Getting Started with the Sana First Health Plan (SFHP)

The Sana First Health Plan (SFHP) is built around a guided path to care, with Sana Care as your starting point for most healthcare needs.

With Sana First, you get support from Sana Care and Care Navigation to help you understand what care you need and find the right provider when in-person or specialty care is needed.

How Sana First Works

For most care, start with Sana Care before scheduling with an outside provider or specialist.

Here's what that looks like:

1. Start with Sana Care. Message your Sana Care team through the Sana App or member portal about your health concern.
2. Get the right level of care. Your Sana Care team can treat many primary care needs virtually. If you need in-person or specialty care, they'll connect you with Care Navigation.
3. Review your provider options. Care Navigation will identify provider options based on your medical needs, location, quality, availability, and cost.
4. Choose your provider. You choose the provider that works best for you from the options provided.
5. Receive your referral. Sana will send the required referral documentation to your selected provider. Once your referral is in place, you can schedule your appointment.

Sana First is not an HMO or EPO with a fixed provider directory. Depending on your needs, Care Navigation may guide you to Sana direct-contract providers, HealthSmart providers, or non-contracted providers who can bill Sana directly.

Why is the referral important?

For care that requires a referral, you must complete the Sana Care referral process before receiving care.

If you receive care that requires a referral without completing this process first, the claim will be denied and you'll be responsible for 100% of the cost.

What Care Doesn't Require a Referral?

You can access the following care directly without starting with Sana Care:

• Emergency Room care
• Urgent Care
• Mental Health
• OB/GYN care
• Pediatric primary and preventive care

If you need Emergency Room or Urgent Care, get the care you need right away. You do not need to contact Sana Care first.

What About Care for My Child?

Children 17 and younger do not start with Sana Care for routine pediatric care. They can continue seeing their pediatrician or family doctor for primary and preventive care without a referral.

If your child's doctor recommends specialty care:

1. Log in to the Sana App or member portal using your Sana account.
2. Switch to your child's profile.
3. Start a conversation with Care Navigation.
4. Upload the pediatrician's referral or after-visit summary.

Care Navigation will review the information and help coordinate the appropriate specialist referral and next steps.

Step by Step: How to Get Guided Care for Adults

1. Connect: Message Sana Care in the Sana App or member portal whenever you need medical care or advice.
2. Evaluation & Options: If you need in person or specialist care, your provider connects you with Care Navigation, who builds a personalized shortlist of high-quality, cost-effective local provider options for you.
3. Selection & Referral Packet: Once you choose a provider, Sana issues a formal referral packet with a unique code and faxes it directly to your chosen doctor's office.
4. Appointment & Follow-Up: You contact the provider to schedule your visit. Sana Care will follow up with you after your appointment to support your next steps.

Have questions? We've got you covered.

• Log in to view account details.
• Search FAQs in our Help Center.
• Connect with Customer Support directly through the chat icon on most Sana pages or call us at (833) 726-2123 Monday through Friday, 7 AM to 7 PM Central.