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Horizon BCBSNJ Expands Member Access for Cologuard® Screening Test

Horizon Blue Cross Blue Shield of New Jersey is pleased to announce that effective July 15, 2018, we have extended our participating agreement with Exact Sciences Laboratories, LLC (Exact Sciences).

With this agreement, your patients enrolled in all fully-insured and Administrative Services Only (ASO) commercial plans¹ now have access to the Cologuard multi-targeted stool DNA screening test at their in-network level of benefits. Horizon BCBSNJ has had a participation agreement in place with Exact Sciences since 2015 for our Horizon BCBSNJ Medicare Advantage members.

The Cologuard test, available only through Exact Sciences, analyzes the presence of blood and certain DNA mutations in a patient’s stool sample and can indicate colon cancer and/or precancerous polyps.

Your patients may be eligible to take the Cologuard test (once every three years) if they are:

  • Between 50 and 85 years of age
  • Asymptomatic and
  • At average risk of developing colorectal cancer

Patients are NOT eligible for this test if they have:

  • Symptoms that you believe may be related to colon cancer
  • Previously had a positive colonoscopy that found polyps or cancer
  • A high-risk family history of colon cancer

Cologuard testing kits may be requested using the Cologuard Order Requisition Form. Completed forms may be submitted to Exact Sciences by:

Cologuard kits will be delivered directly to your patients and will include detailed instructions (in both English and Spanish. Exact Sciences will send completed test results to your office.

More information about Cologuard is available at cologuardtest.com.

¹The agreement entered into with Exact Sciences does not extend to members enrolled in any Horizon NJ Health plans/products [i.e., Medicaid Managed Care, NJ Family Care, Horizon NJ TotalCare (HMO SNP), and Managed Long-Term Services & Supports (MLTSS) plans].

Cologuard® is a registered trademark of Exact Sciences Laboratories, LLC.

Exact Sciences Laboratories, LLC is an independent company that supports Horizon Blue Cross Blue Shield of New Jersey in administration of Cologuard® testing for covered members. Exact Sciences Laboratories, LLC is independent from and not affiliated with Horizon Blue Cross Blue Shield of New Jersey.

Published on: August 16, 2018, 13:57 p.m. ET
Last updated on: January 8, 2020, 03:40 a.m. ET