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San Diego Sharp Health Plans Sends out Wrong Premium Rates

November 7, 2016 By Kevin Knauss Leave a Comment

Sharp, Health, Insurance, Plan, Covered CaliforniaSharp Health Plan of San Diego has sent letters to existing members alerting them that a previous notice of 2017 rates was in error. It is unclear from the member letters why both the 2016 and 2017 rates were stated incorrectly. From limited information, it looks as if the both the 2016 and 2017 were high. The 2017 rates are actually lower than originally reported to members. The corrected rates match the Sharp 2017 IFP rate sheet and rates posted to Covered California.

Sharp Health Plans Network 1 and 2

Sharp will continue to offer two networks of providers to consumers in San Diego County for their HMO plans. All the plans conform to Covered California standard benefit design and are available off-exchange.

Network 1 Premier

Premier offers the most value and access to a smaller pool of high-quality healthcare options. It is a good fit for people who care more about affordability and don’t mind having a little less choice of providers. There’s no compromise on quality here, just more value. If you live in central San Diego County, Network 1 (Premier) might be a better fit for you.

900+ doctors

7 hospitals

  • Sharp Chula Vista Medical Center
  • Sharp Coronado Hospital
  • Sharp Grossmont Hospital
  • Sharp Mary Birch Hospital for Women & Newborns
  • Sharp Memorial Hospital
  • Sharp Mesa Vista Hospital
  • Rady Children’s Hospital

2 medical groups

  • Sharp Community Medical Group (SCMG)
  • Sharp Rees-Stealy Medical Group (SRS)

Network 2 Performance

Performance offers the most flexibility when it comes to choosing a provider and geographic coverage. It is a good fit for people who care more about having the freedom to choose where they get care in San Diego, and who don’t mind paying a little more on their monthly premium to get it. There’s no compromise on quality here, just more choice. If you want the flexibility to access providers across all of San Diego County (or outside of central San Diego County), Network 2 (Performance) might be a better fit for you.

1,100+ doctors

10 hospitals

  • Sharp Chula Vista Medical Center
  • Sharp Coronado Hospital
  • Sharp Grossmont Hospital
  • Sharp Mary Birch Hospital for Women & Newborns
  • Sharp Memorial Hospital
  • Sharp Mesa Vista Hospital
  • Palomar Medical Center
  • Pomerado Hospital
  • Rady Children’s Hospital
  • Tri-City Medical Center

6 medical groups

  • Sharp Community Medical Group (SCMG)
  • Sharp Rees-Stealy Medical Group (SRS)
  • SCMG Arch Health Partners
  • SCMG Graybill Medical Group
  • SCMG Inland North Medical Group
  • Rady Children’s Health Network/CPMG

The Network 2 Performance Platinum and Gold plans use a coinsurance percentage for high-cost medical services. Network 1 Premier Platinum and Gold have a set copayment for high-cost medical services such as Advanced Radiology, Out Patient Surgery Fee, and In Patient Facility Fee.

For 2017 Rates, Summary of Benefits, and Drug Formulary visit Sharp Health Plans

Sharp 2017 Summary of Health Plans

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Filed Under: Sharp Health Plan Tagged With: 2017, Covered California, San Diego, Sharp

About Kevin Knauss

Independent health insurance agent and Certified Insurance Agent for Covered California. Serving all of California. Editor of Health Plan News for California consumers. Feel free to call him for clarification on items posted on this website at 916-521-7216 or email on his contact page of
www.insuremekevin.com

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