Horizon COVID-19 Update – Telemedicine Cost Share Waiver

See below most recent Brief Notes from Horizon regarding COVID-19
Applies to: Fully insured business and SHBP/SEHBP

COVID-19 Update: Eliminating Cost-Sharing for Qualified In-Network Telemedicine Services

In an effort to promote social distancing and to support the public health effort to slow community transmission of COVID-19, effective immediately and through June 13, 2020, Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) is waiving member cost-sharing obligations for covered telemedicine services delivered by an in-network doctor or through Horizon BCBSNJ’s telemedicine platforms.

The waiver applies to qualified telemedicine visits for any covered purpose, including diagnosis or treatment of COVID-19, routine care or mental health care. The waiver does not alter the benefits included in any member’s plan; it only eliminates cost as a potential barrier to using telemedicine to get care.

As with the previously announced cost-sharing changes, the waiver change applies to Horizon BCBSNJ’s fully insured members, and members covered by the State Health Benefits Program (SHBP) and School Employees’ Health Benefits Program (SEHBP).

Horizon BCBSNJ will continue to work with other self-insured customers that provide coverage for their employees on their specific plan designs.

Effective immediately and through June 13, 2020, Horizon BCBSNJ is waiving member cost-sharing obligations for covered services:

  • Provided by an in-network doctor or in-network mental health professional during a qualified telemedicine visit.
  • Associated with a visit to an in-network doctor or in-network mental health professional including primary care doctors, specialists, therapists, LCSWs or urgent care physicians when conducted according to standards established by N.J.S.A. 45:1-61 et seq.
  • Provided through Horizon BCBSNJ’s telemedicine service, Horizon CareOnlineSM.
As with all routine, primary care, mental health or follow-up office visits, no prior authorization is required.

Additional resources for patients
Horizon BCBSNJ members also have no cost, 24/7 access to licensed nurses who can talk with members and direct to reliable sources for the latest information about COVID-19. Fully insured, Commercial market members can access this service at 1-888-624-3096. SHBP/SEHBP members have access to the nurse line and their Horizon Health Guide service at 1-800-414-SHBP (7427).

Depending on the specific benefits included in a member’s plan, additional telemedicine services, such as Chat for Care, may be available at no cost through the Company’s free Horizon Blue app and by signing in to our secure member web portal at HorizonBlue.com.