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Horizon members can sign in to their member account to use our current Treatment Cost Estimator tool, which includes more than 500 services.

The cost estimator tool required under the Rule will be available beginning January 1, 2023, and will include more information, including estimates for additional procedure codes and care received out-of-network.

Cost estimates will reflect the current available information so that members can understand their health care costs based on their benefits, deductible and/or out-of-pocket accumulations. The cost estimator tool must be available to participants, beneficiaries and enrollees, or their authorized representative. The tool must:

• Include both in-network and out-of-network estimated costs.
   
• Allow members or personal representatives to search based on billing code or description of the billing code.
   
• Advise members of their current status toward their deductible, out-of-pocket maximums and their accumulations to date.

This same information must also be available in writing at the member’s request.

Cost estimator tools help members compare cost and quality across health care professionals, so they can select the health care professional who is right for them. Additionally, members can better understand their potential out-of-pocket costs before getting care. This enables them to prepare for the care they need while managing their finances.