OptumHealth Behavioral Solutions of California

New partner for mental health and substance use disorder services.

Our current mental health and substance use disorder partner, Magellan HealthCare Inc.¹, has made a business decision to exit their health plan operations nationwide at the end of this calendar year. After a thoughtful RFP process, we are excited to share that we will partner with OptumHealth Behavioral Solutions of California (Optum Behavioral Health) as our new managed behavioral health partner for all lines of business with an anticipated effective date of Jan. 1, 2026².

Optum Behavioral Health shares our commitment to providing best-in-class mental health and substance use disorder services that are rooted in integration, quality, and innovation. They offer a larger behavioral health network and improved member experience through enhanced navigation and low acuity therapy alternatives as well as speed-to-care strategies.

For your convenience, we've put together a FAQ with additional information. If you have questions that aren't answered below, please feel free to reach out to your dedicated account management executive.

When will the partnership with Optum Behavioral Health be effective?

The scheduled effective date for this partnership is Jan. 1, 2026².

Will this change be applicable to all benefit plans?

Optum Behavioral Health will be providing mental health and substance use disorder services for all Sharp Health Plan members, across all benefit plans, including our employer group plans (HMO/POS/PPO), individual and family plans, and Medicare Advantage plans.

Will members' mental health and substance use disorder benefits change due to the transition to Optum Behavioral Health? What about their copays?

No. Members' plan benefits for mental health and substance use disorder services will not change, and the member costs outlined in their benefit plan will not change as a result of the transition to Optum Behavioral Health. Please note that separate from the transition to Optum Behavioral Health, benefit and copay changes could apply as a result of a renewal.

Will this change impact members' pharmacy benefits for mental health and substance use disorder medications?

No. If they are enrolled in a plan with pharmacy benefits through Sharp Health Plan, there will be no impact to their pharmacy benefits for mental health and substance use disorder medications.

Will members need a new member ID card?

New ID cards will be issued to members related to any changes in benefits upon renewals and also to change the behavioral health partner listed on the back of the ID card. But the member identification and contact phone numbers listed on the card will not change. Members can use their existing ID cards until a new member ID card is issued.

Will members be able to keep their current mental health and substance use disorder providers?

To receive plan benefits, members must see an in network mental health and substance use disorder provider³. If a member's current provider is part of the Optum Behavioral Health network, they will be able to continue seeing their provider. If a member's provider is not part of the Optum Behavioral Health network, Optum Behavioral Health will give that provider an opportunity to join their network. If the provider chooses to join the Optum Behavioral Health network, the member will be able to continue seeing them. If the provider chooses not to join the Optum Behavioral Health network, the member can contact Optum Behavioral Health at 1-866-756-4791 beginning Dec. 15, 2025², to request continuity of care or choose a new provider that is in the Optum Behavioral Health network.

What is continuity of care?

To receive their plan benefits, members must see an in network mental health and substance use disorder provider³. If a member's provider chooses not to join the Optum Behavioral Health network, they can contact Optum Behavioral Health at 1-866-756-4791 beginning Dec. 15, 2025², to request continuity of care. This means they may be able to continue seeing their provider until their care is completed or can be safely transferred to a provider in the Optum Behavioral Health network. Continuity of care may be provided for the completion of care when a member is in an active course of treatment for one of the following conditions:

Condition	Length of Time for Continuity of Care
Acute condition	Duration of acute condition
Serious chronic condition	No more than 12 months from the date of their provider's contract termination with Sharp Health Plan
Maternal mental health condition	12 months from the maternal mental health condition diagnosis or from the end of pregnancy, whichever occurs later

The member's requested mental health or substance use disorder provider must agree to provide continued services to them, subject to the same contractual terms and conditions that apply to contracted providers providing similar services. If the member's provider does not agree, Optum Behavioral Health is not required to authorize continuity of care. Optum Behavioral Health must approve continuity of care prior to the member receiving such services.

If members are approved for continuity of care, will they need to reset any authorizations, especially Rx?

If a member has an existing mental health and substance use disorder authorization, Optum Behavioral Health will honor it through the end of the authorization period. Following the transition, members may contact Optum Behavioral Health to speak with an appropriate clinical representative for mental health and substance use disorder authorizations. Pharmacy benefits will not change, and existing authorizations for medication will remain in effect for the authorization period. Sharp Health Plan will continue to be responsible for medication authorizations.

Can members select a new mental health and substance use disorder provider?

Yes. Members can search the Optum Behavioral Health online provider directory to find an in network provider.

Will a referral for mental health and substance use disorder services be needed before accessing care?

No. Members don't need a referral or prior authorization to access outpatient therapy from a provider in the Optum Behavioral Health network. Some services, such as partial hospitalization, intensive outpatient, applied behavior analysis (ABA), electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS) and psychological and neuropsychological testing will require a referral and prior authorization. Optum Behavioral Health will honor existing prior authorizations for the duration of the authorization period for dates of service beginning Jan. 1, 2026 ².

How will Sharp Health Plan communicate this to members?

We will send a letter to members who accessed mental health and substance use disorder services in 2025. The letter will let them know if their provider is currently in or out of the Optum Behavioral Health network. If their provider is out of the Optum Behavioral Health network, we will share additional information with them, like how to request continuity of care and/or search for a new provider who is in Optum Behavioral Health's network. We will do another member mailing in December for members who were told their provider was out of network but due to contracting efforts their provider is now in network with Optum Behavioral Health.

Since Optum Behavioral Health manages a national network of providers, will Sharp Health Plan members have access to mental health and substance use disorder providers beyond Sharp's service area?

All members, across all benefit plans, will have access to Optum Behavioral Health's in network mental health and substance use disorder providers throughout the state of California. POS and PPO members will have access to Optum Behavioral Health in network mental health and substance use disorder providers nationwide on Tier 2. POS and PPO members will also have access to non-contracted providers on Tier 3.

Is telehealth available with all providers in the Optum Behavioral Health network? How can members see if a provider offers telehealth?

Telehealth is available with most providers in the Optum Behavioral Health network. Their online provider directory indicates if a provider offers telehealth services.

Who should members contact with questions?

Members should contact Customer Care at 1-800-359-2002 with questions.

1. In California, Magellan is doing business as Human Affairs International of California, Inc.

2. Pending regulatory review with the DMHC.

3. POS and PPO enrollees will be able to keep their current provider on the Tier 3 level if their provider is not part of the Optum Behavioral Health California or National Networks.