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Drug list (formulary) Jan. 1, 2027
English | Spanish
Provider & Pharmacy Directory Jan. 1, 2027
Behavioral Health Provider Directory Jan. 1, 2027
Dental insert
Dental DHMO Schedule
(coming soon)
Dental PPO Schedule
Prior authorization requirements Jan. 1, 2027
Step therapy requirements Jan. 1, 2027
Drug list (formulary) Oct. 1, 2026
Provider and Pharmacy Directory July 1, 2026
Provider and Pharmacy Directory Addendum Oct. 1, 2026
Behavioral Health Provider Directory July 1, 2026
Behavioral Health Provider Directory Addendum Oct. 1, 2026
Delta Dental insert
Delta Dental DHMO Schedule
Delta Dental PPO Schedule
Prior authorization requirementsOct. 1, 2026
Step therapy requirementsOct. 1, 2026
Future formulary change fileOct. 1, 2026
Ask for a coverage determination
Coverage determination form
View PDF | Fill out online
Request for redetermination form
Ask for prior authorization
Prior authorization request
Continuity of care form
For new members
Other health insurance coverage questionnaire
Request a refund
Part C member reimbursement request
Part D prescription reimbursement form
Part D late enrollment penalty (LEP) reconsideration request
Share information with loved ones
Appointment of representative
Authorization for use or disclosure of protected health information (PHI)
Member resource guide
Spring/Summer issue
Fall/Winter issue
Enrollment form for 2026 Feb. 13, 2026
Plan change form for 2026
Disenrollment form for 2026
Important contacts
2026 Medicare Enrollment Kit
Low-Income Subsidy (LIS) premium summary chart
2026 Medicare Star Ratings flyer
Sharp Direct Advantage VIP and VIP Plus
Sharp Direct Advantage Gold and Platinum
Sharp Direct Advantage VIP Plus
Sharp Direct Advantage VIP
Sharp Direct Advantage Gold
Sharp Direct Advantage Platinum
Enrollment form for 2027
Plan change form for 2027
Disenrollment form for 2027
2027 Medicare Enrollment Kit
Summary of Benefits Jan. 1, 2027
2027 Medicare Star Ratings flyer
Sharp Direct Advantage Basic
Sharp Direct Advantage Premium
Summary of Benefits Jan. 1, 2026
English | Spanish (coming soon)
Sharp Direct Advantage SDPEBA
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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