Health insurance and how to get care from Sharp

When choosing your health insurance plan, make sure you consider the following:

Plans your existing or preferred doctors accept
Sharp HealthCare accepts almost all health insurance plans, including Sharp Health Plan. Please confirm your coverage with your insurance provider to verify that you can receive care from your selected or preferred Sharp-affiliated doctor.

Difference in costs
Look at the monthly premium, copayment, deductible, coinsurance (if applicable) and out-of-pocket responsibility. If you have any questions about covered services and costs, please call your insurance provider to confirm those important coverage details.

• The copayment, or copay, is the fixed amount you pay for a specific service (such as $25 for each doctor’s visit).

• The deductible is the annual amount that you must pay, out of pocket, before your insurance begins reimbursing for eligible services. For example, if your deductible is $500, then your insurance won’t pay anything until you’ve paid your $500 deductible for the year.

• Coinsurance takes place when you reach your deductible and you and your insurance plan share in paying a percentage of the remaining costs. The percentage you pay of the remaining costs depends on your plan. For example, if your deductible has been met and your coinsurance is 20 percent, your plan will cover the remaining 80 percent of covered services. Typically, you will pay your percentage of costs until you reach your plan’s out-of-pocket maximum.

• Your out-of-pocket costs will depend on how often you need care. Many plans have an annual out-of-pocket maximum cost.

Difference in benefits
Some plans include special programs for chronic health conditions, while others offer financial assistance programs. Be sure to review the added benefits your plan will include.

If you cannot afford insurance, help is available. Sharp offers financial assistance for medically necessary services provided to patients who don't have insurance and are unable to pay for it. Sharp hospitals provide emergency care to all patients, and no patient requiring emergency medical care will be refused service. Learn how to apply for financial assistance now.

Consider contacting Medi-Cal to help manage your payments. Medi-Cal is a a public health insurance program providing health care services for low-income individuals. For more information, call 1-800-541-5555.

In most cases, your parent’s health insurance plan will no longer cover you after your 26th birthday, which means it may be time to enroll in your own plan.

Since Jan. 1, 2020, all Californians are required to have qualifying health insurance coverage throughout the year. Those who do not may face a financial penalty. Learn more by visiting the State of California Franchise Tax Board.

Check with your employer to see if they offer health insurance plans accepted by Sharp.

If you do not have insurance options through your employer, you can purchase a plan through Covered California or directly from private health insurance companies, including Sharp Health Plan. Plans are available for as little as $1 per month, based on income.

Sharp offers three medical groups to make it easy for you to find a doctor who is the perfect fit. No matter which medical group you choose, you will receive:

• Convenient access to Sharp medical offices and hospitals

• Coordinated care provided by a primary care doctor who works in partnership with you and your specialists to maintain your optimal health

• Clinical excellence delivered with understanding and compassion — a level of care we call The Sharp Experience

Learn about Sharp’s three medical groups: Sharp Community Medical Group, Sharp Rees-Stealy Medical Group and SharpCare Medical Group.

We make it easy to choose a Sharp-affiliated doctor.

• Search online with our quick, easy-to-use Find a Doctor tool

• Call 1-800-82-SHARP (1-800-827-4277), Monday through Friday, 7 am to 7 pm, to speak with a physician referral nurse who knows our doctors and can help you find the best match