About Sharp Health Plan

Established in San Diego in 1992, Sharp Health Plan is the highest member-rated health plan in California. It’s been honored with the “Excellent” accreditation by the National Committee for Quality Assurance. NCQA Accreditation is the most comprehensive evaluation in the industry, and the only assessment that bases results on clinical performance and consumer experience. High-performing health plans choose NCQA Accreditation because it satisfies the demands of consumers, employers, and regulators.

Through CaliforniaChoice, Sharp Health Plan offers 12 HMO options – three in each of the Affordable Care Act’s four Metal Tiers – giving you and your employees the flexibility you need at a price you’ll like. As a member, you’ll receive award-winning care from nationally recognized doctors,
medical groups, and hospitals.

Quick Plan Highlights

Here are some of our most popular Sharp Health Plan health plans along with a high level snapshot of plan coverage and out-of-pocket costs. To view a complete list of Sharp Health Plan coverage options, click Download All Plans below to see the most current plan information.

Sharp Bronze HMO B†

NetworkPerformance
Calendar Year Deductible*$4,750 / $9,50010 (combined Med/
Rx ded)(applies to Max OOP)
Out-of-Pocket Max Ind/Fam$6,550 / $13,10010
Dr. Office Visit (PCP)60%
Urgent Care60%
Emergency Room (copay waived if admitted)60%
† HSA Qualified High Deductible Plan
* All services are subject to the deductible unless otherwise stated.
10. In high deductible health plans (HDHPs) linked to Health Savings Accounts (HSAs), an individual in a self-only coverage plan must meet the Self-Only Deductible. In a family plan, each individual in the family must meet the Individual Deductible, until the Family Deductible is met. The Out-of-Pocket Maximum includes the deductible, co-payments and coinsurance. In an individual plan, the Member is responsible for all applicable deductibles, co-payments, and coinsurance up to the Self-Only Out-of-Pocket Maximum. In a family plan, the Member is responsible for all deductibles, co-payments, and coinsurance up to the Individual Out-of-Pocket Maximum, until the combined deductibles, co-payments and coinsurance equal the Family Out-of-Pocket Maximum. When the family’s combined deductibles, co-payments, and coinsurance equal the Family Out-of-Pocket Maximum, all family members have met the Out-of Pocket Maximum.

Sharp Silver HMO A

NetworkPremier
Calendar Year Deductible*$2,100 / $4,2002 (applies to Max OOP)
Out-of-Pocket Max Ind/Fam$6,000 / $12,0002
Dr. Office Visit (PCP)$40 Copay (ded waived)
Urgent Care$70 Copay (ded waived)
Emergency Room (copay waived if admitted)$400 Copay
* All services are subject to the deductible unless otherwise stated.
2. Individuals enrolled in a family plan will reach the annual deductible or out-of-pocket maximum if the member meets the individual deductible or out-of-pocket maximum amount or any combination of enrolled family members meets the family deductible or out-of-pocket maximum amount, whichever comes first. Amounts paid toward the deductible apply toward the out-of-pocket maximum.

Sharp Gold HMO A

NetworkPerformance
Calendar Year Deductible*None
Out-of-Pocket Max Ind/Fam$6,500 / $13,0004
Dr. Office Visit (PCP)$20 Copay
Urgent Care$50 Copay
Emergency Room (copay waived if admitted)70%
* All services are subject to the deductible unless otherwise stated.
4. See plan specific EOC for information on preventitive services.

Sharp Platinum HMO A

NetworkPremier
Calendar Year Deductible*None
Out-of-Pocket Max Ind/Fam$3,500 / $7,0004
Dr. Office Visit (PCP)$15 Copay
Urgent Care$20 Copay
Emergency Room (copay waived if admitted)$150 Copay
* All services are subject to the deductible unless otherwise stated.
4. Individuals enrolled in a family plan will reach the annual deductible or out-of-pocket maximum if the member meets the individual deductible or out-of-pocket maximum amount or any combination of enrolled family members meets the family deductible or out-of-pocket maximum amount, whichever comes first. Amounts paid toward the deductible apply toward the out-of-pocket maximum.

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View More Carriers

The CaliforniaChoice employee benefits program lets your employees select health plans (HMO, PPO, HSA, and more) from eight of California's top carriers while you determine how much your
company will contribute.

Click on any of the logos below to learn more about our carrier partners

Anthem Blue Cross Health Plan Kaiser Permanente oscar Sharp Health Plan Sutter Health Plus UnitedHealthCare Western Health Advantage