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Calpers Performance Network Overview

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Calpers Performance Network Overview CalPERS Performance Network Overview Effective March 31, 2019 Performance Network Plan medical groups The Performance Network offers more choice for people A plan medical group (PMG) is a designated group living in the North County area of San Diego. In addition of doctors, hospitals, specialty care and urgent care to our regional partners, we offer affordable access to centers associated with a network. It is important to Sharp’s award-winning medical groups, all dedicated to keep in mind that referrals and prior authorizations do 1 meeting your health care needs. not transfer between PMGs. You have access to only one PMG at a time. Your PMG will be listed on the front of your member ID card.2 1,700+ Doctors Sharp Rees-Stealy Medical Group This PMG includes more than 500 primary care 13 Hospitals physicians and specialists. Admitting hospitals are Sharp HealthCare facilities and Rady Children’s Hospital. Sharp Rees-Stealy Medical Group 7 Medical Groups physicians serve: • Carmel Valley • Mt. Helix • Chula Vista • Murphy Canyon 40 Urgent Care Centers • Del Mar • Otay Ranch • Downtown San Diego • Point Loma • El Cajon • Rancho Bernardo 450+ Pharmacies • Frost Street / • San Carlos Frost Street North • San Diego • Genesee • Scripps Ranch 15 MinuteClinics® • La Mesa / • Sorrento Mesa La Mesa West • Mira Mesa Find a doctor Visit sharphealthplan.com/CalPERS and click “Find a doctor” to see if your current doctor is in one of the listed plan medical groups, or to find one that fits your needs. 1 The data shown here reflects the Performance Network as of March 31, 2019. Coverage area includes but is not limited to the locations in this document. Service area does not include all San Diego County ZIP codes. Location of employer group headquarters must be within the Performance Network licensed service area. 2 Not all medical groups and independent physicians have access to all hospitals or urgent care centers. Please contact Customer Care at 1-855-995-5004 for more information. Sharp Community Rady Children’s Health Medical Group (SCMG) Network / Children’s Physicians This PMG includes more than 1,100 primary care Medical Group (CPMG) physicians and specialists. This medical group includes This PMG includes more than 400 primary care SCMG, SCMG Arch Health Medical Group, SCMG physicians and specialists. The admitting hospital Graybill Medical Group, SCMG Graybill Temecula is Rady Children’s Hospital. Rady Children’s Health Medical Group, SCMG Inland North, and SharpCare. Network / CPMG physicians serve: Admitting hospitals are Sharp HealthCare facilities, Rady Children’s Hospital and Palomar Medical Centers. • Allied Gardens • Linda Vista SCMG physicians serve: • Carlsbad • Menifee • Chula Vista • Mira Mesa • Alpine • Lakeside • Clairemont • Murrieta • Campo • Mira Mesa • Del Mar Heights • National City • Carlsbad • Mission Valley • Downtown San Diego • Oceanside • Chula Vista • Murietta • Eastlake • Point Loma • Clairemont • National City • East San Diego • Poway • College Area • Oceanside • El Cajon • Rancho Bernardo • Coronado • Point Loma • Encinitas • San Diego • Del Cerro • Poway • Escondido • San Marcos • Downtown San Diego • Ramona • Hillcrest • Scripps Ranch • East San Diego • San Diego • Kearny Mesa • Temecula • El Cajon • San Marcos • La Jolla • University City • Escondido • Santee • La Mesa • Wildomar • Fallbrook • Spring Valley • Hillcrest • Temecula • Imperial Beach • University City • Kearny Mesa • Valley Center • La Jolla • Vista • La Mesa Hospitals Urgent care centers The Performance Network offers access to a broad Visit sharphealthplan.com/CalPERS/urgentcare to selection of hospitals in the region, including: search among the 40 urgent care centers affiliated with the Performance Network. Sharp hospitals3 • Sharp Chula Vista Medical Center • Sharp Coronado Hospital and Healthcare Center • Sharp Grossmont Hospital • Sharp Mary Birch Hospital for Women & Newborns Pharmacies • Sharp Memorial Hospital Outpatient prescription drug benefits are covered and administered by OptumRx. Please review the OptumRx Additional hospitals Outpatient Prescription Drug Plan Evidence of Coverage • Inland Valley Medical Center booklet at optumrx.com/CalPERS for details or contact • Palomar Medical Center Escondido OptumRx’s Customer Care at 1-855-505-8110 • Palomar Medical Center Poway (TTY/TDD: 711). • Rady Children’s Hospital (2 locations) • Rancho Springs Medical Center • Temecula Valley Hospital • Tri-City Medical Center Consider us your personal health care assistant® If you have any questions, please contact Customer Care by email at [email protected] or by phone at 1-855-995-5004 from 7 a.m. - 8 p.m., Monday -Friday. Hours may vary during holidays..
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