--- title: "Members at Sutter Health Plan" description: "Sutter Health Plan offers comprehensive coverage that includes access to an award-winning healthcare network." url: "https://www.sutterhealthplan.org/members" --- 1. [Home](https://www.sutterhealthplan.org/) / 2. Members ![MembersEdited\_AdobeStock\_796519506](https://edge.sitecorecloud.io/sutterhealt962c-sutterhealt8fce-production57cc-4860/media/Project/SutterHealth/SutterHealthPlan/Images/MembersEdited_AdobeStock_7965195063.jpg?h=1260&iar=0&w=2688) ![MembersEdited\_AdobeStock\_796519506](https://edge.sitecorecloud.io/sutterhealt962c-sutterhealt8fce-production57cc-4860/media/Project/SutterHealth/SutterHealthPlan/Images/MembersEdited_AdobeStock_7965195063.jpg?h=1260&iar=0&w=2688) # Members At Sutter Health Plan, we offer coverage you can count on.  [Member portal sign in](https://www.shplan.org/memberportal) [Not registered? Learn more.](https://www.sutterhealthplan.org/members/portal) ## Protect what matters most Choosing a health plan is a big decision. You want comprehensive healthcare coverage, with access to an award-winning network of providers. You also need a plan that's easy to understand and has convenient care options nearby. We’ve got you! Sutter Health Plan provides comprehensive coverage with access to high-quality care for you and your family. ### [Find a provider near you](https://www.sutterhealthplan.org/find-provider) Use our provider locator to search for network doctors, hospitals and other care locations near you. ### [Forms and resources](https://www.sutterhealthplan.org/members/forms-resources) Find all the essential member forms and resources you need. ### [Explore your benefits](https://www.sutterhealthplan.org/members#videos) Watch these videos to learn more about your benefits, care options, and tools to manage your health.  ## Comprehensive care and coverage **Virtual care options** **Nurse advice line** **Pharmacy benefits** **Behavioral health benefits** **Sutter Walk-In Care** **Urgent Care close to you** **Plan partners** **Wellness resources** ### Virtual care options You have access to the care you need, when and where you need it, including video visits for many healthcare services. [Video visit appointments](https://www.sutterhealth.org/video-visits) **Virtual care options** ### Virtual care options You have access to the care you need, when and where you need it, including video visits for many healthcare services. [Video visit appointments](https://www.sutterhealth.org/video-visits) **Nurse advice line** ### Nurse advice line Enjoy 24/7 access to registered nurses who can answer your medical questions and help determine the level of care you may need. [Call 855-836-3500]() **Pharmacy benefits** ### Pharmacy benefits CVS Caremark® manages pharmacy benefits for our members, including retail pharmacies, mail order and specialty prescriptions, claims processing, and medication prior authorization requests [View pharmacy benefits](https://www.sutterhealthplan.org/members/pharmacy-benefits) **Behavioral health benefits** ### Behavioral health benefits Members have access to mental health and substance use disorder (MH/SUD) services through Carelon Behavioral Health of California, Inc. [View Behavioral health benefits](https://www.sutterhealthplan.org/members/plan-partners/behavioral-health-benefits) **Sutter Walk-In Care** ### Sutter Walk-In Care From colds and allergies to sore throats and minor sprains, members have access to Sutter Walk-In Care services for everyday health needs, available in the Greater Sacramento Area. [Find Sutter Walk-In Care](https://www.sutterhealthplan.org/about-us/walk-in-care) **Urgent Care close to you** ### Urgent Care close to you Same-day treatment for urgent medical conditions, with shorter wait times and lower costs than emergency room visits. [Find an Urgent Care](https://www.sutterhealthplan.org/find-location-results?facets=%5B%7B%22i%22%3A%22c_shpService%22%2C%22v%22%3A%5B%22Urgent+Care%22%5D%7D%5D&limit=10&verticalKey=shp-facilities) **Plan partners** ### Plan partners We contract for certain healthcare benefits not provided through medical groups, including but not limited to behavioral health, vision, acupuncture, chiropractic and more. [See all plan partners](https://www.sutterhealthplan.org/members/plan-partners) **Wellness resources** ### Wellness resources Browse our health and wellness resources designed to help you achieve your personal health and wellness goals. [View programs](https://www.sutterhealthplan.org/members/health-wellness) ## Coverage for Individual and Family Plans View our available individual and family health plans. Follow these step-by-step instructions for enrolling in Sutter Health Plan. [Enroll today](https://www.sutterhealthplan.org/members/enroll) Online health and wellness tools  ### Scout by Sutter Health™ Teens and young adults can use Scout at no cost to help manage their everyday mental health.    [Get started with Scout](https://www.sutterhealth.org/health/scout) ### My Health Online Members can connect with their Sutter Health care team through My Health Online (MHO), a secure patient portal for appointments, health management and more.\* [MHO login](https://www.sutterhealth.org/patient-resources/my-health-online) \*Members can view lab and test results from Sutter facilities, schedule Sutter Walk-In Care and video visits, and access other MHO features. If their primary care physician (PCP) doesn’t participate in MHO, they won’t be able to schedule appointments or message their PCP through MHO. ## Estimate healthcare costs Use our real-time cost estimator tool in the Member Portal to compare personalized out-of-pocket costs for in-network services. [Access estimator tool](https://shplus.org/memberportal) [View Machine-Readable Files](https://www.sutterhealthplan.org/technical-information) ## Explore your benefits  Your health matters — and understanding your benefits should be simple. We’ve created short, easy-to-watch videos designed to help you make the most of your coverage. Learn about your benefits, care options, and tools to manage your health with confidence. **Sutter Health Plan overview**  Comprehensive coverage and access to convenient care designed to fit your needs.  **Choosing a plan**  Learn how to compare plan options and select the one that best fits your needs.  **High Deductible Health Plan (HDHP) explained**  Understand how HDHPs work and why they might be a good choice for you. **Pharmacy benefits**  See how your prescription coverage works and explore ways to save on medications. 1 / 4 1 / 4 **Sutter Health Plan overview**  Comprehensive coverage and access to convenient care designed to fit your needs.  **Choosing a plan**  Learn how to compare plan options and select the one that best fits your needs.  **High Deductible Health Plan (HDHP) explained**  Understand how HDHPs work and why they might be a good choice for you. **Pharmacy benefits**  See how your prescription coverage works and explore ways to save on medications. Stay healthy, stay covered ### [Choosing a primary care provider](https://www.sutterhealthplan.org/members/choose-pcp) Find the right primary care physician (PCP) to meet your needs.  ### [Preventive care resources](https://www.sutterhealthplan.org/members/preventive-care) You have access to no-cost preventive care services designed to help keep you healthy.  ### [Care while traveling](https://www.sutterhealthplan.org/members/accessing-care-traveling) Helpful information about your benefits while traveling and useful tips on accessing care on the go.  Member FAQs **Are all Sutter Health providers included in the Sutter Health Plan network?** No. Sutter Health Plan has a service area in which we offer healthcare coverage. Not all Sutter hospitals, physician organizations and other healthcare services are part of the Sutter Health Plan service area or network. Use the [Find a Provider](https://www.sutterhealthplan.org/find-provider-results) or [Find a Location](https://www.sutterhealthplan.org/find-location-results) tool to search for participating providers in your area. **Can I still use Sutter Health Plan if I live outside the service area?** If enrolling in an individual and family plan, you must live or reside in the [Sutter Health Plan service area](https://www.sutterhealthplan.org/about-us/service-area) to be eligible for coverage. If enrolling through your employer, you must live, reside or physically work in the Sutter Health Plan service area to qualify for coverage. **Can I visit a non-participating provider?** Yes, but only with a referral or prior authorization from your medical group. **Do I need to select a primary care physician (PCP)?** Yes, all new members must select a PCP who coordinates their care and helps with everyday health needs. If you don’t choose one, we’ll assign one to you. **I'm new to Sutter Health Plan. Can I keep my current PCP?