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Advantage EPO Essentials

Horizon Advantage EPO members use the Horizon Managed Care Network in New Jersey and may have access to BlueCard providers outside of New Jersey. This product does not require PCP selection or referrals. There are no benefits for out-of-network services, unless accessed in an emergency or otherwise approved. The Advantage EPO Essentials plan is available to individuals under 30 and is a good choice if you don’t expect to use a lot of medical services.

Features

  • Enjoy access to our entire Managed Care Network, the largest physician network in NJ*
  • No primary care physician required
  • No referrals needed
  • Prescription coverage included
*Based on physician data as of 8/28/17 and is subject to change.
Individual Deductible $7,350
  • Enjoy access to our entire Managed Care Network, the largest physician network in NJ*
  • No primary care physician required
  • No referrals needed
  • Prescription coverage included
  • pdf-form-icon Summary of Benefits and Coverage
Family Deductible $14,700
Individual Max Out-of-Pocket $7,350
Family Max Out-of-Pocket $14,700
Primary Care Physician Visit $0 copayment for three visits then deductible
Specialist Visit Deductible then no charge
Outpatient Surgery Deductible then no charge
Inpatient Hospital Stay Deductible then no charge
Emergency Room Deductible then no charge

*Based on physician data as of 8/28/17 and is subject to change.

Advantage EPO Bronze

Horizon Advantage EPO members use the Horizon Managed Care Network in New Jersey. This product does not require PCP selection or referrals. There are no benefits for out-of-network services, unless accessed in an emergency or otherwise approved. Bronze plans, on average, pay for 60% of the covered medical expenses; you pay 40%, and money-saving subsidies may be available. The Advantage EPO Bronze Plan is a good choice if you don’t expect to use a lot of medical services.

Features

  • Enjoy access to our entire Managed Care Network, the largest physician network in NJ*
  • No primary care physician required
  • No referrals needed
  • Prescription coverage included
*Based on physician data as of 8/28/17 and is subject to change.
Individual Deductible $3,000
  • Enjoy access to our entire Managed Care Network, the largest physician network in NJ*
  • No primary care physician required
  • No referrals needed
  • Prescription coverage included
  • pdf-form-icon Summary of Benefits and Coverage
Family Deductible $6,000
Individual Max Out-of-Pocket $7,350
Family Max Out-of-Pocket $14,700
Primary Care Physician Visit $30 copayment
Specialist Visit Deductible then 50% coinsurance
Outpatient Surgery Deductible then 50% coinsurance
Inpatient Hospital Stay Deductible then $500 per day copayment
Emergency Room $100 copayment & deductible then 50% coinsurance

*Based on physician data as of 8/28/17 and is subject to change.

Advantage EPO Silver

Horizon Advantage EPO members use the Horizon Managed Care Network in New Jersey. This product does not require PCP selection or referrals. There are no benefits for out-of-network services, unless accessed in an emergency or otherwise approved. Like other Silver plans, it pays for 70% of your covered medical expenses on average; you pay 30%, and money-saving subsidies may be available. The Advantage EPO Silver Plan is a good choice if you want a balance between monthly premiums and out-of-pocket costs.

Features

  • Enjoy access to our entire Managed Care Network, the largest physician network in NJ*
  • No primary care physician required
  • No referrals needed
  • Prescription coverage included
*Based on physician data as of 8/28/17 and is subject to change.
Individual Deductible $2,500
  • Enjoy access to our entire Managed Care Network, the largest physician network in NJ*
  • No primary care physician required
  • No referrals needed
  • Prescription coverage included
  • pdf-form-icon Summary of Benefits and Coverage
Family Deductible $5,000
Individual Max Out-of-Pocket $7,350
Family Max Out-of-Pocket $14,700
Primary Care Physician Visit $30 copayment
Specialist Visit $50 copayment
Outpatient Surgery Deductible then 50% coinsurance
Inpatient Hospital Stay Deductible then 50% coinsurance
Emergency Room $100 copayment & deductible then 50% coinsurance

*Based on physician data as of 8/28/17 and is subject to change.

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