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OMNIA Health Plans

OMNIA Health Plans give enrolled members the flexibility to use any hospital participating in our Horizon Hospital Network and any physician, other health care professional or ancillary provider participating in our Horizon Managed Care Network. OMNIA Health Plan members will maximize their benefits and have lower out-of-pocket costs when they use physicians, ancillary providers, hospitals or other health care professionals who are designated as OMNIA Tier 1. There are no out-of-network benefits except in cases of medical emergencies.

Features of our OMNIA Health Plans:

  • Primary Care Physicians (PCPs) are not required.
  • No referrals.
  • Certain services/supplies require prior authorization.
  • Members are covered for eligible preventive services (physical exams, well-child care, immunizations, etc.) with no member cost sharing when these services are provided by an in-network physician or other health care professional, regardless of tier status.
  • No out-of-network benefits, except in cases of medical emergencies.
  • Some OMNIA Health Plans include BlueCard® (out-of-area) coverage.
  • Some OMNIA Health Plans are qualified High-Deductible Health Plans (HDHPs) and are compatible with or paired with a Health Savings Account (HSA).