after-hours hotline might be a good option if a medical question arises. Compassionate nurses are ready to answer health-related questions or point your child in the right direction. Call a nurse at 1.800.359.2002, 5 p.m – 8 a.m., Monday to Friday, or 24 hours on weekends.

Out-of-area emergency care with Assist America®

Your child can get connected with doctors, hospitals, and pharmacies when 100 miles or more away from home with Assist America.

To get out-of-area emergency care through Assist America:

  • Call the Assist America hotline: 1.800.872.1414
  • Say you’re a Sharp Health Plan member and use the Sharp reference number: 01-AA-SHP-09073

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Supplemental insurance

For college-bound dependents who will be going to school outside the service area, we encourage parents to investigate what the college offers in terms of free or low cost health services. Parents may want to consider purchasing supplemental health insurance to provide additional coverage for non-emergency or urgent services while dependents are away from home.

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