- Understand what services your plan covers while you’re away from home. While out-of-area urgent and emergency care is a covered benefit, all routine and follow-up care must come from your assigned medical group within the Sutter Health Plus service area.
- Register for the Sutter Health Plus Member Portal to view your benefits, confirm cost-shares, access member ID cards and more from your computer, tablet or smartphone.
- Pack your Member ID card, which contains important contact information.
- Stay up-to-date on your immunizations, including your annual flu shot. For international travel, talk to your doctor in advance about vaccinations or drugs specific to the region you’re visiting. Sutter Health Plus may not cover some of these immunizations and medications. Consult your Evidence of Coverage (EOC) for details.
- Learn about travel alerts and warnings, safety, security, and health care through the U.S. Department of State.
- Visit your doctor before you leave, if you need to manage a medical condition before your trip.
- Refill your eligible prescriptions. Request a vacation override to pick up your prescriptions early (up to a 90-day supply) by calling MedImpact at (844) 282-5330.
- In case of an emergency, find and save the local 9-1-1 equivalent phone number.
- Go to the nearest hospital or medical facility that can provide the urgent or emergency care you need; you don’t need approval from Sutter Health Plus to get emergency or urgent care.
- If you are admitted to an out-of-network hospital, contact Member Services at (855) 315-5800 as soon as reasonably possible upon discharge, to request authorization for post-stabilization care. Sutter Health Plus will then determine if you should receive care from the provider or arrange to have another designated provider care for you while you’re away.
- If you don’t notify Sutter Health Plus as soon as reasonably possible, we may not cover services you receive after transfer to a network provider would have been possible.
- For new prescriptions, fill them at any network pharmacy. Visit MedImpact to search for a nearby pharmacy.
- If you have valid refills left on your prescription, transfer your prescription from your local pharmacy to another in-network pharmacy for pick-up (you can transfer certain drugs only once).
If you received emergency or urgent care from an out-of-network provider and need to file a claim for out-of-pocket costs, you must file a claim for reimbursement.
- After your trip, you must complete and file a Member Claim Form located on the Sutter Health Plus Member Portal or you can download a PDF version. Include any bills and receipts from the provider.
- Sutter Health Plus will send you a written decision 30 days of receiving the claim from you or the provider––unless we request additional information within that 30-day period.
- If your claim is denied in whole or in part, we will send you a written decision explaining the denial, and how to file a grievance.
For more information on preparing for your trip, receiving urgent or emergency care, or claims submissions, call Member Services at (855) 315-5800.