Senior Market Product Overview

Medicare Advantage

For 2018, Horizon Blue Cross Blue Shield of New Jersey is offering a new Medicare Advantage (MA) plan, Horizon Medicare Blue Advantage (HMO), for Medicare-eligible individuals. This $0 monthly premium plan offers low out-of-pocket costs, helping members on a fixed income get quality care they can afford. With Horizon’s Medicare Blue Advantage (HMO) plan, members can also save more by having access to our lowest prescription drug deductible, as well as low copays on both Primary Care Physician (PCP) visits and specialist visits. Members will also have access to the OMNIA Health Alliance, which includes doctors and hospitals working with us to make quality care affordable.

Horizon Medicare Blue Advantage (HMO) will be offered throughout New Jersey (excluding Burlington, Camden, Cape May, Gloucester, Passaic, and Salem counties) in four distinct services areas: Regions 1, 2, 3 and 4. Plan benefits are mostly the same across all of the regions; however, there are some differences in premiums and Rx deductibles. Horizon Medicare Blue Advantage (HMO) Regions 1, 2, and 3 offer a $0 monthly plan premium, while Region 4 (Morris, Atlantic, and Cumberland counties) offers a $75 monthly plan premium. Horizon Medicare Blue Advantage (HMO) Part D also differentiates slightly amongst all 4 regions. Region 1 and 2 offer a deductible of $285 for tiers 3, 4, and 5, while Region 3 offers a $345 deductible for tiers 3, 4, and 5. Region 4 offers a $0 deductible for all tiers. Members must reside in the counties shown below to enroll in the respective product.

New Medicare Advantage Individual Products for 2018 New Jersey County Service Areas
Horizon Medicare Blue Advantage (HMO) Region 1: Ocean, Monmouth
Horizon Medicare Blue Advantage (HMO) Region 2: Bergen, Essex, Hudson, Middlesex, Union, Mercer
Horizon Medicare Blue Advantage (HMO) Region 3: Somerset, Sussex, Warren, Hunterdon
Horizon Medicare Blue Advantage (HMO) Region 4: Morris, Atlantic, Cumberland

Horizon BCBSNJ is renewing the following MA products for Medicare-eligible individuals. Members must reside in the counties shown to enroll in the respective product. Members in the plans listed below will have access to Horizon BCBSNJ’s statewide Horizon Managed Care Network. Please see below for changes to the service areas for each 2018 HBCBSNJ Medicare Advantage plan.

Medicare Advantage Individual Products New Jersey County Service Areas
Horizon Medicare Blue Value (HMO) Cape May, Hudson, Salem, Union, Warren
Horizon Medicare Blue Value w/Rx (HMO) Cape May, Hudson, Salem, Union, Warren
Horizon Medicare Blue Choice w/Rx (HMO) Atlantic, Burlington, Camden, Cumberland, Gloucester, Hunterdon, Mercer, Morris, Passaic, Somerset, Sussex
Horizon Medicare Blue (PPO)

Horizon NJ TotalCare (HMO SNP)
Sussex

Atlantic, Cumberland, Essex, Gloucester, Hudson, Hunterdon, Mercer, Monmouth, Morris, Passaic, Salem, Somerset, Sussex, Union, Warren

Horizon Medicare Blue Access Group (HMO-POS) plans with and without prescription drug coverage are available to employer groups in New Jersey. Horizon BCBSNJ offers base group HMO-POS plans, and benefit riders are available for purchase to customize the plans for employer groups. Cost sharing and premiums will vary depending on the riders selected.

Medicare Advantage Group Products Service Area
Horizon Medicare Blue Access Group (HMO-POS) New Jersey
Horizon Medicare Blue Access Group w/Rx (HMO-POS) New Jersey

Our Horizon Medicare Blue Group (PPO) and Horizon Medicare Blue Group w/Rx (PPO) plans are available to employer groups to purchase to cover members in New Jersey and nationwide. These plans offer in- and out-of-network benefits. Horizon BCBSNJ offers a base group PPO plan, and benefit riders are available for purchase to customize the plan for employer groups. Cost sharing and premiums will vary depending on the riders selected.

Medicare Advantage Group Products Service Area
Horizon Medicare Blue Group (PPO) National
Horizon Medicare Blue Group w/Rx (PPO) National

Medigap

The following are Horizon BCBSNJ’s 2018 Medigap supplemental product offerings available in New Jersey. There are no changes from the prior year. Members can also enroll in a stand-alone Prescription Drug Plan (PDP) when choosing a Medigap product, if they want to have Part D prescription drug coverage.

Medigap Products
Horizon Contemporary Medigap Plan A Horizon Contemporary Medigap Plan K
Horizon Contemporary Medigap Plan G Horizon Contemporary Medigap Plan F
Horizon Contemporary Medigap Plan C Horizon Contemporary Medigap Plan N

Prescription Drug Plans

The following are Horizon BCBSNJ’s 2018 stand-alone PDP offerings. Members must reside in New Jersey to enroll in these products.

PDP Products Service Area
Horizon Medicare Blue Rx Standard (PDP) New Jersey
Horizon Medicare Blue Rx Enhanced (PDP) New Jersey

For 2018, Horizon BCBSNJ is offering lower premiums for both Horizon Medicare Blue Rx Standard (PDP) and Horizon Medicare Blue Rx Enhanced (PDP) with a $0 Rx deductible. Our network includes pharmacies with preferred cost-sharing, which may offer members lower cost-sharing than the standard cost-sharing offered by other pharmacies within the network. Our network also includes many well-known retail pharmacies such as:

  • CVS
  • Rite Aid
  • ShopRite
  • Target
  • Walmart

If Horizon BCBSNJ members or other New Jersey Medicare beneficiaries have questions or need help selecting a product, they may call 1-800-365-2223 or visit our website at Medicare.HorizonBlue.com.