Your care team

Sep 13, 2019, 14:01 PM
Heading : Your care team
Subtitle :
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.

Your network

A network is a group of doctors, hospitals and other medical service providers associated with your unique plan.
 

Your plan medical group (PMG)

Your plan medical group

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 (PCP)

Your primary care physician

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.


Looking for a doctor?

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.

Find a doctor online

Find a doctor online

Use the online search tool, and select “Sharp Advantage” as the network in the drop-down menu.
 
Provider and pharmacy directory

Download the provider and pharmacy directory

Easily search our provider and pharmacy directory. Click “Access Medicare provider directories,” then click “Downloadable provider and pharmacy directories” to select your Group Plan directory.
 

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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