** Yes, you can keep your current PCP as long as they’re in the Sutter Health Plan network and part of your medical group. Use the [Provider Locator](https://www.sutterhealthplan.org/find-provider) to find out if they’re in-network. **I'm new to Sutter Health Plan. Can I keep my current specialist?** Yes, you can keep your current specialist if they’re part of the Sutter Health Plan network and are in the same medical group as your PCP. If you need specialty care and have a specific Sutter Health Plan specialist in mind, you’ll need to select a PCP in the same medical group as the specialist. You’ll also need to ask your new PCP for a referral to the specialist. Use the [Provider Locator](https://www.sutterhealthplan.org/find-provider) to verify your specialist’s medical group. In some cases, your PCP may refer you to a specialist within the Sutter Health Plan network who’s outside your medical group. **How do I find a PCP?** You can find a PCP by using the [Provider Locator](https://www.sutterhealthplan.org/find-provider). **How do Sutter Health Plan network providers get my medical records?** Sutter Health Plan providers can typically access electronic health records (EHRs) from Kaiser Permanente, UC Davis Medical Group, UC San Francisco Health or Stanford Health. A fee may apply if you request these records for personal use. If your previous medical group was Sutter Independent Physicians or another group, you must submit a Medical Records Request Form to your former physician to release your records. To request medical records, speak with your new Sutter Health Plan PCP. **My dependent is outside the Sutter Health Plan service area. How do they get care?** Your dependent must select a PCP and medical group within the [Sutter Health Plan service area](https://www.sutterhealthplan.org/about-us/service-area). Urgent and emergency care outside the service area is covered, but your dependent must receive all follow-up care from their medical group. **What if I want to change my PCP later?** You can change your PCP anytime through the [Member Portal](https://shplus.org/memberportal) or by calling Customer Service at [855-315-5800](tel:855-315-5800). **What information is on my ID card?** Your Sutter Health Plan ID card lists your PCP, medical group, out-of-pocket deductibles, important contact information and more. **When will I receive a Sutter Health Plan member ID card?** Sutter Health Plan mails member ID cards for each covered member (you and any dependents you have) a few days after you enroll. **Where can I find more information about my health plan coverage?** Log in to your [Member Portal](https://shplus.org/memberportal) to access your Benefits and Coverage Matrix (BCM), Evidence of Coverage and Disclosure Form (EOC) and Summary of Benefits and Coverage (SBC). ## Our service area  Get seamless care across Northern California. Our network in the Greater Sacramento, Central Valley and Bay Area includes access to award-winning hospitals, providers, urgent care, same-day care and many new care centers that are coming soon. [View service area](https://www.sutterhealthplan.org/about-us/service-area) We’re here to help Customer Service can help answer your questions about enrollment, benefits, portal access and more. ### Message us Submit a secure message and we’ll contact you within five business days.  [Complete the form](https://feedback.sutterhealth.org/f/136895/8368 "Complete the Form") ### Call us Call 855-315-5800 or TTY 855-830-3500, weekdays: 8:00 am – 7:00 pm. Call [855-315-5800](tel:+18553155800) ### Email us Email shpcustomerservice@sutterhealth.org with details about how we can help you. [Email now](mailto:shpcustomerservice@sutterhealth.org) ```json {"@context":"https://schema.org","@type":"WebPage","name":"Members at Sutter Health Plan","description":"Sutter Health Plan offers comprehensive coverage that includes access to an award-winning healthcare network.","url":"https://www.sutterhealthplan.org/members","breadcrumb":{"@id":"https://www.sutterhealthplan.org/members#breadcrumblist"}} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealthplan.org/members#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealthplan.org/"},{"@type":"ListItem","position":2,"name":"Members"}]} ``` ```json {"@context":"https://schema.org","@type":"VideoObject","name":"Sutter Health Plan Overview","thumbnailUrl":"https://cf-images.us-east-1.prod.boltdns.net/v1/static/817826402001/a6ad2010-eff9-4487-bf17-750e89810ff0/3a95b75c-7fe7-493c-9a77-5e67f1b8088c/1280x720/match/image.jpg","uploadDate":"2025-10-22T20:40:31.861Z","embedUrl":"https://players.brightcove.net/817826402001/79bcaa57-54d7-453c-9f1f-8ab3ef7b15de/index.html?videoId=6383529660112","description":"Sutter Health Plan is an HMO plan that includes access to a network of award-winning providers. With plans that include comprehensive coverage for preventive care, mental health, pharmacy benefits and flexible care options that fit your schedule. ","duration":"PT2M1S","transcript":"Choosing a health plan is a big decision.