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Forms, guides and other resources

Find all the documents you need about your benefits in one place.

All members

Download forms, guides and other resources for all members.

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2023

Plan information

Drug list information

  • Prior authorization requirements (coming soon) Jan. 1, 2023
  • Step therapy requirements (coming soon) Jan. 1, 2023
  • Future formulary change file (coming soon) Jan. 1, 2023

2022

Plan information

Drug list information


Member forms

Ask for prior authorization

For new members

  • Other health insurance coverage questionnaire

    • Request a refund

    Share information with loved ones

    Member resources

    Individual plan members

    Find forms, guides, and other resources for our individual plans.

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    2023

    Forms

    • Enrollment form for 2023
    • Plan change form for 2023
      • Disenrollment form for 2023 (coming soon)

    Plan information

    Evidence of Coverage

    • VIP Plan - EOC
    • Gold Card - EOC
    • Platinum Card - EOC

    Annual Notice of Changes

    2022

    Forms

    Plan information

    Evidence of Coverage

    Annual Notice of Changes

    Former Sharp employees

    Get details about coverage for former Sharp HealthCare employees.

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    2023

    Forms

    • Enrollment form for 2023
    • Plan change form for 2023
      • Disenrollment form for 2023 (coming soon)

    Plan information

    Evidence of Coverage

    • Basic Plan - EOC
    • Premium Plan - EOC

    Annual Notice of Changes

    2022

    Forms

    Plan information

    Evidence of Coverage

    Annual Notice of Changes

    City of San Diego retirees (SDPEBA)

    Find out more about our exclusive plan for City of San Diego retirees.

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    2023

    Forms

    • Enrollment form for 2023 (coming soon)

    Plan information

    Annual Notice of Changes Jan. 1, 2023

    • Sharp Direct Advantage SDPEBA - ANOC

    Evidence of Coverage
    Jan. 1, 2023

    • Sharp Direct Advantage SDPEBA - EOC
      • English (coming soon) | Spanish (coming soon)

    2022

    Aug. 1, 2022 to Dec. 31, 2022

    Forms

    Plan information

    Annual Notice of Changes Aug. 1, 2022 to Dec. 31, 2022

    Evidence of Coverage
    Aug. 1, 2022 to Dec. 31, 2022

    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_2023 Website

    Page Last Updated: 10/01/2022
    • 9/29/2020 9:47:24 PM
    • 10/1/2022 6:47:13 AM
    • 9/9/2022 11:41:24 PM
    • 1/1/0001 12:00:00 AM