• Make sure you understand what services are covered by Sutter Health Plus while you’re away from home.
• Check your Evidence of Coverage and Disclosure Form (EOC) for specifics on what to do in case of an emergency while you’re away.
• Register for the Sutter Health Plus Member Portal; you can access your benefits, copays, member identification (ID) cards and more from your computer, tablet or smartphone.
• Remember to pack your member ID card, which contains important contact information.
• Make sure your preventive immunizations are up-to-date, including your annual flu shot.
• If you’re leaving the country, talk to your doctor, in advance, about vaccinations or drugs specific to the region you’re visiting; vaccination and drugs needed for travel may not be covered by Sutter Health Plus. Review your EOC for details.
• Learn about travel alerts and warnings, safety, security, and healthcare through the U.S. Department of State.
• If you have an ongoing medical condition, visit your doctor.
• Refill your eligible prescriptions to have enough to last while you’re away.
• Find and save the local 911 equivalent phone number.

• If you have a medical emergency or need urgent care*, go to the nearest hospital or medical facility that can give you the 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, after your treating physician determines you are medically stable, contact Sutter Health Plus Member Services at (855) 315-5800 as soon as reasonably possible to request authorization for any post-stabilization care.
• Sutter Health Plus determines if you should receive care from the out-of-network provider, or arranges 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.

*When traveling in the Sutter Health Plus service area, we encourage you to access an in-network urgent care facility.

There are several ways to get your prescription while you are away from home:

• Request a vacation override, allowing you to pick up your prescription drug early (up to a 90-day supply) by calling CVS Caremark^® at (844) 740-0635; members are eligible for one vacation override per prescription within a six-month period; standard cost sharing applies.
• If you have valid refills left on your prescription, transfer your prescription from your local pharmacy to an in-network pharmacy for pick-up (limitations may apply).
• If you have a new prescription, fill it at any network pharmacy. For a list of network pharmacies, search Pharmacy Locator at CVS Caremark.
• If you use a CVS retail pharmacy or mail order, get up to a 100-day supply, as your benefit plan allows, for the same cost of two 30-day supplies; sign up with CVS Caremark Mail Service Pharmacy at (844) 740-0635 or visit CVS Caremark. Mail order does not apply to specialty drugs.

• 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.
• For medical services, complete 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.
• If you paid out-of-pocket for a prescription drug at a retail pharmacy, submit a claim at CVS Caremark.
• Sutter Health Plus will send you a written decision within 30 days after we receive the claim from you or the out-of-network provider, unless we notify you within that initial 30 days that we need additional information.
• 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 Sutter Health Plus Member Services at (855) 315-5800.