Horizon Medicare Blue Group (PPO)

A Horizon Medicare Group PPO Plan gives employers the option of offering Medicare Advantage benefits to retirees who travel and/or live outside of New Jersey. The plan includes national coverage with no referrals through the Blue Cross and Blue Shield Association® Network Sharing Arrangement. Thirty-seven states, plus Puerto Rico, participate in this network. Plan options with both medical and prescription drug benefits are available.

Horizon Medicare Group PPO Plans:

  • Gives employers the option of offering Medicare Advantage benefits to retirees who travel and/or live outside of New Jersey.
  • Members do not have to select a Primary Care Physician (PCP).
  • National coverage with no referrals through the Blue Cross and Blue Shield Association® Medicare Advantage Network sharing arrangement.
  • Thirty-seven states, plus Puerto Rico, participate in this network.
  • MA PPO members can obtain in-network benefits in states not participating if they choose to receive services from participating Medicare providers.
  • Plan options with both medical and prescription drug benefits.

How PPO coverage works:

  • Members pay less by using doctors, hospitals and other health care professionals that participate in the Blue Cross and Blue Shield Association’s Medicare Advantage Network sharing arrangement.
  • If an option with different out-of-network cost share is selected, members may pay more if they seek care outside of the network.
  • If members reside or travel where there is no MA Blue PPO Network, then they will receive the in-network level of benefits when seeing a provider that accepts Medicare reimbursement.
  • Members do not have to select a Primary Care Physician (PCP).

For more information please, email MAPDGroups@HorizonBlue.com.