You do not need a referral to see an in-network specialist. However, you must select a provider who participates in Horizon NJ Health’s network. Please let your PCP know if you are seeing a specialist.
Is Horizon NJ Health considered Medicare?
Our PlansHorizon NJ TotalCare (HMO D-SNP)
It covers all Medicare and Medicaid benefits, plus additional features and services all at no cost to you. With one easy plan, from a name you trust, you get a team of doctors, specialists and Care Managers working together just for you.
Is Horizon NJ Health the same as Blue Cross Blue Shield?
Headquartered in West Trenton, NJ, Horizon NJ Health is wholly owned by Horizon Blue Cross Blue Shield of New Jersey.
Is Horizon NJ Health the same as 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.
Do you need a referral to see a specialist with Horizon NJ Health? – Related Questions
Does Horizon NJ Health pay for braces?
Covered Coverage includes (but is not limited to) arm, leg, back and neck braces; artificial eyes; artificial limbs and replacements; certain breast prostheses following mastectomy; and prosthetic devices for replacing internal body parts or functions. Also covers certified shoe repair, hearing aids and dentures.
Are dental implants covered by Horizon NJ Health?
Comprehensive Dental Benefits
The following covered services require Prior Authorization: crowns, bridges, full dentures, partial dentures, gum treatments, root canals, surgical extractions, complex oral surgery, implants when medically necessary to support a complete denture, and orthodontics.
Is Horizon NJ Health NJ FamilyCare Medicaid?
With Horizon NJ TotalCare (HMO D-SNP), members get both Medicare and Medicaid benefits in one plan. To keep these benefits, the member must keep his or her Medicaid (NJ FamilyCare) eligibility up to date and renew annually.
What type of insurance is Horizon NJ?
Learn about Horizon NJ Health, a Medicaid Managed Care health plan offered through the NJ FamilyCare program.
What is Medicaid in NJ called?
NJ FamilyCare is the name for New Jersey’s Medicaid program. It helps qualified New Jersey residents get access to affordable health insurance.
What type of plan is Horizon NJ Health?
Horizon NJ TotalCare (HMO D-SNP)
It covers all Medicare and Medicaid benefits, plus additional features and services all at no cost to you. With one easy plan, from a name you trust, you get a team of doctors, specialists and Care Managers working together just for you.
Does Horizon NJ Health cover weight loss?
Horizon NJ Health is a Medicaid plan which covers weight loss surgery. Dr. Gritsus participates in Horizon NJ Health for weight loss surgery only, not general surgery.
Does Horizon NJ Health cover ER visits?
Go to the nearest hospital to treat your emergency, even if the hospital or doctor does not participate with Horizon NJ Health. All hospitals must provide emergency care. You are covered for emergencies 24 hours a day, seven days a week. This includes follow-up care in and out of the hospital.
Does Horizon NJ Health cover MRI?
The Advanced Imaging Services included in this program are CT/CTA, MRI/MRA, PET and Nuclear Medicine studies (including Nuclear Cardiology).
Does Horizon NJ Health Cover shingles vaccine?
As a Horizon health plan member, you can get a flu shot and other immunizations, including shingles, hepatitis A and B, pneumococcal and human papillomavirus (HPV), at no cost when you go to in-network doctors and certain pharmacies.
Does CVS accept Horizon NJ Health?
You can fill your prescription(s) at one of more than 2,000 convenient pharmacy locations throughout New Jersey, including major retail pharmacies such as CVS, Walgreens and Rite Aid.
Can Horizon NJ Health be used in other states?
Horizon NJ Health will need to coordinate care between your doctor and any doctor not participating with Horizon NJ Health. Horizon NJ Health will not cover care received outside of the United States and its territories. For more information on emergency care please visit “When to Use the Emergency Room”.
Which HMO is the best in NJ?
According to our research, the best PPO plan in New Jersey is the Aetna Medicare Explorer Premier Plus plan, while the top HMO plan is the Humana Gold Plus H6622-063 plan.
Is Horizon NJ Medicare or Medicaid?
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.
Can I use my NJ insurance card in another state?
All health insurance plans regardless of the state of purchase will cover emergency services at any hospital in the United States, with the exception of Hawaii. However, non-emergency care, like primary care visits, might not be covered.
What insurance is accepted in all 50 states?
Most Blue Cross Blue Shield members can rest easy since Blue Cross Blue Shield coverage opens doors in all 50 states and is accepted by over 90 percent of doctors and specialists. And if your extended travel plans take you abroad, you can ensure you have access to quality care through GeoBlue.