\nWe understand.\nIf you're looking for caring coverage that is connected, convenient,\nand designed to fit your needs, we may be the right plan for you.\nWe are an HMO plan, which means you choose a primary care\nphysician, also called a PCP, who gets to know you and coordinates most\naspects of your care, including referrals to specialists when needed.\nThis personalized approach helps ensure you receive the right care\nat the right time.\nWith access to a network of award-winning providers,\nincluding many Sutter Health doctors, care centers and hospitals,\nyou'll have coverage for the every day and everything in between.\nOur plans include comprehensive coverage for preventive care, mental health,\npharmacy benefits and more, and also digital tools to support your well-being.\nWe know life gets busy.\nThat's why we offer flexible care options to fit your schedule, like same day care\nand virtual or in-person visits\nfor everyday health needs, when and where you need it.\nManaging your coverage is easy with our member portal.\nYou can easily check your benefits, view claims, estimate\ncosts, request an ID card, and even change your PCP.\nStay connected to your care wherever you are.\nWith My Health Online, Sutter’s secure patient portal, you can book appointments,\nmessage your care team, view test results, pay bills and more at your fingertips.\nWe also provide\nsupport for your wellness journey with personalized tools and resources,\nincluding a digital health assessment, action plan, modules, and a health\ncoaching program to help you set goals and make lasting changes.\nIf you have questions about your coverage options, our customer service\nteam is here to help.\nCall 855-315-5800.\nMonday through Friday, 8 a.m. to 7 p.m.\ninclude holidays.\nYou can also reach us by email at shpcustomerservice@sutterhealth.org"} ``` ```json {"@context":"https://schema.org","@type":"VideoObject","name":"Choosing a Plan","thumbnailUrl":"https://cf-images.us-east-1.prod.boltdns.net/v1/static/817826402001/846fcf41-bdb3-4628-884e-2d91615f859f/bb9fd70c-869f-4d27-b521-b51d20b8d13f/1280x720/match/image.jpg","uploadDate":"2025-10-10T17:08:56.945Z","embedUrl":"https://players.brightcove.net/817826402001/79bcaa57-54d7-453c-9f1f-8ab3ef7b15de/index.html?videoId=6382576056112","description":"Explore the different types of health plans available to you. Learn how a Health Maintenance Organization (HMO) plan works and understand the differences between a Traditional and HDHP HMO plan. ","duration":"PT2M54S","transcript":"Choosing the right health plan for you\nbegins with understanding your options.\nLet's explore what an HMO is\nand the different types of plans available\nto help you find the best fit for your health care needs.\nWith an HMO like Sutter Health Plan, you choose your primary care physician\nwho manages most of your care\nand refers you to specialists and other services as needed.\nThese plans typically have lower premiums\nand out-of-pocket costs compared to PPO plans,\nbut they are limited to a specific network of providers.\nWhen choosing a health plan,\nit's smart to understand how each plan works.\nTraditional plans typically offer set copays for many covered services, and\nmay have a co-insurance for some benefits where you pay a percentage of the cost.\nThese plans may also have a deductible, which is the amount\nyou pay for covered services until the deductible is met.\nOnce you've met the deductible, you'll pay cost shares\nfor all covered services until you reach the out-of-pocket maximum.\nHigh Deductible Health Plans, or HDHP, work a bit differently with these plans,\nyou'll pay the full cost of all covered services until you meet your deductible.\nOnce you reach it, you'll only pay cost shares\nfor covered services until your out-of-pocket maximum is met.\nThe good news no matter which type of plan you choose, preventive services\nare covered at no cost-share.