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Drug list (formulary) Jan. 1, 2026
English | Spanish
Provider & Pharmacy Directory Jan. 1, 2026
Behavioral Health Provider Directory Jan. 1, 2026
Dental insert
Delta Dental DHMO Schedule
Delta Dental PPO Schedule
Prior authorization requirements Jan. 1, 2026
Step therapy requirements Jan. 1, 2026
Drug list (formulary) Oct. 1, 2025
Provider & Pharmacy Directory July 1, 2025
Behavioral Health Provider Directory July 1, 2025
Prior authorization requirements Oct. 1, 2025
Step therapy requirements Oct. 1, 2025
Future formulary change file Oct. 1, 2025
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
Bank withdrawal pre-authorization form
Other health insurance coverage questionnaire
Request a refund
Part C member reimbursement request
Part D prescription reimbursement claim
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)
Medicare Member Resource Guide
Spring/Summer issue
Fall/Winter issue
Enrollment form for 2026
Plan change form for 2026
English | Spanish (coming soon)
Disenrollment form for 2026
Important contacts
(coming soon)
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
English |Spanish
Sharp Direct Advantage Gold
Sharp Direct Advantage Platinum
Enrollment form for 2025 Apr. 4, 2025
Plan change form for 2025
Disenrollment form for 2025
2025 Medicare Enrollment Kit Dec. 4, 2024
Summary of Benefits Jan. 1, 2025
2025 Medicare Star Ratings flyer
Sharp Direct Advantage VIP Plan
Sharp Direct Advantage Gold Card
Sharp Direct Advantage Platinum Card
Important contacts (Extra & Group VIP)
Important contacts (Basic & Premium)
Summary of Benefits Jan. 1, 2026
Sharp Direct Advantage Basic
Sharp Direct Advantage Premium
Enrollment form for 2025
2025 Medicare Enrollment Kit
Sharp Direct Advantage Basic Plan
Sharp Direct Advantage Premium Plan
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.
H5386_2026_Medicare Website