Medicare Retiree and Non-Medicare Spouses


If you are a Medicare eligible retiree (age 65+ with Part A and B) and wish to enroll your non-Medicare spouse you will need to complete two forms.  The Medicare eligible retiree should complete the Sharp Direct Advantage enrollment form, and the spouse should complete the Sharp non-Medicare enrollment form.  

Both enrollment forms should be submitted at the same time and you should make a note on the top of the Sharp non-Medicare enrollment form that this form is for a non-Medicare spouse and list the name of the Medicare eligible retiree on top of the form. 

These form can be emailed to , faxed (619) 431.3078, mailed or dropped off to the SDPEBA office, 9620 Chesapeake Drive, Ste 203-B, San Diego, CA 92123.

If you have any questions please contact SDPEBA by email or phone 888.315.8027

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