Horizon Direct Access
Horizon Direct Access is a direct access plan that gives you flexibility in choosing your medical care. You can coordinate your care through your Primary Care Physician (PCP) to obtain the highest level of benefits (the selection of a PCP is optional), visit a physician in the Horizon BCBSNJ Managed Care Network, or go directly to any licensed doctor. The plan also covers you throughout the United States and around the world through the BlueCard® PPO program. Horizon Direct Access is a managed care plan that gives you access to many health care services and programs and our large national participating physician network. We've made your health care plan easy for you to understand and use. We offer preventive care benefits, emergency medical care, away-from-home care, and value-added programs.
Good health begins with your Primary Care Physician
Your Horizon Direct Access plan starts with your Primary Care Physician (PCP). Your PCP is a duly licensed practitioner who has entered into an agreement with us to participate in the Horizon BCBSNJ Managed Care Network and is responsible for coordinating all aspects of your medical care, including referrals to specialists, ancillary providers, or inpatient facilities. Or you may go to any other physician or specialist if you choose not to coordinate care through your PCP. Selecting a PCP can help make sure you receive the right care at the right time, by the right health care professional. As your personally selected doctor, your PCP provides medical care or refers you to the appropriate source for medical care, whether that source is a specialist physician, ancillary provider, or inpatient facility. Your PCP also coordinates the health care services you obtain from providers participating in the Horizon Managed Care Network and provides care or a referral for preventive care services.
Easy service with no hassles
When using participating Horizon Direct Access doctors and hospitals, members have no claim forms to file and virtually no paperwork. All Horizon Direct Access providers handle all of the paperwork for them. Plus, Horizon BCBSNJ offers toll-free customer service Monday through Friday, 8 a.m. to 6 p.m., Eastern Time (ET), so members can get the help they need. Members also have access to Member Online Services, where they can look up claim status and enjoy other online services to make their health care experience more satisfying.
How to locate a Horizon Direct Access provider
Members can locate Horizon Direct Access network providers with the Doctor & Hospital Finder or they can also call Member Services at 1-800-355-BLUE (2583) to access participating providers.
Portable benefits coverage
You have peace of mind knowing that your coverage includes the BlueCard PPO program. The BlueCard PPO program links you directly to care anywhere in the country as well as in Puerto Rico and the US Virgin Islands. More than 90 percent of all doctors and hospitals throughout the United States participate in the BlueCard PPO national network. Use the National Doctor and Hospital Finder to locate participating doctors and hospitals near or at your travel destination in the United States. For international travel,you can access doctors, hospitals and other health care professionals through Blue Cross Blue Shield Global Core and GeoBlue.