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Understanding Your Coverage

Are You New to Horizon?

Learn about your new individual or family health coverage.

Individual or Family Health Coverage

Transcript

Hi. We want to help you understand your new Horizon plan.

Your plan helps you stay healthy with a yearly wellness visit, vaccinations and preventive health screenings, at no additional cost to you when you receive care from in-network doctors, hospitals and other health care professionals.

[Text appears: Coverage Includes:

  • Yearly wellness visit
  • Vaccinations
  • Preventive health screenings ]

Other services such as lab and radiology services, and pre-and post-natal care, including Doula services, may include some out-pocket-costs,

[Text appears: Coverage Includes:

-Lab and radiology services

-Pre- and postnatal care, including Doula services]

like your monthly premium, a deductible, copays and/or coinsurance.

[Text appears: Out-of-Pocket Costs

  • Premium
  • Deductible
  • Copays
  • Coinsurance ]

Let’s walk through each of these together.

Your premium is the amount you pay for your health insurance every month. Be sure to make your first premium payment.

[Text appears: Premium

The amount you pay for your health insurance every month ]

Paying your premium on time is important to keeping your health coverage.

If your plan has a deductible, this is the amount you pay for covered services, other than preventive care, before your health plan kicks in.

[Text appears: Deductible

The amount you pay for covered services before your health plan kicks in ]

When you get care, you’ll need to pay a copay. Copays are a fixed amount you pay for each medical visit to an in-network doctor or other health care professional, usually at the time of service.

[Text appears: Copay

The amount you pay at the time the service is received ]

And lastly, coinsurance is the percentage you pay for a covered service after you've fully paid your deductible.

[Text appears: Coinsurance

The percentage of costs of a covered health care service you pay after you’ve paid your deductible ]

You can check your Summary of Benefits and Coverage to find information about these costs.

[Image on screen: Member portal is displayed on laptop computer screen]

When you need to get care, be sure to have your member ID card ready.

In addition to your physical member ID card, you can also access your digital member ID card by registering and signing in to HorizonBlue.com and the Horizon Blue app.

[Image on screen: Digital member ID card is displayed on mobile device via the Horizon Blue app]

[Image on screen: Member portal is displayed on laptop computer screen, Horizon Blue app is displayed on mobile device]

[Text appears:

HorizonBlue.com

Horizon Blue app]

To make sure your doctors participate with your plan, use Horizon’s online Doctor and Hospital Finder.

[Image on screen: Doctor & Hospital Finder is displayed on laptop computer screen, QR code]

[Text appears: HorizonBlue.com/doctorfinder]

And don’t forget about your medicines.

Check to see which ones are covered under your new plan.

[Image on screen: MyPrime.com webpage is displayed on laptop computer screen, QR code]

[Text appears: MyPrime.com]

We offer convenient ways to help you get the answers and the care you need.

[Text appears: Connect With Us

  • HorizonBlue.com
  • Horizon Blue app
  • Read FAQs
  • Email us
  • Chat ]

Sign in at HorizonBlue.com, or the Horizon Blue app.

[Image on screen: Member portal and FAQs are displayed on laptop computer screen]

No matter what your health care needs are, Horizon is committed to helping you achieve your best health.

Thank you for being a Horizon member.

[Image on screen: Horizon Blue Cross Blue Shield of New Jersey logo]

[Text appears: Legal disclaimer]

Understanding Your Pharmacy Benefits

Have pharmacy coverage from Horizon? Learn more here.

Navigating the Health Network

If you need help finding a provider, understanding your network choices or getting your member information, you can learn more here.

Qualifying Life Events

When major events happen in your life, the last thing you want to think about is having to change your health insurance coverage.

Understanding Your Costs

The more you know about your health plan, the easier it is to make the best health care decisions.

Understanding Your HMO Plan

Learn more about your coverage if you are enrolled in an HMO plan from Horizon.

Understanding Your OMNIA Health Plan

All the resources you need in one place.