Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ), top priorities are the health and well-being of their members and employees.

They are closely following the news about COVID-19. