member login horizon medicare blue patient-centered w/rx (hmo)

by Emanuel Huel DVM 10 min read

Horizon BCBSNJ Members Health Plans, Tools, Forms, …

11 hours ago For 2022, the Horizon Medicare Blue Advantage (HMO) plan will be offered to Medicare-eligible beneficiaries in eight New Jersey counties: Atlantic, Cumberland, Hunterdon, Mercer, Morris, Somerset, Sussex and Warren.. Features of our Horizon Medicare Blue Advantage (HMO) Plan: Primary Care Physician (PCP) selection is required. No referrals. Certain services/supplies … >> Go To The Portal


What are the features of the horizon Medicare blue Advantage (HMO) plan?

Features of our Horizon Medicare Blue Advantage (HMO) plan: 1 Primary Care Physician (PCP) selection is required for members enrolled in... 2 Referrals are not required for Horizon Medicare Blue Advantage (HMO) plan members. 3 Prior authorization is required for certain services/supplies. 4 Routine vision, hearing and dental benefits are included.

What are the hours of operation for Horizon Medicare plans?

about Horizon Medicare plans. 8 a.m to 8 p.m ET every day. Please be aware you have clicked on a link to visit another site operated by a third party. Horizon Blue Cross Blue Shield of New Jersey provides such links for your convenience and reference only.

Are there any out-of-network benefits with Horizon Medicare?

No out-of-network benefits, except in cases of medical emergencies. BlueCard® (out-of-area) coverage is not included. The Horizon Medicare Blue Advantage (HMO) plan uses a subset of physicians and other health care professionals who participate in the Horizon Managed Care Network, as well as a subset of facilities in the Horizon Hospital Network.

Does Horizon BCBSNJ offer Medicare Advantage plans?

The Horizon Medicare Blue Advantage (HMO) plan is not offered to Medicare-eligible beneficiaries that reside in Burlington, Camden, Cape May, Gloucester, Passaic and Salem counties. However, members who reside in these counties will have other Medicare Advantage options with Horizon BCBSNJ.

Is Horizon Blue Cross Blue Shield the same as Horizon NJ Health?

Headquartered in West Trenton, N.J., Horizon NJ Health, is a wholly-owned subsidiary of the Horizon Blue Cross Blue Shield of New Jersey, an independent licensee of the Blue Cross Blue Shield Association. Learn more at www.horizonNJhealth.com.

Is Horizon NJ Health a PPO or HMO?

If you qualify for both Medicaid and Medicare, Horizon NJ TotalCare (HMO D-SNP) is the plan that is right for you. It covers all Medicare and Medicaid benefits, plus additional features and services all at no cost to you.

Is Horizon Blue Cross Blue Shield of NJ Medicare?

Horizon Insurance Company ("HIC") has a Medicare contract to offer HMO, HMO-POS, PPO and Part D Medicare plans, including group-Medicare Advantage plans and group Part D Prescription Drug plans.

Is Horizon NJ Health Medicare or Medicaid?

Horizon NJ Health, New Jersey's largest managed healthcare company serving the publicly insured, provides quality healthcare services for more than 500,000 children and adults in the Medicaid and NJ FamilyCare programs. Horizon NJ Health provides benefits for New Jersey residents enrolled in the Medicaid program.

Is Horizon Blue Cross Blue Shield NJ direct a PPO?

The plan also covers you throughout the United States and around the world through the BlueCard® PPO program. Horizon Direct Access is a managed care plan that gives you access to many health care services and programs and our large national participating physician network.

Which NJ Medicaid HMO is best?

According to the NJ FamilyCare/Medicaid “HMO Performance Report” released last month, Horizon NJ Health received a 92% overall performance score, the highest of all New Jersey's Medicaid managed care plans and the only plan to improve its overall score from previous reports.

Is Horizon NJ Direct Medicare?

A7. Yes. The Horizon Medicare Advantage NJ DIRECT (PPO) plans provide in- and out-of-state coverage.

Is Horizon NJ Health free?

The medical care and services you get through Horizon NJ Health are free or low cost. Your benefits are determined by the NJ FamilyCare Program and are based on your income level and the number of people in your family.

Is Horizon Blue Cross Blue Shield only in NJ?

Horizon Blue Cross Blue Shield of New Jersey, headquartered in Newark, New Jersey is the only licensed Blue Cross and Blue Shield Association plan in New Jersey, providing health insurance coverage to over 3.2 million people throughout all of New Jersey....Horizon Blue Cross Blue Shield of New Jersey.3 Penn Plaza EastGeneral informationFloor count17/215 more rows

Is NJ FamilyCare the same as Medicaid?

New Jersey Medicaid, also known as the New Jersey Family Care program, is a health care program for those in financial need, funded by the federal government and the NJ state government. It's different from New Jersey Medicare.

Does Horizon NJ Health have an app?

Welcome to your Horizon health plan! We're glad to have you as our member. With the Horizon Blue app, you get 24/7 access to your member ID card, plan information, as well as care and support from your smartphone or other mobile device.

What is Horizon Blue Card?

What Is BlueCard? BlueCard enables eligible members to receive medical care when they are outside of New Jersey, Horizon Blue Cross Blue Shield of New Jersey's service area.

Find In-Network Doctors

If you need to find a new doctor who participates in one of our networks, our Doctor & Hospital finder makes it easy to find a health care professional who matches your needs.

Find In-Network Pharmacies

Search from more than 66,000 in-network pharmacies at Prime Therapeutics.

Find Covered Prescription Drugs

Find formulary drugs, prior authorization, and step therapy at Prime Therapeutics.

What is Horizon BCBSJ Pediatrics?

Recognizing that the health care needs of our youngest members require care designed just for them, Horizon BCBSNJ also has our Patient-Centered Pediatric Program. The program emphasizes preventive and developmental goals, and focuses on children with chronic conditions, such as asthma and diabetes.

How to be a patient centered doctor?

By receiving health care from a patient-centered practice: 1 The focus is on you — helping you get the care you need, when you need it. 2 The doctor directs a team of health professionals, including a nurse care coordinator, who can offer support, information and assistance. 3 Frequent communication within the team about care will allow your doctor to closely monitor your health conditions and respond immediately to you. 4 You have more ways to be in touch with the care team by phone, email and in person.

What is a nurse care coordinator?

The doctor directs a team of health professionals , including a nurse care coordinator, who can offer support, information and assistance. Frequent communication within the team about care will allow your doctor to closely monitor your health conditions and respond immediately to you.

How to contact HMOs in Puerto Rico?

Just call the 24-hour hotline at 1-800-810-BLUE (2583).

What is a PCP in HMO?

Your PCP is a duly licensed practitioner who has entered into an agreement with us to participate in the Horizon BCBSNJ Managed Care Network and is responsible for coordinating all aspects of your medical care, including referrals to specialists, ancillary providers, or inpatient facilities. Your PCP:

Does Horizon HMO have paperwork?

When using Horizon HMO doctors and hospitals, members have no claim forms to file and virtually no paperwork. All Horizon HMO providers handle all of the paperwork for members. 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. Members also have online access to claim status and other services to help make their health care experience more satisfying.