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Understanding Your Coverage

Whether you’re a new member who’s just getting started or an existing member looking to get more out of your benefits, we’ve gathered some helpful resources here.

Understanding Your Costs

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

 HCR (Health Care Reform) Preventive Care Information Guide

Under the Affordable Care Act, Horizon BCBSNJ provides coverage for certain preventive care services at no costs to our members.

How to Find an In-Network Provider, Care Facility or Pharmacy

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.

Out-of-Network Payments

If your health plan includes benefits for out-of-network services or supplies, and you opt for such services or supplies, you generally will have higher out-of-pocket expenses than if you used in-network providers.

Calculator for the Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act

New Jersey has a law, the Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act (the “Act”), to help protect you from surprise bills, including bills for emergency services from doctors, hospitals and other health care professionals who are not in your health plan’s network (also called out-of-network providers). Read questions and answers to help you understand out-of-network care, surprise bills and how the Act can help you.

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.

Staying In Network

When you use a doctor or hospital that participates in our network, you will have lower out-of-pocket costs than if you use a doctor or hospital that does not participate.

The Role of Your Primary Care Physician or Personal Doctor

Your Primary Care Physician (PCP)1 or personal doctor is the most important part of your health care team. Learn more here.

Third Party Designation for Senior Citizen Insureds

Members who are enrolled in a Horizon BCBSNJ commercial product and are age 62 years or older can designate an additional person to receive a copy of certain notices.

Understanding the Exchange

Who to Contact When You Have a Question

Horizon Blue Cross Blue Shield of New Jersey wants you to have the information you need, when you need it.