Horizon BCBS Plans for New Jersey Health Insurance Exchange

Horizon BCBS plans for New Jersey Health Insurance Exchange are designed to provide residents with affordable and comprehensive health insurance options.

Horizon BCBS offers a range of plans, including bronze, silver, gold, and platinum levels, each with varying levels of coverage and premium costs.

These plans cover essential health benefits, including doctor visits, hospital stays, prescription medications, and preventive care services.

One of the key benefits of Horizon BCBS plans is that they often have lower out-of-pocket costs compared to other health insurance plans.

Horizon BCBS offers a variety of plan types to suit different needs and preferences. Each plan type has its own unique features and benefits.

The OMNIA Health Plans, for example, have lower premiums and don't require members to seek referrals for specialized treatment services, as long as the providers are in-network. This makes them a great option for those who want more flexibility in their healthcare choices.

Horizon's EPO (Exclusive Provider Organization) plan allows members to receive full benefits if they stay in-network, while the BlueCard PPO plan lets members see any provider they want, even those out of network, with greater coverage for in-network providers.

Here are some of the plan types offered by Horizon BCBS:

These are just a few examples of the plan types offered by Horizon BCBS. It's worth doing some research to find the plan that best fits your individual needs and budget.

EPO plans offer members the freedom to use any participating physicians, hospitals, and health care professionals without referrals, as seen in the Horizon Advantage EPO Silver plan.

This plan type often has lower premiums with flexible coverage, like Horizon Advantage EPO Silver, which has a $25 copay for primary care and a $50 copay for specialists.

In an EPO plan, you typically don't need to choose a primary care physician, as with Horizon Advantage EPO Silver and Horizon Advantage EPO Bronze.

Out-of-network benefits for emergency care are often included in EPO plans, such as Horizon Advantage EPO Silver.

Here's a comparison of some key features of Horizon Advantage EPO plans:

EPO plans like Horizon Advantage EPO Essentials often have high deductibles to keep premium costs low, but this means they don't pay for routine doctor visits or prescription drugs.

Horizon Blue Cross Blue Shield of New Jersey offers individual exchange products, which can be a great option for those who may qualify for a premium subsidy.

These plans are available off the exchange, but some may also be offered on the exchange. Going on the exchange can be beneficial if you qualify for a premium subsidy, which can help lower your insurance costs.

To qualify for the subsidy, you must not be eligible for group coverage or if you are, it must be considered unaffordable, meaning it will cost you more than 9% of your annual income.

The income requirements for subsidy on the exchange are as follows:

If you think you may qualify for the subsidy, visit healthcare.gov to go through the process. Otherwise, contact your broker or get quotes directly on the Horizon BCBS website for the individual exchange products.

Horizon BCBS plans offer comprehensive coverage for addiction treatment, including rehab facilitation and addiction treatment plans. They also cover mental health treatment, including counseling and therapy, inpatient mental health, and addiction treatment.

Horizon BCBSNJ has a leadership role in mental health coverage, prioritizing the integration of behavioral health into primary care. This integration can reduce medical expenses.

Horizon BCBSNJ covers a range of mental health services, including providers and facilities specializing in mental health, individual and group counseling, crisis intervention, and online wellness tools.

Here are some of the mental health services covered by Horizon BCBSNJ:

Dual diagnosis treatment, which covers both mental health and substance use disorders, is also covered by Horizon BCBSNJ. This is consistent with their commitment to helping members recover from addiction and mental health disorders.

Horizon BCBSNJ plans are named after metal tiers: Bronze, Silver, Gold, and Platinum. Each plan offers a different level of coverage, with Bronze plans paying for 60% of covered medical expenses, Silver plans paying for 70%, and Platinum plans paying for 90%.

Horizon BCBS plans offer a range of options to fit different needs and budgets.

The OMNIA Bronze Plan is the lowest premium option, but it comes with higher out-of-pocket costs. It's a good choice if you don't expect to use many medical services.

Bronze plans pay for 60% of covered medical expenses, leaving members to pay 40%. Money-saving subsidies may be available to help make it more affordable.

The OMNIA Silver Plan is a mid-level option that balances monthly premiums and out-of-pocket costs. It's a good choice for those who want a balance between affordability and coverage.

Silver plans pay for 70% of covered medical expenses, leaving members to pay 30%. Subsidies may also be available to help reduce costs.

The OMNIA Silver HSA Plan is a good option for healthy individuals who want comprehensive coverage for unexpected health issues. It's a Silver plan with a lower premium and an HSA account to help cover higher deductible costs.

Platinum plans, on the other hand, offer the highest level of coverage, paying for 90% of covered medical expenses. The OMNIA Platinum Plan is the highest premium option, but it comes with the lowest out-of-pocket costs.

If you think you qualify for a premium subsidy, visit healthcare.gov to go through the process. You must not be eligible for group coverage, or if you are, it must be considered unaffordable, meaning it will cost you more than 9% of your annual income.

To qualify for the subsidy, your income must fall within certain ranges. Here are the income requirements for a subsidy on the exchange:

Horizon Advance EPO plans provide access to a variety of doctors, specialists, and hospitals. Members must select a Primary Care Physician to coordinate care and provide referrals to specialists who participate with the Horizon Advance EPO product.