Horizon Brief Notes: Member Cost Sharing for Most Telemedicine Visits Will Resume 2/3
Posted on January 27, 2022
See Horizon Brief Notes Below Regarding Member Cost Sharing for Most Telemedicine Visits Will Resume 2/3/22
Horizon Brief Notes
Applies to: Fully Insured Commercial Market Health Plans
Member Cost Sharing for Most Telemedicine and Telehealth Visits Will Resume Effective February 3, 2022
Horizon has always been committed to making sure members have access to the care they need. To make it easier for members to get care during the COVID-19 public health emergency, fully insured Horizon health plans waived out-of-pocket costs for all covered services received through telemedicine and telehealth visits.
Related to the enactment of a new state law, P.L. 2021, c.310, which governs coverage for the delivery of care through telemedicine and telehealth, effective February 3, 2022, there will be a change to the waiver of out-of-pocket costs. Specifically, the cost share waiver for telemedicine and telehealth visits not related to COVID-19 testing will end. Cost-share waiver for telemedicine and telehealth was previously tied to the Public Health Emergency and the State of Emergency in New Jersey, but this new law guarantees coverage for all forms of health care services delivered via telehealth or telemedicine while removing the cost-share waiver.
What Does This Mean for Members?
Effective February 3, 2022, when fully insured members in the Commercial market use Horizon CareOnlineSM or another telemedicine service from their doctor or other health care professional for any care other than to determine the need for a COVID-19 diagnostic test, members will be responsible for their copay, coinsurance and/or deductible for covered services.
Horizon encourages members to continue to use the Horizon Blue app to access Horizon CareOnline or to find in-network doctors, other health care professionals and hospitals.
Over-the-Counter (OTC), At-Home COVID-19 Test Kits and Vaccines
As a reminder, free over-the-counter (OTC), at-home COVID-19 test kits are available through the Biden-Harris Administration website. OTC, at-home COVID-19 test kits are also available at no cost to members through their Horizon pharmacy benefits or other contracted Pharmacy Benefits Managers.
Horizon also encourages all members to follow the advice of all respected public health experts to get vaccinated and boosted against COVID-19. The COVID-19 vaccines are available at no cost.