How to find in-network Providers for Mental Health (All SDPEBA Sharp Plans)
Last November, Sharp announced that they were partnering with Magellan to provide greater mental health options for all its plans, including the Medicare Direct Advantage plan. This means that there are a lot more in-network providers available to you, but you’ll need to go through some hurdles to find them.
The best way, in our opinion, is to go through Sharp and Magellan’s “Find a Provider tool” linked here.
From there, you’ll then need to select HMO Plan (note: if you’re already logged into an online Sharp account it may skip this step).
You can then either select “Find Care Now” or do a specific search.
Using the Search Function
By using the search function, you can enter your zip code, select between outpatient, inpatient, partial/intensive outpatient, community support, telehealth, and specialty services, and then click search. Don’t worry if you mess things up or want to make any changes, you’ll be able to adjust your search after clicking search.
From there you’ll get a list of providers who meet your needs and the ability to filter down that list based on profession, gender, and a lot of other options.
One issue we found with the search function is that the “Specialty/Name” box doesn’t have a great track record of finding exactly the type of care you need. For example, if you’re looking for someone who specializes in Cognitive Behavior Therapy, no matter how you phrase it, it won’t show up. But it does work for other specialties. In this case, the “Find Care Now” button has better results.
Medical Questionnaire: Find Care Now
Once you select Find Care Now, you’ll have a couple of choices: outpatient, inpatient, partial/intensive outpatient, community support, telehealth, and specialty services. Select the care that best fits your needs.
If you’re not sure which option applies to you, just know that inpatient services refer to services where you stay overnight in a clinical setting. Outpatient services are more like doctor visits/therapy sessions, where you come in for an appointment and then leave. The other options are more specific and tend to only apply to individuals who are seeking a specific type of care. Additionally, you’ll have an option to specify if you want “Telehealth” options later.
After that, you’ll then be able to choose between professional care/groups and a facility. Usually you’ll select professional care/groups when looking for something like a therapist and facilities when looking for something like a psychiatric hospital or rehabilitation clinic.
After that, you can select telehealth, in-person, or all and enter your location and the distance you’re willing to travel.
Note that if you selected “Specialty Services” in step one, you’ll have an extra step where you’ll need to select a specialty from a list.
Once you’ve done that, you can click “View Matches” and see the list of options available near you. After that, you can go through that list and select a provider!
Magellan ID Card
If, at any point, Magellan asks you to bring your Magellan ID card, that is your Sharp ID card. We alerted them to this error as it can be quite confusing.
Phone Line
There is now a dedicated Sharp phone line ran by Magellan that you can reach by calling 866-512-6190 and pressing 7. This might be a better way to find a provider if you’re looking for a specialist, but you definitely get more information online.