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Understanding how your health plan works is an important first step.
Your care is determined by your network, your plan medical group (PMG) and your primary care physician (PCP), who is your personal doctor. Your network, PMG and PCP are listed on the front of your member ID card.
A network is a group of doctors, hospitals and other medical service providers associated with your unique plan.
A plan medical group (or “PMG”) is a designated group of doctors and hospitals associated with your network. You have access to hospitals, specialty care and urgent care centers affiliated with your PMG. It is important to keep
in mind that referrals and prior authorizations do not transfer between PMGs. You have access to only one PMG at a time.
Your primary care physician (or “PCP”) is who you will see if you need a checkup or routine care, want advice about a health problem, or get sick or hurt. They provide care as soon as you need it, listen carefully and explain things in a way that is easy to understand. Your PCP
will also coordinate the care you receive from other providers including specialists.
Sharp Health Plan offers several ways to look for a PCP or specialist. You can access our online provider and pharmacy directory. If you want a provider and pharmacy directory
mailed to you, or if you need help finding a network provider, please call 1-855-562-8853 (TTY/TDD: 711). Hours of operation: Oct. 1 – March 31 from 8 am – 8 pm Pacific time, 7 days a week; April 1 –
Sept. 30 from 8 am – 8 pm Pacific time, Monday through Friday. Calling after hours will direct you to our voicemail system and a Customer Care representative will return your call the next business day.
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.