\nBefore you pick a health plan, think about the care\nyou and your family may need in the coming years\nand how much you can afford on monthly premiums and out-of-pocket costs.\nA traditional plan may be a good fit if you see your doctors or specialists\noften, have a high level of medical needs, or are planning\na life change like expanding your family or an upcoming surgery.\nThese plans usually have higher monthly premiums,\nbut lower out-of-pocket costs when you receive care.\nIf you only see your doctor for routine checkups and minor illnesses,\nan HDHP may be the better option.\nHDHPs typically have lower monthly premiums\nbut higher out-of-pocket costs until you meet your deductible.\nSome people prefer lower monthly payments and are willing to pay more\nwhen they need care.\nOthers choose higher premiums to reduce costs, such as co-pays and deductibles.\nTo find the right balance, compare\neach plan's deductible, coinsurance, and out-of-pocket maximum.\nUnderstanding these differences can help\nyou choose a plan that fits both your health needs and your budget.\nIf you have questions about your coverage options, our customer service team\nis here to help.\nCall 855-315-5800 Monday through Friday, 8 a.m. to 7 p.m. including holidays.\nYou can also reach us by email at shpcustomerservice@sutterhealth.org."} ``` ```json {"@context":"https://schema.org","@type":"VideoObject","name":"HDHP Explained ","thumbnailUrl":"https://cf-images.us-east-1.prod.boltdns.net/v1/static/817826402001/6be06071-890f-4902-8125-abd7398383a0/2fb0a7ed-148c-4894-b8f5-c55beb8facbe/1280x720/match/image.jpg","uploadDate":"2025-10-21T21:23:27.173Z","embedUrl":"https://players.brightcove.net/817826402001/79bcaa57-54d7-453c-9f1f-8ab3ef7b15de/index.html?videoId=6383480564112","description":"Learn how HDHPs work, including an explanation on deductibles and out-of-pocket expenses, as well as the differences between HDHPs and traditional plans, to help you understand potential costs.","duration":"PT4M24S","transcript":"Are you considering a high deductible health plan,\nalso known as an HDHP, but you're not quite sure how it works?\nThis video explains deductibles and out-of-pocket expenses,\nas well as the differences between HDHPs and traditional plans\nto help you understand potential costs and determine\nif an HDHP is the right plan for you.\nHDHPs are different from traditional HMO plans.\nWith an HDHP, you pay the full cost for covered services\nuntil you meet your deductible,\nexcept for preventive care, which is always covered at no cost to you.\nOnce you meet your deductible, you'll only pay cost shares,\nsuch as a copay or coinsurance for covered services\nuntil you reach your out-of-pocket maximum.\nIt's important to know that this is different from your monthly premium,\nwhich is the amount you pay for health care coverage.\nYour premium doesn't count towards your deductible or your out-of-pocket maximum.\nHDHPs also come with a unique benefit.\nThey’re the only type of plan that lets you contribute to a health savings account\nor HSA.\nThis account allows you to save money tax-free for qualified\nmedical expenses, HDHPs typically have lower monthly\npremiums and higher out-of-pocket costs until your deductible is met.\nAn HDHP may be a good fit if you're generally healthy\nand only visit the doctor for routine checkups or minor illnesses.\nThere are different deductibles for an HDHP.\nLet's review them.\nThe first one is an Individual or Self-Only Deductible.\nThis applies if you enroll in a plan for yourself only,\nand you pay 100% of out-of-pocket costs until the deductible is met,\nexcept for preventive care.\nThe second type is an Individual Family Member Deductible.\nIf you're part of a family plan, each person has their own deductible to meet.\nThat means each family member pays the full cost of their care\nuntil they meet their individual deductible,\nor the family deductible is met, whichever comes first.\nLastly, there's the Family Deductible.\nThis applies to all members within a family.\nThe deductible is met when any one family members or combination\nof family members costs for covered services reach the family deductible.\nOnce it's met, no one in the family pays toward the deductible\nany more, even if they haven't met their individual amount.\nUnderstanding which deductible applies to you is important because it can help\nyou choose the right plan that fits your health care needs and budget.\nLet's see what this might look like.