You may qualify for reimbursement if you paid for covered benefits within the past 180 days.
If you receive emergency or urgent care services outside of San Diego or southern Riverside counties, you may be asked to pay for those services. If that occurs, you can request reimbursement from us. We will need a copy of the medical records for that
visit, an itemized bill and proof of payment in order to determine if the services are covered. Applicable co-payments will apply.
In some cases, you may be asked to pay for prescription drugs that are normally covered by Sharp Health Plan. An example is when you are traveling outside of California and urgently need to fill a prescription. You can request reimbursement for covered
prescription drugs from us. In order to determine if the medication is covered, we will need a copy of the print-out from the pharmacy showing the medication you received and a receipt showing proof of payment. Applicable co-payments will apply.
Sharp Health Plan will cover 8 individual at-home COVID-19 tests per month for each member. Tests may be packaged individually or with multiple tests in one package (for example, two tests packaged in one box). Tests submitted for reimbursement must be
authorized by the U.S. Food and Drug Administration (FDA). The FDA features lists of approved tests on its website. To request reimbursement, you’ll need
the brand name and the Universal Product Code (UPC) from the at-home test box. An itemized sales receipt is also required. The UPC is listed underneath the barcode and is typically a 12-digit number.
Call Customer Care toll-free at 1-800-359-2002 or send us a message.
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