Need out-of-area care?

Here’s what you need to know about getting out-of-area care.

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 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.)

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Emergency travel services

When faced with a medical emergency while traveling 100 miles or more away from home or in another country, 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, hospital admission assistance, emergency medical evacuation, medical monitoring, prescription assistance, compassionate visits and more.

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 mobile app.
  • Say you’re a Sharp Health Plan member and use the Sharp reference number:
    01-AA-SHP-09073
  • Staffed 24 hours a day / 365 days a year
  • Out-of-area emergency services do not require an authorization from your PCP

Download the brochure

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
  • 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 with a term of over six months
  • With mental or nervous disorders unless hospitalized

Exclusions

  • Trips exceeding 90 continuous days (for student is one semester, approximately 120 days) from legal residence without prior notification to Assist America.(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 (toll-free within the U.S.) or +1-609-986-1234 (collect call 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

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.

Download the Reimbursement form
 

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

Talk to a nurse

Talk to a nurse after-hours from anywhere

Calling our after-hours hotline 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.