OMNIA℠


The OMNIA Health Plan consists of 4 tiers that provide different levels of savings:

  • Inner Circle Prime
  • HMH Inner Circle
  • OMNIA Tier 1
  • Tier 2

It gives you and your eligible dependents access to a large network of doctors, specialists, hospitals and facilities in New Jersey. You’ll enjoy the highest level of benefits at the lowest out-of-pocket costs when you use facilities, doctors and health care professionals that participate in HMH Inner Circle programs. Choose Inner Circle Prime for the greatest savings with no copays and no deductibles when you use participating doctors, hospital and other health care professionals, or Inner Circle for the same high level of benefits, with no deductible and a low copay. As part of this plan you’ll also have access to in-network coverage outside of New Jersey using BlueCard®.

There are no out-of-network benefits with this plan.

New for 2021: OMNIA℠

Transcript

Narrator: Hackensack Meridian Health is pleased to offer our team members a new plan for 2021.

This new plan, the OMNIA Health Plan, gives you greater access to a wide range of doctors, hospitals, and other health care professionals. Plus, with the Inner Circle and Inner Circle PRIME tier providers, you’ll enjoy the highest level of benefits with low or no copays, coinsurance or deductibles. And, as with every Hackensack Meridian Health 2021 health plan, you’ll also have access to in-network coverage outside of New Jersey through BlueCard®.

The amount of money you pay out-of-pocket will depend on which tier your doctor or facility participates in. Let’s walk through each of the four possible scenarios.

You’ve injured your knee playing softball and need to see a specialist. Your team mate suggests you make an appointment with Dr. Smith. You refer to the Doctor and Hospital finder at Horizon Blue.com/hmh or the Horizon Blue app, look up Dr. Smith and discover that she participates in the Inner Circle PRIME tier. This means that your visit will cost you nothing.

In this next scenario, you refer to the Doctor and Hospital Finder and learn that Dr. Smith participates in the Inner Circle tier. While she is not in the PRIME tier, you will still save money by choosing Dr. Smith. With an Inner Circle doctor, you still have no deductible to meet and no coinsurance. Your only cost will be a $15 specialist copay. If you were seeing a PCP at this level, your copay would be $5.The OMNIA Health Plan also includes two additional tiers of in-network providers. OMNIA Tier 1 includes thousands of physicians and other health care professionals within the Horizon Managed Care Network.

In our third example, if you visit the Doctor and Hospital Finder and learn that Dr. Smith is in OMNIA Tier 1, it means your visit will cost you a $100 specialist copay, or $50 for a PCP. In addition, all other services beyond office visits are subject to a $1,500 annual deductible and once met, you will then be responsible for 30% coinsurance. Tier 2 also includes in-network doctors, specialists and facilities. If you choose to see a physician or hospital within Tier 2, you will pay more out-of-pocket.

In this final case, you choose to see Dr. Smith and learn that she falls within Tier 2. You must first meet a $2,000 deductible before your Horizon Blue Cross Blue Shield of New Jersey benefits kick in. Once you have satisfied your annual deductible, you will then be responsible for 50% of all costs up to your out-of-pocket maximum.

This plan gives you many options to get the high quality care you need so you can get and stay healthy. To find an in-network doctor, specialist, facility or hospital, visit HorizonBlue.com/hmh.