Individual plans

We offer three Sharp Direct Advantage® plans for San Diego County residents.

Our Medicare Advantage plans for individuals provide comprehensive medical services plus added benefits like vision, hearing, dental and free health coaching.

To join, you must:

  • Be eligible for Medicare Part A and Part B
  • Reside in San Diego County
 VIP Plan
Gold Card (HMO)Platinum Card (HMO)
Plan overview
Monthly plan premium$0$0$57
Annual out-of-pocket maximum$2,900 yearly limit for services you receive from in-network providers
Doctor visits
Primary care physician visit$0$5$5
Specialist visit$0$20$20
Preventive care$0
Lab services / X-rays$0 / $10$0 / $10$0 / $0
Diagnostic radiology (e.g., MRIs)$75$7515% of the cost
Hospital visits and emergencies
Inpatient hospital coverage

$225/day for days 1–7

$0/day for days 8 +

$150/day for days 1–8. 

$0/day for days 9 +

Outpatient hospital coverage$0–100$20–225$20–$175
Emergency care$90
Urgently needed services$30 ($90 for worldwide urgent care and emergency coverage)
Supplemental benefits
   Delta Dental DHMO$0 monthly premium$13 monthly premium$0 monthly premium
   Delta Dental PPO New!$50 monthly premium$50 monthly premium$50 monthly premium
Routine eye exam (every 12 months)$0$0$0
Hearing aids$3,000 allowance every 36 months$3,000 allowance every 36 months$3,500 allowance every 36 months
Silver&Fit® Fitness Benefit$0$0$0
Chiropractic care$10, limit 30 visits per year (combined)$10, limit 30 visits per year (combined)$10, limit 30 visits per year (combined)

Over-the-counter (OTC) items


Loaded to your Sharp Health Plan Advantage card

Up to $100 per quarterUp to $100 per quarterUp to $125 per quarter
Medicare Part D drugs: initial coverage
Retail: 1-month supply
   Tier 1 (Preferred Generic)$2
   Tier 2 (Generic)$8
   Tier 3 (Preferred Brand)$40
   Tier 4 (Non-preferred Brand)$95
   Tier 5 (Specialty)33% of the cost
   Tier 6 (Select Care) 
question mark iconIncludes select generic drugs.
Mail order: 100-day supply
   Tier 1 (Preferred Generic)$0
   Tier 2 (Generic)$0
   Tier 3 (Preferred Brand)$80
   Tier 4 (Non-preferred Brand)$190
   Tier 5 (Specialty)Not offered
   Tier 6 (Select Care) 
question mark iconIncludes select generic drugs.

Best Medicare Advantage Plan in California

Sharp Health Plan was the only plan to be included in the 2024 U.S. News and World Report list of Best Insurance Companies for Medicare Advantage in California.

Best Insurance Companies - Medicare Advantage - California (US News & World Report 2024)

Gold and platinum ID cards

The Sharp Experience is your Medicare advantage


You may see Sharp HealthCare doctors. But the only way to ensure you have The Sharp Experience from coverage to care is with a Sharp Direct Advantage plan, only from Sharp Health Plan.


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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Page Last Updated: 4/17/2024
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