Page 6 - New Hire Kit (Non-Union)

Elite-rated health care Your care team
*

Sharp Health Plan has a family of providers close to where you live and work. In addition to regional partners, Having one doctor, your primary care physician (PCP), who oversees all of the care you receive is one of the many
our network includes Sharp Rees-Stealy Medical Group and Sharp Community Medical Group, both awarded “Elite” advantages of being a member of Sharp Health Plan. The intent of this coordinated care is to have one team working
status, the highest possible rating for Standards of Excellence. * together to provide the best health care possible and to help you stay healthy.

2,400+ Doctors ** Your network

A network is a group of doctors, hospitals and other medical service providers associated with your unique
health plan. Your network is listed on the front of your member ID card.
13 Hospitals **

Your plan medical group

10 Medical Groups ** A plan medical group (PMG) is a designated group of physicians 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 / authorizations do not transfer between PMGs. You only have access to one PMG at
a time. Your PMG is listed on the front of your member ID card.
40 Urgent Care Centers **
Care within your PMG

The following services must be obtained within your PMG. In most cases, a referral from your PCP is required.
15 MinuteClinics ®
• Dialysis • Outpatient Surgery & Procedures
• Durable Medical Equipment (DME) • Physical Therapy / Occupational Therapy / Speech Therapy

• Home Health • Radiology
• Hospital • Skilled Nursing Facility (SNF)
• Infusion • Specialist
• Lab • Urgent Care

• Maternity

Care outside of your PMG

There may be times when you need to access care outside of your PMG. These services do not require prior
authorization or referrals from your PCP.

All members can get these services: Service must be provided by:

Emergency Room Services Nearest Hospital

Mental Health / Chemical Dependency Psychiatric Centers at San Diego (PCSD)

You can get these services if they are in your plan: Service must be provided by:

Acupuncture / Chiropractic American Specialty Health (ASH)

Dental Premier Access

Vision Vision Service Plan (VSP)
* Recipients of "Elite" status in the 2018 national Standards of
Excellence™ survey by America's Physician Groups, formerly CAPG.
** Based on the Choice Network.

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