Horizon POS (Point of Service)
Coordinate your care with the Primary Care Physician (PCP) you select through your Horizon POS plan. Your PCP refers you to specialists available to you through your Horizon POS plan and submits your claims. Or you can go directly to any other licensed physician in exchange for paying more costs and submitting your own claims.
As a Horizon POS member, you have access to many health care services and programs and our large participating physician and hospital networks. We've made your health care plan easy for you to understand and use. We offer preventive health care benefits, an easy-to-use referral system, direct access to your Ob/Gyn, emergency medical care, value-added programs, and much more. You also have the choice of going directly to any provider for care. We refer to this as out-of-network care.
Good health begins with your Primary Care Physician
Your Horizon POS 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. If you do not wish to coordinate care through your PCP, you may visit physicians and specialists who are outside the participating network for covered services. Through this option, you pay more of the costs.
Easy service with no hassles
When using participating Horizon POS doctors and hospitals referred by your PCP, members have no claim forms to file and virtually no paperwork. All Horizon POS 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.
Portable benefits coverage
Horizon POS covers you for emergencies when traveling outside the state. You are covered at the in-network level of benefits if you call Member Services within 48 hours of a true medical emergency. If you receive nonemergency care in another state, you have coverage at the out-of-network level for eligible and medically necessary services.