NJ DIRECT ZERO


NJ DIRECT ZERO offers the same benefits as NJ DIRECT, but encourages members to use in-network doctors, hospitals and other health care professionals by offering a zero copayment for primary care and specialist visits!

NJ DIRECT ZERO is offered to School Employees’ Health Benefit Program (SEHBP) active members and retirees who are not Medicare-eligible and are enrolled in an SEHBP plan. The plan offers the same benefits as NJ DIRECT, but encourages members to use in-network doctors, hospitals and other health care professionals by offering a zero copayment for primary care and specialist visits!

Members also have lower out-of-pocket costs when using in-network doctors and facilities in the BlueCard® PPO network nationwide.

Out-of-network benefits are included, but at comparably higher out-of-pocket expenses versus other NJ DIRECT plans1.

Members enrolled in NJ DIRECT ZERO can also receive $500 annually if they participate in NJWELL and complete the required activities.

Other features include:

  • 100% coverage for preventive services (physical exams, well-child care, immunizations) in network.
  • No requirement to select a Primary Care Physician (PCP).
  • See a specialist without a referral.
  • No claims to file when accessing care in network
  • Access to more than 1.3 million doctors, hospitals, facilities and other health care professionals in the U.S. through BlueCard®.
  • Blue Cross Blue Shield Global℠ Core coverage for eligible services when you and your covered dependents travel abroad.
  • Dedicated nurses for additional support in managing a condition or an episode of care..
  • Precious Additions®, a prenatal education and information program.
  • Online services to manage your personal benefit and claim information.
  • My Health Manager, powered by WebMD®, for a range of health and wellness tools and resources online.

All plans include:

  • Well Care and Preventive Care: Services such as annual physical and gynecological exams, well baby/child medical care, immunizations and annual vision exams are covered 100% when using an in-network doctor.
  • Behavioral Health and Substance Use Disorder: Counseling services are covered for mental/nervous conditions and alcohol/substance use disorder.
  • Horizon Health Guides: Your Horizon Health Guide can help with all your health care needs: answering questions, making medical appointments, solving issues, helping with claims, finding care, even making health and wellness benefit suggestions tailored to you. And we’ll help you manage a chronic health condition. Coming in February!
  • Telemedicine: Talk to a doctor 24/7/365 using Horizon CareOnline℠.
  • Health Programs: Registered nurses help you manage a chronic or complex health condition.
  • Precious Additions®: A prenatal education program supported by My Health Manager®, powered by WebMD®, gives you access to online tools and resources.

Your health plan may also include care outside of NJ through these options:


Some services require prior authorization.