Out-of-area care

Here’s what you need to know.

You are covered for urgent care and emergency services outside the San Diego and Riverside county area. You or someone acting on your behalf should notify us or your doctor within 48 hours if you are admitted to a hospital, that way your medical history can be shared and your doctor can help coordinate your care.

Learn more about the care options for you and your loved ones when you are traveling or temporarily residing out of the San Diego coverage area, including emergency travel assistance services, filling prescriptions, MinuteClinic^® and Sharp Nurse Connection^®.

See what's covered

(Have a child away at school? Find out about out-of-town coverage for children.)

Emergency Travel Assistance Services

When faced with a medical emergency while traveling 100 miles or more away from home or in another country for less than 90 days, we can connect you to doctors, hospitals, pharmacies and other service providers.

We partner with Assist America^® to bring you key services including medical consultation, evaluation and referral, foreign hospital admission assistance, emergency medical evacuation, medical monitoring, prescription assistance, compassionate visits and more.

Out-of-area emergency services do not require authorization from your PCP.

Conditions and exclusions apply; please see below.

We're ready to help

Call the Assist America hotline: 1-800-872-1414 (outside the U.S., call +1-609-986-1234) or download the Assist America Travel App.
Staffed 24 hours a day, 365 days a year.
To view your reference number, log in to your Sharp Health Plan online account.
View our brochure to learn more about Assist America.

Conditions & exclusions

Assist America’s obligation to provide or contract for the global emergency assistance services is subject to the following conditions and exclusions:

Conditions

Assist America will not provide services in the following instances:

Travel undertaken specifically for securing medical treatment (Medical Tourism)
Injuries resulting from participation in acts of war or insurrection
Commission of an unlawful act(s)
Attempt at suicide
Incidents involving the use of drugs unless prescribed by a physician
Transfer of Participant from one medical facility to another medical facility of similar capabilities and providing a similar level of care

Assist America will not evacuate or repatriate a Participant:

Without medical authorization
With mild lesions, simple injuries such as sprains, simple fractures, or mild sickness which can be treated by local doctors and do not prevent the Participant from continuing his/her trip or returning home
With a pregnancy beyond 28 weeks
With mental or nervous disorders unless hospitalized

Exclusions

Trips exceeding 90 continuous days (for student is one semester, approximately 120 days) from legal residence. (Separate purchase of Expatriate coverage is available at assistamerica.com)
Students at home/school campus address (as they are not considered to be in travel status)

While assistance services are available worldwide, transportation response time is directly related to the location/jurisdiction where an event occurs. Assist America is not responsible for failing to provide services or for delays in the delivery of services caused by strikes or conditions beyond its control, including by way of example and not by limitation, weather conditions, availability of airports, flight conditions, availability of hyperbaric chambers, communications systems, or where rendering of service is limited or prohibited by local law or edict.

All attending physicians and attorneys are independent contractors and not under the control of Assist America. Assist America is not responsible or liable for any malpractice committed by professionals rendering services to a Participant.

Assist America must arrange for the services it provides and does not accept reimbursement. Assist America is not medical or travel insurance. The cost of medical treatments is the responsibility of the policyholder or its health insurance as applicable.

If you have questions about Assist America’s services or the above conditions and exclusions, contact Assist America’s 24/7 Operations Center at 1-800-872-1414 (within the U.S.) or +1-609-986-1234 (outside the U.S.).

Filling your prescription while traveling

If you're traveling when your prescription runs out, you might have to pay for a refill that is normally covered by your plan. But don't worry, it's easy to request a reimbursement. To get a prescription reimbursement, please send us:

A copy of the pharmacy print out with the name of your medication
A copy of your payment receipt
A completed copy of the reimbursement form

Download the Reimbursement form

You can mail or fax these to us within 180 days of your prescription purchase at:

Sharp Health Plan
Attn: Customer Care
8520 Tech Way Ste 200
San Diego CA 92123-1450

Fax 1-619-740-5871

You will still be responsible for your deductible or copay amount.

Contact us if you have any questions about the reimbursement process.

Convenience with MinuteClinic

If you’re traveling and experience minor illness or injury, stop by a MinuteClinic^®. These are walk-in medical clinics located inside select CVS Pharmacy^® stores nationwide. And you’ll only need to pay the amount equal to your PCP copayment for an office visit. (Medicare members pay their PCP copayment.)

Find a location

Helpful links

Talk to Customer Care ➜

See frequently asked questions about coverage ➜

Out-of-town coverage for children ➜

Talk to a nurse after-hours from anywhere

Calling our After-Hours Nurse Advice line might be a good option if a medical question arises during your travels. Compassionate nurses are ready to answer health-related questions or point you in the right direction to get the care you need. Call a nurse at 1-800-359-2002, 5 pm – 8 am, Monday to Friday, or 24 hours on weekends.

During the COVID-19 outbreak, there may be times when our after-hours nurse advice line directs you to your primary care physician's office for any medical questions or concerns. This is to ensure the quickest and best care possible when they’re experiencing high call volumes.