Medicare AdvantageWhen it comes to choosing a plan, determine what’s most important to you. If you want
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WHAT YOU SHOULD KNOW
*$0 premium only available in the following counties: Ocean, Monmouth, Bergen, Essex, Hudson, Middlesex, Union, Mercer, Somerset, Sussex, Warren, and Hunterdon. | $0 Rx deductible only available in the following counties: Morris, Atlantic, and Cumberland.
**Horizon Medicare Blue Select (HMO-POS) only available in Union County. | Out-of-network/ non-contracted providers are under no obligation to treat
HMO members must select a Primacy Care Physician (PCP) and may only use in-network providers from our managed care network, except for emergency care or urgent care while traveling outside of our service area.
MA PPO members receive the in-network level of benefits when they use in-network providers in our managed care network in New Jersey, or use participating Blue Plans’ MA PPO networks in designated states. Otherwise, out-of-network benefits will be applied. Out-of-pocket costs may be higher when you use out-of-network providers, except for emergency or urgent care.
This information is not a complete description of benefits. Call 1-888-328-4542 (TTY 711) for more information.
ATTENTION: If you speak Spanish, language assistance services, free of charge, are available to you. Call 1-888-328-4542 (TTY 711).
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-888-328-4542 (TTY 711).
If you decide to switch your billing type to premium withhold or move from premium withhold to direct bill, it may take up to three months for the change to take effect and you will ultimately be responsible for paying those premiums.
If Horizon Blue Cross Blue Shield of New Jersey denies your claim or a service, we will explain our decision to you. You have the right to appeal and ask us to review the claim or service that was denied. If a decision was not made in your favor, your appeal will be reviewed by an independent organization that works for Medicare.
ELEGIBLE PARA MEDICARE?
Si usted es elegible para Medicare, podrá inscribirse en un plan Medicare Advantage de Horizon Healthcare of New Jersey, Inc durante períodos específicos del año conocidos como períodos de inscripción o períodos de elección. Los materiales de inscripción están disponibles en español si se necesitan.
Para más información acerca de la inscripción, comuníquese con Servicio a Clientes de Horizon Healthcare of New Jersey, Inc. al 1-877-234-1240 (usuarios de TTY/TDD: 1-800-852-7899) de lunes a viernes entre las 8 a.m. y las 8 p.m., hora del Este.
COMMUNITY EVENTS
Being involved in and committed to New Jersey’s diverse communities is what defines
Horizon Blue Cross Blue Shield of New Jersey as your preferred local health plan.
HELP LINE
8 a.m. to 8 p.m.
Monday to Sunday
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1-877-234-1240
711 (TTY)
USEFUL LINKS
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Horizon NJ TotalCare (HMO SNP) is an HMO Medicare Advantage Dual Special Needs plan with a Medicare contract and a contract with the State of New Jersey Medicaid Program. Enrollment in Horizon NJ TotalCare (HMO SNP) depends on contract renewal. Products are provided by HHNJ and Horizon Blue Cross Blue Shield of New Jersey, both of which are independent licensees of the Blue Cross and Blue Shield Association. Communications are issued by Horizon Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its companies.
Medicare Supplement plans are provided by Horizon Insurance Company and Horizon Blue Cross Blue Shield of New Jersey Blue Cross and Blue Shield Association. Horizon Insurance Company (“HIC”) contracts with CMS to offer HMO, HMO-POS, PPO and Part D Medicare plans. Enrollment in HIC Medicare products depends on contract renewal. Products are provided by HIC and Horizon Blue Cross Blue Shield of New Jersey, both of which are independent licensees of the Blue Cross and Blue Shield Association. Communications are issued by Horizon Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its companies.
Medicare Beneficiaries may enroll in Horizon Medicare Advantage and Medicare Rx Drug plans through the CMS Medicare Online Enrollment Center. For more information, contact Horizon Blue Cross Blue Shield of New Jersey at 1-877-234-1240, 8 am to 8 pm, Monday to Friday, Eastern Time. If you are speech or hearing-impaired, please call TTY# 711.
The Office of the Medicare Ombudsman (OMO) helps you with complaints, grievances and information requests. You may file a complaint or concern at Medicare Complaint Form.
The Blue Cross® and Blue Shield® names and symbols are registered marks of the Blue Cross and Blue Shield Association. The Horizon® name and symbols are registered marks, , and OMNIASM and Horizon CareOnlineSM are service marks of Horizon Blue Cross Blue Shield of New Jersey of Horizon Blue Cross Blue Shield of New Jersey.
Horizon Blue Cross Blue Shield of New Jersey complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, gender, national origin, age, disability, pregnancy, gender identity, sex, sexual orientation or health status in the administration of plan, including enrollment and benefit determinations.
Spanish (Español): Para ayuda en español, llame al 1-800-365-2223 (TTY 711).
Chinese (中文): 如需中文協助❜請致電 1-800-365-2223 (TTY 711).
© 2019 Horizon Blue Cross Blue Shield of New Jersey, Three Penn Plaza East, Newark, New Jersey 07105.