Members also have online access to claim status and other services to help make their health care experience more satisfying. If you purchased your coverage directly through Horizon BCBSNJ: Call Horizon BCBSNJ's Member Services at the phone number on the back of your ID card. PDF BENEFIT A/ABP B C D - Horizon NJ Health Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey Horizon Insurance Company Horizon Healthcare of New Jersey Braven Health andor Horizon Healthcare Dental Inc each an independent licensee of the Blue Cross Blue Shield. PDF Horizon BCBSNJ: State Health Benefits Program- NJ DIRECT ... Three Penn Plaza East, Newark, New Jersey 07105. This website does not display all Qualified Health Plans available through Get Covered NJ.To see all available Qualified Health Plan options, go to the New Jersey Health Insurance Marketplace at Get Covered NJ.. Products and services are provided by Horizon Blue . Horizon BCBSNJ is committed to giv ing our members access to safe and effective medicine. New Jersey State Mandate (P.L. Horizon NJ TotalCare (HMO D-SNP) is an HMO Medicare Advantage Dual Eligible Special Needs plan with a Medicare contract and a contract with the State of New Jersey Medicaid Program. The Horizon Dental Companion Plan is similar to the Horizon Dental PPO Access Plan, but sold only to groups that have Horizon BCBSNJ medical coverage. Medicare prescription drug coverage (Part D) is available to everyone with Medicare. Health Plan Brochure Spanish. Jefferson Health, New Jersey Accepted Insurance Plans. Each NJ health insurance carrier implemented this differently, and Horizon's answer was the Young Grins plan and later the Family Grins and Family Grins Plus plans. To help protect its members and their families from losing their health care coverage, Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) today announced that for the next 60 days it is waiving the "actively at work" requirement for group policies. The full name of this health insurance company is Horizon BlueCross BlueShield of New Jersey. For more information on how to enroll in a Health Plan, call an NJ FamilyCare Health Benefits Coordinator at 1-800-701-0710 (TTY: 711). To see all available Qualified Health Plan options, go to the New Jersey Health Insurance Marketplace at Get Covered NJ. Enrollment in HIC Medicare products and/or Horizon NJ TotalCare (HMO D-SNP) depends on contract renewal. If you purchased your coverage through the Exchange (federal Marketplace): Contact HealthCare.gov or 1-800-318-2596. High Deductible Health Plan The High Deductible Health Plan (HDHP) costs less out of your paycheck than the Direct Access plan, The plan covers frequently needed, eligible preventive and diagnostic services and selected eligible basic services at 100 percent when members use dentists participating in the Horizon PPO Network. Read Horizon Reviews. Gold Horizon Healthcare of New Jersey, Inc. HMO $510.23 Horizon HMO Gold C www.horizonblue.com Gold Horizon Healthcare Services, Inc. EPO $605.70 OMNIA Gold C M www.horizonblue.com Gold AmeriHealth HMO HMO $659.06 IHC Gold HMO Regional Preferred $20/$50 C M www.amerihealth.com health of people in all the different populations we serve. It's important that the medicine you take is safe and effective. NJ DIRECT M EMBER G UIDEBOOK 1 . If Horizon Blue Cross Blue Shield of New Jersey denies your weight loss surgery claim and you think it should be covered, consider filing an appeal. Application for Health Coverage & Help Paying Costs T HI NGS T O KN OW Use this application to see what coverage choices you qualify for • Free or low-cost insurance from Medicaid or the Children's Health Insurance Program (CHIP), known as NJ FamilyCare • you stay well • A new tax credit that can help pay your premiums for health coverage This website is operated by Horizon Blue Cross Blue Shield of New Jersey and is not New Jersey's Health Insurance Marketplace. All State and Federal employee health products. Welcome to Get Covered New Jersey, the state's official health insurance marketplace where you can shop for and enroll in quality, affordable health coverage, and the only place to receive financial help to lower premium and out-of-pocket costs. The following gender affirming-related surgical procedures are eligible for coverage when the corresponding medical necessity criteria are met: INTRODUCTION . The NJ FamilyCare program allows eligible children, single adults and families to get affordable, quality health care through Horizon NJ Health. We are your hometown health plan. Each plan offers a different level of coverage, and one might better fit your needs depending on your situation. Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2020 - 12/31/2020 Horizon BCBSNJ: State Health Benefits Program- NJ DIRECT (PPO) Coverage for: All Coverage Types Plan Type: PPO (NJ DIRECT (PPO)) 1 of 11 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. As a member of Horizon NJ Health, you get the benefits and services you are entitled to in the Managed Long Term Services & Supports. This website does not display all Qualified Health Plans available through Get Covered NJ.To see all available Qualified Health Plan options, go to the New Jersey Health Insurance Marketplace at Get Covered NJ.. Products and services are provided by Horizon Blue . Most health services are coordinated by one of five managed care organizations, or regional PACE providers, contracted with the Division of Medical Assistance and Health Services. Horizon Blue Cross Blue Shield of New Jersey Medicare Advantage & Horizon NJ TotalCare (HMO D-SNP) Horizon NJ Health Independence Blue Cross (Commercial) New Jersey Medicaid (Fee For Service) UnitedHealthcare Commercial UnitedHealthcare Community Plan WellCare of New Jersey Medicaid As of July 2021 The information provided is not a guarantee of . All Horizon HMO providers handle all of the paperwork for members. Horizon nj health plan a coverage. Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2018 - 12/31/2018 Horizon BCBSNJ: State Health Benefits Program- NJ DIRECT10 (PPO) Coverage for: All Coverage Types Plan Type: PPO (NJ DIRECT (PPO)) 1of 11 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Products are provided by Horizon Healthcare Dental, Inc. and Horizon Blue Cross Blue Shield of New Jersey. Newark NJ 07105-2200 www.horizonblue.com . Products are provided by HIC and/or Horizon NJ Health. This website is operated by Horizon Blue Cross Blue Shield of New Jersey and is not New Jersey's Health Insurance Marketplace. First Health: All products: First Managed Care Option: All products: Horizon BCBS of New Jersey: All Commercial Products, including HMO, PPO, EPO, POS, Direct Access, Indemnity, and Omnia. 1-800-682-9090. Horizon NJ TotalCare (HMO D-SNP) is an HMO Medicare Advantage Dual Eligible Special Needs plan with a Medicare contract and a contract with the State of New Jersey Medicaid Program. Your benefit package is determined by the NJ FamilyCare Program based on your income level and the number of people in your family. OPRA is a state law that was enacted to give the public greater access to government records maintained by public agencies in New Jersey. This Guide identifies the covered drug list (formulary) for your prescription drug plan. This plan does not provide out-of-network benefits. Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2021 - 12/31/2021 Horizon BCBSNJ: State Health Benefits Program- NJ DIRECT15 (PPO) Coverage for: All Coverage Types Plan Type: PPO (NJ DIRECT (PPO)) /BlueCard 1 of 8 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Note, however, that the law does not apply to dental plan organizations or dental service organizations, so DU31 does . Home - Horizon NJ Health. 22. *Without proof of prior creditable coverage, a benefit waiting period of 6 months for Class II and 12 months for Class III and ortho applies. Horizon Blue Cross Blue Shield of New Jersey requires adherence and will only cover a medically necessary PAP device beyond the first three months of therapy when PAP use is greater than or equal to 4 hours per night on 70% of nights during a consecutive 30 day period during the first three months of therapy. To find out if your plan is accepted, please check the lists below. If your doctor wants to prescribe a drug that is not included in our formulary, he or she will need to call us to get prior . 1-800-682-9094. The State Health Benefits Program (SHBP)was established in 1961. Check if you have BlueCard® coverage, which provides access to Blue Cross Blue Shield's national network of hospitals and doctors. Call 1-800-637-2997 (TTY 711). A New Jersey Therapist who accepts Horizon Healthcare, may be in network with Horizon Healthcare, or you can make a claim on your Horizon insurance as an out of network Horizon Healthcare provider. A student staying in New Jersey will be covered under your existing Horizon BCBSNJ plan. Helping Furloughed Employees Maintain Health Coverage. Pennington NJ 08534 Mailstop. Horizon Blue Cross Blue Shield of New Jersey is pleased t o present the Classic Drug Guide for the Health Insurance Marketplace. 086-19-71 EC003171 (0719) July 2019 | Member Services: 1-844-444-4410 (TTY 711) Effective April 1, 2019. This website is operated by Horizon Blue Cross Blue Shield of New Jersey and is not New Jersey's Health Insurance Marketplace. . Enrollment in HIC Medicare products and/or Horizon NJ TotalCare (HMO D-SNP) depends on contract renewal. It offers medical and . Horizon NJ TotalCare (HMO D-SNP) is an HMO Medicare Advantage Dual Eligible Special Needs plan with a Medicare contract and a contract with the State of New Jersey Medicaid Program. New Jersey Medicaid is a medical assistance program, providing healthcare coverage for nearly 1.75 million New Jersey residents. We can also help you complete your application. • One of the largest provider networks in New Jersey—choose from The medical care and services you get through Horizon NJ Health are free or low cost. If you purchase medical coverage outside of the Health Insurance Marketplace, you must either attest that you have pediatric dental coverage from another carrier or purchase a SAPD plan. Horizon BCBSNJ offers toll-free customer service Monday through Friday, 8 a.m. to 6 p.m., Eastern Time (ET), so members can get the help they need. Products are provided by HIC and/or Horizon NJ Health. As a member of Horizon NJ Health, you get the benefits and services you are entitled to with the NJ FamilyCare Program. How does a PDP plan work? This website does not display all Qualified Health Plans available through Get Covered NJ.To see all available Qualified Health Plan options, go to the New Jersey Health Insurance Marketplace at Get Covered NJ.. Products and services are provided by Horizon Blue . Infertility is defined as the failure to conceive after one year of unprotected sexual intercourse. Keeping You and Your Family Healthy: The only NJ FamilyCare plan from Horizon Blue Cross Blue Shield of New Jersey. (0616) An Independent Licensee of the Notice of Nondiscrimination Horizon Blue Cross Blue Shield of New Jersey complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. Communications may be issued by Horizon Blue . Horizon Blue Cross Blue Shield of NJ plans are named after metal tiers: Bronze, Silver, Gold, and Platinum; this makes it easy to compare options. It was founded in 1932. With the NJ Educators Health Plan (NJEHP), you have access to one of the largest doctor and hospital networks in New Jersey and 1.3 million providers nationwide through the BlueCard® PPO Network. can call the Horizon NJ Health Pharmacy Department at . Enrollment in HIC Medicare products and/or Horizon NJ TotalCare (HMO D-SNP) depends on contract renewal. 711. For low-income individuals, New Jersey Medicaid provides coverage for all essential health benefits, including substance use disorder treatment. Products are provided by HIC and/or Horizon NJ Health. New Jersey IVF Coverage Mandate. To 6 pm and Saturday 8 am. If you purchased coverage through the NJ State Based Exchange (SBE): Contact . NJ FamilyCare health plans include Aetna Better Health of New Jersey, Amerigroup New Jersey, Horizon NJ Health, UnitedHealthcare Community Plan, and WellCare. This website is operated by Horizon Blue Cross Blue Shield of New Jersey and is not New Jersey's Health Insurance Marketplace. To get more information about a Health Plan, view the Member Handbook, Provider Directory, or Drug Formulary click on the Health Plan logo below: Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, Braven Health, and/or Horizon Healthcare Dental, Inc., each an independent licensee of the Blue Cross Blue Shield Association. 2001, c. 295) effective 06/29/2002, which requires health benefits coverage for expenses incurred in conducting colorectal cancer screening at regular intervals for persons age 50 and over, and for persons of any age who are considered to be at high risk for colorectal cancer. Help is here. We are here to help you understand your benefits and take charge of your health. However, if they are leaving the state, things can get a bit more complicated. Typically, you pay a predictable portion of your prescription drug costs — in other words, a deductible, copayments or coinsurance — and the plan pays the rest. Uninsured? Health Plan Brochure English. *Horizon NJ Health will continue to pay both the Medicare and Medicaid components of claims for Horizon NJ TotalCare (HMO SNP) members, eliminating the need to file Medicare claims separately; however, any other coverage available for a Horizon NJ TotalCare (HMO SNP) member should be filed first with that insurance program. Please refer to this Dear Valued Customer: Thank you for choosing Horizon Blue Cross Blue Shield of New Jersey for your health insurance coverage. Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, Braven Health, and/or Horizon Healthcare Dental, Inc., each an independent licensee of the Blue Cross Blue Shield Association. This document is for informational purposes only and does not constitute a binding agreement. All Medicare products: Horizon NJ Health: Medicaid HMO and Total Care Dual Special Needs Plan Horizon Blue Cross Blue Shield of New Jersey Gender Reassignment/Gender Affirming Surgery. Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2022 - 12/31/2022 Horizon BCBSNJ: State Health Benefits Program- NJ DIRECT (PPO) Coverage for: All Coverage Types Plan Type: PPO (NJ DIRECT (PPO))/BlueCard 1 of 9 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. 21. Who is eligible for Part D coverage? You can apply for NJ FamilyCare online. If you have health insurance coverage with Horizon Healthcare, or you're looking for Horizon Nutritionists and Dietitians in New Jersey (or New Jersey Nutritionists and Dietitians who accept Horizon), please contact these Nutritionists and Dietitians and confirm that they are either in-network with Horizon Healthcare are or can help you with . You can also access the Horizon Tier 2 network in New Jersey and National Blue Card network (for coverage outside of New Jersey). horizonNJhealth.com or call Member Services toll free at . The law applies to any health coverage issued in New Jersey by most carriers, including, for instance, hospital and medical coverage offered by an HMO, or stand-alone vision and pharmacy coverage offered by an insurance company. You may also ask us for a coverage determination or appeal by phone at 1-800-391-1906, (TTY 771), 24 hours a day, 7 days a week. That's why Horizon NJ Health has a committee made up of doctors and pharmacists who review and approve our formulary. Our Health Insurance Appeals page will get you started, then head over to the Disputes & Appeals page for Horizon Blue Cross Blue Shield of New Jersey to learn how to proceed. Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, Braven Health, and/or Horizon Healthcare Dental, Inc., each an independent licensee of the Blue Cross Blue Shield Association. Get the benefits your family is looking for with Horizon NJ Health. Single letter of referral from a qualified mental health professional (see Policy Guidelines II, III), and; . To ensure that as many residents as possible could benefit from the new financial help, the State of New Jersey extended the health insurance enrollment window through the . At Jefferson Health New Jersey, we want to make sure you and your family receive the healthcare you need, that's why we accept most major insurance and managed health plans, as well as all Affordable Care Act (ACA) Plans. For over 75 years, we've been helping New Jersey residents with their health care coverage needs. The approved prescription drugs that Horizon NJ Health covers make up our formulary. This website is operated by Horizon Blue Cross Blue Shield of New Jersey and is not New Jersey's Health Insurance Marketplace. Choosing the health insurer for PIP option may reduce your premium, but you need to make sure that your health insurer would provide adequate coverage if you were injured in an auto accident. Horizon Young Grins Horizon Young Grins, our stand-alone pediatric dental (SAPD) plan, meets the requirements of the Affordable Care Act (ACA). Health Coverage from the State's Leading Health Insurer: Horizon Blue Cross Blue Shield of New Jersey Put our coverage advantages to work for you with a plan that meets your needs and fits your budget! In the United States approximately 15-20 percent of married couples will experience some degree of infertility. Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2022 - 12/31/2022 Horizon BCBSNJ: State Health Benefits Program- CWA Unity DIRECT2019 (PPO) Coverage for: All Coverage Types Plan Type: PPO (CWA Unity DIRECT2019 (PPO))/BlueCard Members referring to a Horizon NJ Health Policy should discuss the policy with their treating physician or dentist, and should refer to their specific benefit plan for the terms, conditions, limitations and exclusions of their coverage. The Braven Health Advantage. Newark, NJ 07105-2200 HorizonBlue.com CMC0008179 Blue Cross and Blue Shield Association. This website does not display all Qualified Health Plans available through Get Covered NJ.To see all available Qualified Health Plan options, go to the New Jersey Health Insurance Marketplace at Get Covered NJ.. Products and services are provided by Horizon Blue . If you have health insurance coverage with Horizon Healthcare, or you're looking for Horizon Chiropractors in New Jersey (or New Jersey Chiropractors who accept Horizon), please contact these Chiropractors and confirm that they are either in-network with Horizon Healthcare are or can help you with your Horizon coverage. A Medicare Prescription Drug Plan (PDP) works like other insurance plans. Horizon Blue Cross Blue Shield offers health insurance plans to individuals in New Jersey and has a vast network of doctors, hospitals and specialists in its provider network. The financial help available through this relief bill and the State of New Jersey builds on the state's efforts to provide access to health coverage for more New Jerseyans. This website does not display all Qualified Health Plans available through Get Covered NJ .To see all available Qualified Health Plan options, go to the New Jersey Health Insurance Marketplace at Get Covered NJ .. Products and services are provided by Horizon Blue . Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, Braven Health, and/or Horizon Healthcare Dental, Inc., each an independent . prescription drug coverage to qualified State and local government public employees, retirees, and For a pharmacy near you, visit our Provider Directory at . Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2022 - 12/31/2022 Horizon BCBSNJ: State Health Benefits Program- NJ DIRECT HD1500 Coverage for: All Coverage Types Plan Type: HDHP (NJ DIRECT (HDHP))/BlueCard 1 of 8 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2022 - 12/31/2022 Horizon BCBSNJ: State Health Benefits Program- NJ DIRECT HD1500 Coverage for: All Coverage Types Plan Type: HDHP (NJ DIRECT (HDHP))/BlueCard 1 of 8 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Evident in its name, Horizon is a subsidiary of BlueCross BlueShield. Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2022 - 12/31/2022 Horizon BCBSNJ: School Employees' Health Benefits Program- NJ DIRECT10 (PPO) Coverage for: All Coverage Types Plan Type: PPO People with hearing or speech difficulties can call our TTY/TDD service at . See forms below to find out more information on the Horizon Blue Cross Blue Shield of New Jersey prescription drug coverage Determination and Redetermination process. Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2022 - 12/31/2022 Horizon BCBSNJ: State Health Benefits Program- NJ DIRECT 2030 (PPO) Coverage for: All Coverage Types Plan Type: PPO (NJ DIRECT (PPO)) /BlueCard 1 of 9 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. It serves millions members in Delaware, New Jersey, New York, and Pennsylvania. Yes. 1 You also have coverage worldwide through Blue Cross Blue Shield Global Core.That makes it easy to find an in-network doctor or hospital.You can choose to go out of network, too, but you'll pay . In an effort to help protect its members and their families from losing health care coverage, Horizon Blue Cross Blue Shield of New Jersey said Wednesday it is waiving the "actively at work . To see all available Qualified Health Plan options, go to the New Jersey Health Insurance Marketplace at Get Covered NJ. Horizon NJ Health Policies have been developed by the various Horizon NJ Health Policy Committees (the . Braven Health is the first and only New Jersey Medicare plan built in partnership with two of the state's most comprehensive health systems, Hackensack Meridian Health, RWJBarnabas Health and Horizon Blue Cross Blue Shield of New Jersey, a health insurer with nearly 90 years of experience.Together, we're creating an improved health care experience for New . The enclosed information will help you better understand your benefits and the value-added programs Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, Braven Health, and/or Horizon Healthcare Dental, Inc., each an independent . Now is a great time to start researching your health insurance options for 2022. When the Affordable Care Act(ACA) was introduced, the law required that health plans include pediatric dental as one of the essential health benefits.
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