Medicare Advantage

2019 Sharp Health Plan – Medicare Advantage Options

For more information on Medicare, please call the number below to speak with a healthcare specialist:

1-800-810-1437 TTY 711

Sharp Health Plan is an insurance company for residents of San Diego County, California. The company offers Medicare Advantage plans for all qualifying San Diegans and has Medicare plans that are exclusively for retired employees of Sharp HealthCare or the City of San Diego. The Medicare Advantage plans available to the general public are known as Sharp Direct Advantage. These are HMO plans, so members receive their care from a set network of providers in the San Diego area.

There are two Sharp Direct Advantage plans available, one of which has a $0 premium. Both Sharp Direct Advantage plans include prescription drug coverage. One plan includes dental care. For the other, dental coverage is available as an add-on option. Members also have access to vision discounts, wellness programs and treatment at CVS MinuteClinics.

Sharp Health Plan has been in business since 1992. The company is owned by Sharp HealthCare, a local medical system that began with one hospital in 1950 and now includes multiple hospitals, doctors and other treatment centers. Sharp HealthCare generated $3.5 billion in revenue during the 2016 fiscal year.

In addition to Medicare Advantage programs, Sharp Health Plan also offers individual and group health insurance plans. Covered California gave the insurer a rating of 5.0 out of 5.0 stars for its 2018 health insurance plans.

The insurer has also received accolades from the National Committee for Quality Assurance (NCQA) and is considered accredited by the organization, receiving a mark of “Excellent.” In addition, Sharp Health Plan was given a score of 4.5 out of 5.0 stars in NCQA’s 2018-2019 review of private health plans. Both of Sharp’s Medicare Advantage plans have a 4-star rating from the Centers for Medicare and Medicaid Services.

Sharp Medicare Advantage in 2019

You can only buy Medicare Advantage from Sharp in 2019 if you live in San Diego. For specific plan information and availability, get a customized quote based on your zip code. To give you an idea of the costs and coverage of these plans, we’ve compared two policies below.

Sharp Medicare Advantage (2019)
Direct Advantage Gold Card HMO Direct Advantage Platinum Card HMO
Monthly premium $0 $66
Copay (primary) $10 $10
Deductibles $0 for medical $0 for drug $0 for medical $0 for drug
Network In-network coverage only In-network coverage only
Rx coverage? Yes Yes
Rx cost $4 copay for tier 1 $4 copay for tier 1
Special features Hearing aids and expanded chiropractic; gym membership, health coaching and travel benefits Hearing aids, comprehensive dental, acupuncture and expanded chiropractic; gym membership, health coaching and travel benefits
Out-of-pocket max $3,400 $3,300
CMS Star Rating 4 4

Sharp Health Plan doesn’t offer Medicare supplement insurance (aka “Medigap) in 2019. If you have original Medicare and want to keep it instead of switching to Medicare Advantage, you may need to buy Medigap coverage to fill to gaps in your out-of-pocket expenses. There are lots of other companies in California and elsewhere selling Medicare supplement plans.

If you’re not sure whether you need Medicare supplemental insurance or a private Medicare Advantage plan, relax. We’ve got you covered. Our Medicare experts can help you find the right policy to fit your needs and budget. Get a quote today for accurate pricing and availability based on where you live.