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Your network, your plan medical group (PMG) and your primary care physician (PCP) make up your care team. Knowing your care team is the first step to understanding how your health plan works.
Your primary care physician (PCP) is who you will see for a checkup or routine care, advice about a health problem, or if you're sick or hurt. Call your PCP first for all of your health care needs.
If you have a medical concern or need a follow-up appointment, a video or phone visit1 might be the ideal option.
In most cases, when you need specialty care, your PCP will refer you to a specialist in your PMG. You can access OBGYN care within your PMG without a referral from your PCP.
If you need medical attention right away and your life is not in danger, you can most likely be treated at an urgent care center within your PMG.2
If your life is in danger or you are at risk of being permanently disabled, it is an emergency. Call 911 or go to the nearest emergency room right away.
MinuteClinic® is the walk-in medical clinic located inside select CVS Pharmacy® stores. MinuteClinic provides convenient access to basic care without an appointment.3
Registered nurses are available through Sharp Nurse Connection® after hours and on weekends. Call 1-855-562-8853 from 5 pm – 8 am, Monday to Friday, and 24 hours a day on weekends.
When faced with a medical emergency while traveling 100 miles or more away from home or in another country, we connect you to doctors, hospitals, pharmacies and other services.
Whether you need a new eye doctor or want to join a gym using your benefits, our “Important contacts” handout has the right numbers for you to call.
Every time you talk to a health care provider — PCP, specialist, a nurse or another person on your care team — we recommend asking these three basic questions:
Anytime! For example, you can ask your PCP questions during your visit, before or after your physical exam or medical test. You can ask your nurse when you are having your vital signs taken. You can also call Customer Care at 1-855-562-8853 (TTY/TDD: 711).
Let your PCP, nurse or provider know if you still don’t understand. You could say, “This is new to me. Will you please explain that to me one more time?”
Know that you aren’t alone, and it’s OK to feel nervous — everyone wants help when it comes to understanding health information. When you see your doctor, specialist or nurse, take your time in asking questions. You should never feel rushed or embarrassed if you don’t understand something. It’s okay to ask your provider as many times as you need to.
1 Select doctors offer this service.
2 You may need prior authorization from your primary care physician. You must use an urgent care facility within your plan medical group unless you are traveling outside San Diego or southern Riverside counties.
3 Your share of the cost for a MinuteClinic visit is equal to what you pay for a PCP office visit (deductible may apply). There is no copayment for flu vaccinations.
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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