Case Management FAQs

Yes, all programs are free to eligible members of Horizon BCBSNJ. Participation in the programs will not affect your premium or your status with the plan.

The Case Management Program is for members facing a life-changing medical condition, such as:

• A high-risk pregnancy or a newborn with medical issues.
• A cancer diagnosis.
• The need for heart surgery, an organ transplant, ventilator management, extensive home care or home infusion.
• A severe injury or paralysis.

All programs are completely voluntary. You can contact us at any time to cancel your participation.

Yes, we always work to ensure that all of your personal health information remains confidential.

DMEs and prescriptions are not covered as part of this program, but they may be available as part of your health plan. Check your plan information for details.

You may have been identified either through claims data, pharmacy data, your doctor's referral or case management. Members can be referred to our Case Management Program from other departments at Horizon BCBSNJ, including our Utilization Management department and Chronic Care Program department, the 24/7 Nurse Line, as well as, rehabilitation facilities, facility discharge planners, behavioral health providers, practitioners, caregivers and pharmacy vendors.

Eligible Horizon BCBSNJ members may enroll themselves or an eligible dependent in the Case Management Program by calling 1-888-621-5894 and selecting option 2. Representatives are available for assistance Monday through Friday, from 8 a.m. to 5 p.m., Eastern Time.