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City of San Diego (SDPEBA) retirees

Our exclusive plan for City of San Diego retirees and their dependents.

As a City retiree who is eligible for Medicare, you get comprehensive medical services plus added benefits like vision, hearing, and free health coaching.

Membership in SDPEBA (San Diego Public Employee Benefit Association), MEA (Municipal Employees Association), REA (Retired Employees’ Association), or RFPA (Retired Fire and Police Association) is not required to join.

To join, you must:

Be eligible for Medicare Part A and Part B
Reside in San Diego County, and
Be a City of San Diego retiree or dependent

	Sharp Direct Advantage (HMO)
Plan overview
Monthly plan premium	$208
Deductible	$0
Annual out-of-pocket maximum (medical)	$1,500
Doctor visits
Primary care physician visit	$10
Specialist visit	$10
Preventive care	$0
Lab services / X-rays	$0
Diagnostic radiology (e.g., MRIs)	$0
Hospital visits and emergencies
Urgently needed services	$10
Emergency room (waived if admitted to hospital)	$50
Hospitalization	$0/day
Outpatient surgery	$50
Supplemental benefits
Routine eye exam (every 12 months)	$0
Hearing aids	$3,500 allowance every 36 months
Silver&Fit^®	$0
Chiropractic care	$10, limit 30 visits per year (combined)
Acupuncture	$10, limit 30 visits per year (combined)
Over-the-counter (OTC) items New! Loaded to your Sharp Health Plan Advantage Card	Up to $100 per quarter
Prescription drug coverage
30-day retail prescription drugs
Preferred Generic / Generic	$10 / $10
Preferred Brand / Non-Preferred	$20 / $20
Specialty / Select Care Includes select generic drugs.	25% of the cost / $0
100-day mail prescription drugs
Preferred Generic / Generic	$20 / $20
Preferred Brand / Non-Preferred	$40 / $40
Specialty / Select Care Includes select generic drugs.	Not offered / $0

One of the Best Medicare Advantage Plans in California

Sharp Health Plan was included in the 2025 U.S. News and World Report list of Best Insurance Companies for Medicare Advantage in California along with 5 other insurers in California.

Best Insurance Companies - Medicare Advantage - California (US News & World Report 2025)

The Sharp Experience is your Medicare advantage

You may see Sharp HealthCare doctors. But the only way to ensure you have The Sharp Experience from coverage to care is with a Sharp Direct Advantage plan, only from Sharp Health Plan.

FIND OUT MORE

Enroll online

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Attend an online seminar

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.

H5386_2025_Medicare Website_Rev 2

Page Last Updated: 10/03/2024