\nHere's an example of a family of four.\nRobert, Grace, Tyler, and Eva.\nThey're enrolled in an MDP with an individual family member\ndeductible of $3,400, and a family deductible of $5,000.\nIn March, Robert paid $400 for diagnostic services.\nTyler paid $300 for labs and Ava paid $200 for physician fees.\nGrace spent $3,400 on her hand surgery, and has met\nthe individual family member deductible of $3,400 combined.\nThe family paid $4,300 on health care services,\nbut they still have to spend $700 on covered services\nuntil they meet their family deductible of $5,000.\nIn November, both Grace and Robert were hospitalized due to pneumonia.\nSince Grace has already met her individual deductible,\nshe's only responsible for the applicable cost shares,\nsuch as co-pays or coinsurance for her hospitalization.\nOn the other hand,\nsince the family deductible hasn't been met and Robert hasn't met\nhis individual deductible, he must pay for 100% of his hospitalization\nuntil the remaining $700 of the $5,000 family deductible is met.\nEven after both deductibles are met, Robert will still be responsible\nfor cost shares like copays or coinsurance for any covered services\nuntil the plan's out of pocket maximum is reached.\nThe family deductible is met when the family collectively spends\n$5,000 on covered health care services.\nAs a member, you can easily check your deductible and out-of-pocket\nspending in the Balanced Summary section of your member portal\nand see what you've paid, such as copays,\ncoinsurance, and other costs excluding your monthly premium.\nIf you have any questions about your coverage options,\nour customer service team is here to help.\nCall 855-315-5800.\nMonday through Friday, 8 a.m. to 7 p.m.\ninclude holidays.\nYou can also reach us by email at shpcustomerservice@sutterhealth.org"} ``` ```json {"@context":"https://schema.org","@type":"VideoObject","name":"Pharmacy Benefits","thumbnailUrl":"https://cf-images.us-east-1.prod.boltdns.net/v1/jit/817826402001/5e8d81cb-fab3-4c88-b0af-49870a88304f/main/1280x720/1m3s221ms/match/image.jpg","uploadDate":"2025-11-07T20:23:06.345Z","embedUrl":"https://players.brightcove.net/817826402001/79bcaa57-54d7-453c-9f1f-8ab3ef7b15de/index.html?videoId=6384803209112","description":"Sutter Health Plan and CVS Caremark make prescriptions simple and convenient. Learn about the different options for filling your prescriptions whether you prefer picking them up at your local pharmacy or having them delivered to your door.","duration":"PT2M6S","transcript":"At Sutter Health Plan, we partnered\nwith CVS Caremark to make getting your prescriptions easy and convenient.\nWhether you prefer picking them up at your local pharmacy or having them\ndelivered to your door, you have options that fit your needs.\nNo need to add an extra stop to your busy day.\nFill your prescriptions at many independent and chain pharmacies,\nlikely the same places you already shop.\nAnd with the CVS Caremark Retail-90 program,\nyou can get up to a 100 day supply of your maintenance medications\nfor the cost of just two retail copays at select pharmacies, including CVS.\nSave even more time with CVS Caremark Mail Service Pharmacy,\nwhere you can get up to a 100 day supply of your maintenance prescriptions\nfor the cost of two 30 day copays and with free standard shipping.\nIf you take specialty medications, they'll need to be filled through CVS\nSpecialty and will be shipped directly to your home at no extra cost.\nBefore your new health\nplan coverage begins, check if you have any prescription refills left.\nIf you do, fill them through your current plan\nso you have enough until you can get established with your new doctor.\nIf not, contact your previous doctor to get a refill or a new prescription.\nOnce your coverage starts, you can transfer prescriptions to a CVS\nCaremark network pharmacy or bring in a new prescription to fill.\nAnd for prescriptions you take regularly, consider\nthe Retail-90 program or mail order to save time and money.\nFor more information, visit the CVS Caremark guest website\ninfo.caremark.com/oe/sutterhealthplan to check drug costs,\nfind a pharmacy, view the formulary and learn more about mail order options.\nIf you have questions about your coverage options, our customer service\nteam is here to help.\nCall 855-315-5800.\nMonday through Friday, 8 a.m. to 7 p.m.\ninclude holidays.\nYou can also reach us by email at shpcustomerservice@sutterhealth.org"} ```