Understanding Your OMNIA℠ Health Plan

Welcome to your OMNIA Health plan — you’ve made a great choice.

As an OMNIA Health Plan member, you get the peace of mind that comes with New Jersey’s largest and most trusted health insurer.

You also get the strength and stability that comes with our years of experience serving our members.

You have the freedom to receive care from any doctor, specialist, or hospital participating in our managed care and hospital networks. No referrals required.

And, if your plan includes prescription drug coverage, it’s accepted at pharmacies across the state.

As an OMNIA Health Plan member, you can also save money. Doctors and hospitals are grouped into two tiers — OMNIA Tier 1 and Tier 2.

When you choose an OMNIA Tier 1-designated doctor and hospital for your care, you will pay less out of pocket, including lower copays and deductibles, or even no deductibles at all.

Visit our Online Doctor & Hospital Finder today to find out who’s participating in our networks.

You can also use our exclusive, member-only tools when you sign in to the secure member web portal and Horizon Blue app.

Once signed in, you can see your plan summary, detailed information on office visits, services rendered, how much your OMNIA Health Plan paid and how much you owe, if any, your Member ID card and much more.

Having all this detailed information at your fingertips 24/7 lets you get the most out of your OMNIA Health Plan.

Now and always, Horizon Blue Cross Blue Shield of New Jersey is here when you need us most.

Health insurance can be confusing. But knowing how your health plan works, like what’s covered and what’s not, will help you get the most out of your benefits.

[Text appears: Understanding Your OMNIA Health Plan: OMNIA Tier 1 and Tier 2]

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

With your OMNIA Health Plan, you must get care from doctors, hospitals and other health care professionals that are in network.

Your OMNIA Health Plan does not include out-of-network coverage, unless it is a true medical emergency.

With your OMNIA Health Plan, all in-network doctors and hospitals are listed as either OMNIA Tier 1 or Tier 2.

You’re covered if you get care from any doctor or hospital in these tiers. But you’ll pay less for your care if you use an OMNIA Tier 1 doctor or hospital.

Let’s look at an example.

You’ve injured your ankle while running and need to see a specialist.

It’s easy to find a specialist that’s in OMNIA Tier 1 or Tier 2 by using the Horizon Blue app.

You can also visit the Doctor & Hospital Finder at HorizonBlue.com/doctorfinder, simply select the type of care you’re looking for, and choose your OMNIA Health Plan from the dropdown menu.

If you select a specialist in OMNIA Tier 1 here, you’ll pay lower out-of-pocket costs. It’s that simple!

And if your OMNIA Health Plan includes BlueCard®, you also have access to in-network coverage for routine care outside of New Jersey through the BlueCard network.

[Image on screen: HorizonBlue app screen showing a member ID card with the suitcase logo circled]

Remember, to get to the most from your OMNIA Health Plan, you must get care from an in-network doctor or hospital.

Connect with us to learn more.

[Text appears: Connect With Us – HorizonBlue.com, Horizon Blue app]

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

[Text appears: Horizon Blue Cross Blue Shield of New Jersey disclaimer]

Choosing an in-network doctor or hospital is an important decision.

[Text appears: OMNIA Health Plan—Save Money by Staying In Network]

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

And we’ve made it easier by giving you the freedom to get care from any in-network doctor, hospital or other health care professional listed as OMNIA Tier 1 or Tier 2.

Both OMNIA Tier 1 and Tier 2 are considered in network for all OMNIA Health Plans.

Why is this so important?

In-network doctors and hospitals have agreed to provide high-quality care and services to Horizon members, but at a lower cost to you.

Your OMNIA Health Plan does not include out-of-network benefits. That means, if you get care from an out-of-network doctor or hospital, you’ll have to pay for your care out of your own pocket.

The only exception is a true medical emergency. You’re always covered for emergency care no matter who you see or where you go.

Don’t worry though; finding an in-network doctor or hospital is easy!

Just sign in to the Horizon Blue app or visit the Doctor & Hospital Finder at HorizonBlue.com/doctorfinder.

And if your OMNIA Health Plan includes BlueCard®, you also have access to in-network coverage for routine care outside of New Jersey through the BlueCard network.

[Image on screen: HorizonBlue app screen showing a member ID card with the suitcase logo circled]

Knowing how to use your OMNIA Health Plan will help you get the most from your benefits so you can achieve your best health.

Connect with us to learn more.

[Text appears: Connect With Us – HorizonBlue.com, Horizon Blue app]

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

[Text appears: Horizon Blue Cross Blue Shield of New Jersey disclaimer]