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. Call 1-855-562-8853, TTY/TDD: 711 to view a copy of the EOC.
  • 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).

Additional plan materials

Summary of benefits

Enrollment periods explained

Part of enrollment is understanding the different enrollment periods. Learn about each option and what changes you can make to your plan.

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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