Welcome to this year’s dental open enrollment
Please take a moment and review the disclaimer.
Thank you for your interest in the Horizon DPO, the state’s dental plan from Horizon Blue Cross and Blue Shield of New Jersey. This dental plan, also known as Horizon dental choice or HDC, is a comprehensive dental plan which offers benefits and services with little or no cost to you when these services are provided by the primary care dentist you select from the HDC network.
By enrolling in the Horizon Dental Choice plan, you also receive access to the Horizon Healthy Discounts program, called Blue365, and you will be eligible to earn points towards your NJWELL annual incentive.
With Horizon dental choice, you have no copayment for preventative services and most basic services. This means services such as your dental exams, cleanings, x-rays and even sealants would be at no charge. For Eligible major and specialty dental services, such as crowns, root canals, bridgework or dentures, you pay a fixed copayment. There is also coverage for orthodontia or braces, for children and adults on your plan. For children up to the age of 18, there is a copayment of $1000, or 50% of the treatment plan, whichever is less. The copayment for Adults is $1750 or 50% of the treatment plan, whichever is less. This means that the total cost for your child’s orthodontia services, which may take 2 years or more, will be no more than $1000 when you are referred by your HDC primary care dentist to a participating orthodontist for the start of treatment.
For all services, there are no deductibles, no annual maximums and no claim forms to file. Services must be performed by your HDC primary care dentist, which you will select when you enroll. Your primary care dentist could also refer you to a specialist from Horizon’s PPO network. There are no out of network benefits. Each family member can have their own primary care dentist. If at any time, you wish to change your primary care dentist, you can simply call 1-800 4 dental, which is the number on the back of your ID card. You can then select another dentist from the HDC network. If that changes is made by the 15th of the month, you can see your new dentist after the 1st of the following month. Your ID card will show the name of your primary care dentist. If you change dentists, you will receive a new ID card.
Please refer to the State’s Dental member guide book for employees or retirees for a detailed list of covered services and specific copayments, when applicable, as well as eligibility rules and enrollment policies.
Do you need help finding a dentist? You can use the online doctor and hospital finder to search for a primary care dentist. Here’s how it works: Visit horizonblue.com/doctorfinder, select dentists in the category menu, then choose Horizon dental choice for your plan, enter your ZIP Code and click search.
Again, if you need to see a specialist, your primary care dentist will coordinate services.
Horizon provides a member portal and by signing into horizonblue.com/members, you can get information on claim status, verify your enrollment or benefits, request a new ID card or locate a dentist. You could also call the toll free number which is 1-800 the number 4 DENTAL, for 24 hour seven day a week assistance. This number will be on the back of your ID card.
With the Horizon dental choice plan, you will also have access to Blue365 a discount program administered by the Blue Cross Blue Shield Association. You can register at the website you see here, www.blue365deal.com. If you do not have medical coverage with Horizon and only have the Horizon dental choice plan, use the Alpha prefix 224 access. Through Blue365 you can save on products and services from national and local retailers such as fitness apparel and equipment, child safety products, health magazines, glasses, contacts, oral care products and more.
At Horizon, we understand that oral health is very important to your overall wellness. Research shows that there’s a synergic relationship between oral health and overall wellness. Gum disease is linked to a host of illnesses including heart disease, diabetes, respiratory disease, osteoporosis and rheumatoid arthritis. Your dentist can play an important role is spotting undiagnosed chronic diseases and helping to manage effects of the disease on your teeth and gums. Your Horizon health guide may connect you to care management programs and help you understand the impact that certain medications and chronic conditions may have on your oral and overall health.
As soon as you are enrolled, schedule your preventative dental visit. Then you record your visit on the NJWELL rewards page to earn points towards your annual incentive.
Thank you for your interest in the Horizon DPO, Horizon dental choice.
If you have any questions please do not hesitate to contact us or visit horizonblue.com/SHBP.
Thank you
