Out‑of‑area care

Emergency room

In a life or limb threatening emergency, go to the nearest hospital. Emergency room visits that are not medical emergencies will not be covered. Sharp Health Plan must approve any recommended follow‑up care.

Emergency travel services

When you’re faced with a medical emergency while traveling 100 miles or more away from home, we connect you to doctors, hospitals, pharmacies and other emergency travel assistance services.

Video and phone visits

If you have a non-emergency medical concern or need a follow-up appointment, a video or phone visit may be right for you. Behavioral health services are also available via telehealth. Ask your PCP about available telehealth options.

Urgent care

Urgent care services do not require an authorization from your PCP when you’re out of the service area. Ask the urgent care center to bill Sharp Health Plan; the claims address is on the back of your member ID card. Some non-contracted facilities may not be willing to bill Sharp Health Plan. In those cases, you can pay for the service, then fill out our reimbursement form. Note: When you’re home, contact your PCP before accessing urgent care services.

MinuteClinic

When you need treatment for a minor illness or injury, visit a MinuteClinic^®. Clinics are in select CVS Pharmacy^® store locations and are staffed by certified family nurse practitioners.

After-Hours Nurse Advice

When you have a health question or concern after regular business hours, a single phone call to our After-Hours Nurse Advice line puts you in touch with a registered nurse.

Call 1-800-359-2002 — 5 pm to 8 am, Monday to Friday and 24 hours on weekends.

Prescription drugs

Your prescriptions are covered the same way as when you fill them with your local pharmacist.