How can we help?

No-cost flu shots are available to Horizon BCBSNJ members with medical benefits who are enrolled in a fully insured¹ plan or a self-insured² plan.

To get a no-cost flu shot or other vaccination, members must use pharmacies in New Jersey that are contracted with Horizon BCBSNJ’s medical network to provide immunizations. If you live outside of New Jersey, you can go to a MinuteClinic® at select CVS locations. Find a pharmacy near you that offers no-cost flu shots. Or, call your doctor.

You can find out if you are covered for diagnostic tests, such as X-rays and MRIs, by signing in and following these steps:

1. Click Benefits & Coverage.
2. Click What’s Covered.
3. Under the Medical tab, go to the dropdown menu titled Service you may need to select the correct type of diagnostic service (Diagnostic X-Ray or MRI/Cat Scan) and click Show Coverage Details.
4. Then check the chart(s) to see if the benefit is covered, how much your plan will pay, and if prior authorization is required. You may need to scroll down to view all the information you need.

Check the column titled Prior Authorization if it is required for this benefit. Your in-network doctor or other health care professional or hospital will be responsible for requesting prior authorization for you.

You can also get help scheduling your test at a participating facility by calling 1-866-969-1234.

You can find out if you are covered for chiropractic care by signing in and following these steps:

1. Click Benefits & Coverage.
2. Click What’s Covered.
3. Under the Medical tab, go to the dropdown menu titled Service you may need to select Chiropractic and click Show Coverage Details.
4. Then check the chart(s) to see if the benefit is covered, how much your plan will pay, how many sessions are covered and if prior authorization is required. You may need to scroll down to view all the information you need.

To find a participating chiropractor, visit our Doctor & Hospital Finder and click Medical. Then, type Chiropractic Medicine.

You can find out if you are covered for physical therapy by signing in and following these steps:

1. Click Benefits & Coverage.
2. Click What’s Covered.
3. Under the Medical tab, go to the dropdown menu titled Service you may need to select Physical Therapy and click Show Coverage Details.
4. Then check the chart(s) to see if the benefit is covered, how much your plan will pay, how many sessions are covered and if prior authorization is required. You may need to scroll down to view all the information you need.

To find a participating physical therapist, visit our Doctor & Hospital Finder and click Medical. Then, type Physical Therapist.

You can find out if you are covered for lab services by signing in and following these steps:

1. Click Benefits & Coverage.
2. Click What’s Covered.
3. Under the Medical tab, go to the dropdown menu titled Service you may need to select Diagnostic Lab and click Show Coverage Details.
4. Then check the chart(s) to see if lab services are covered and if you need prior authorization. You may need to scroll down to view all the information you need.

To find a participating lab near you, use our Doctor & Hospital Finder and click Medical. Then type Laboratory – Patient Centers.

Pathology services provided in a hospital setting to members enrolled in Horizon BCBSNJ managed care plans by a practice that participates in the Horizon Managed Care Network are allowed as an exception to the LabCorp/Quest Diagnostics network use requirements.

To find a participating DME provider, visit our Doctor & Hospital Finder and click Medical. Then, type Durable Medical Equipment Supplier.

Find out if you have coverage for DME by signing in and following these steps:

1. Click Benefits & Coverage.
2. Click What’s Covered.
3. Under the Medical tab, go to the dropdown menu titled Services you may need. Select Durable Medical Equipment, Durable Medical Equipment Purchase, or Durable Medical Equipment Rent, and click Show Coverage Details. Note: Some DME can be rented, while others must be purchased. The decision to rent or purchase depends on several factors, including, but not limited to, the type of equipment, length of need and information provided by your doctor.
4. Check the chart(s) to see if the benefit is covered, how much your plan will pay, and if prior authorization is required. You may need to scroll down to view all the information you need.

Find out if you have coverage for DME by signing in and following these steps:

1. Click Benefits & Coverage.
2. Click What’s Covered.
3. Under the Medical tab, go to the dropdown menu titled Services you may need. Select Durable Medical Equipment, Durable Medical Equipment Purchase, or Durable Medical Equipment Rent, and click Show Coverage Details. Note: Some DME can be rented, while others must be purchased. The decision to rent or purchase depends on several factors, including, but not limited to, the type of equipment, length of need and information provided by your doctor.
4. Check the chart(s) to see if the benefit is covered, how much your plan will pay, and if prior authorization is required. You may need to scroll down to view all the information you need.

Horizon BCBSNJ is closely monitoring the COVID-19 pandemic and remains committed to providing our members with access to quality health care. Visit HorizonBlue.com/coronavirus-2019 to learn more about how Horizon BCBSNJ is helping our members and communities. Be sure to check HorizonBlue.com/coronavirus-2019 regularly, as it is continuously updated as more information becomes available.

Durable Medical Equipment, or DME, is equipment or supplies designed for home use that provide therapeutic benefits to people who have certain medical conditions and/or illnesses. Examples of DME include breast pumps, sleep apnea machines, diabetic supplies (such as blood testing strips or monitors), orthotics, prosthetics, wheelchairs, hospital beds and oxygen tanks, among others.

All Horizon BCBSNJ members have full coverage for preventive care at no cost as long as the care is provided by an in-network doctor or health care professional.Listed below are a few examples of preventive care services:

• Vaccinations (flu, measles and hepatitis)
• Cancer screenings (colorectal screenings, mammograms and Pap tests)
• Adult well care (cholesterol and blood pressure)
• Newborn care (hearing and blood tests)
• Children well-visits (obesity, evaluation, measurements)
• Pregnancy care (gestational diabetes, screenings)

For more details, and to see if a specific service is covered under your health plan, sign in and follow these steps:

1. Click Benefits & Coverage.
2. Click What’s Covered.
3. Under the Medical tab, go to the dropdown menu titled Service you may need. Choose the appropriate preventive service. For routine physicals, select Routine Physical. For vaccinations, select Flu Vaccination or Immunizations.
4. Click Show Coverage Details.