Horizon Advantage EPO provides integrated medical and pharmacy benefits, including wellness and emergency care. In New Jersey, members have access to all doctors, specialists and hospitals that participate in Horizon’s Managed Care Network. That means access to over 6,400 Primary Care Physicians (PCPs) and over 23,500 specialists throughout the state.*
Advantage EPO also provides members with access to doctors and hospitals outside of New Jersey with BlueCard® PPO. More than 600,000 physicians and over 6,000 hospitals participate in the network, the largest health care network in the nation.*
If care is received from a nonparticipating provider, there is no benefit coverage. It is the member’ responsibility to confirm that the doctors and specialists they are seeing participate in the network. Claims will not be paid if care is received from a doctor who is not in the network.
No PCP or Referral Needed
With the Advantage EPO plan, members do not need to select a PCP, and referrals are not needed to access specialty care. Members can access any network doctor or hospital at any time and enjoy the in-network level of benefits. Although members are not required to select a PCP, there are lower out-of-pocket costs when care is coordinated through a PCP.
When in New Jersey, care must be received from doctors, hospitals and health care professionals in the Managed Care network. If members are outside of New Jersey, care should be received from a participating BlueCard® PPO doctor, hospital or other health care professional.
In a life- or limb-threatening emergency, members should go to the nearest hospital regardless of their network participation status.
Easy Service — No Hassles
Horizon members can get support and care from their mobile device or computer – anytime, anywhere – with the Horizon Blue app.
*Numbers accurate at time of posting.