Pre-enrollment checklist

Before making an enrollment decision, it is important that you fully understand our benefits and rules.

Got questions? Speak to a customer service representative by calling 1-855-562-8853, TTY/TDD: 711.

Understanding the benefits

• Review the full list of benefits found in the Evidence of Coverage (EOC), especially for those services that you routinely see a doctor. Visit our Forms and guides page to view the EOC on our website, or call 1-855-562-8853, TTY/TDD: 711 to request a printed copy.
• Review the provider directory (or ask your doctor) to make sure the doctors you see now are in the network. If they are not listed, it means you will likely have to select a new doctor.
• Review the provider and pharmacy directory to make sure the pharmacy you use for any prescription medicines is in the network. If the pharmacy is not listed, you will likely have to select a new pharmacy for your prescriptions.

Understanding important rules

• In addition to your monthly plan premium, you must continue to pay your Medicare Part B premium. This premium is normally taken out of your Social Security check each month.
  


• Benefits, premiums and/or copayments / co-insurance may change on January 1.
  


• Except in emergency or urgent situations, we do not cover services by out-of-network providers (doctors who are not listed in the provider directory).


• Effect on Current Coverage. If you are currently enrolled in a Medicare Advantage plan, your current Medicare Advantage healthcare coverage will end once your new Medicare Advantage coverage starts. If you have Tricare, your coverage may be affected once your new Medicare Advantage coverage starts. Please contact Tricare for more information. If you have a Medigap plan, once your Medicare Advantage coverage starts, you may want to drop your Medigap policy because you will be paying for coverage you cannot use.

Additional plan materials

Sharp Direct Advantage is offered by Sharp Health Plan. Sharp Health Plan is an HMO with a Medicare contract. Enrollment with Sharp Health Plan depends on contract renewal. Read the full disclaimer.

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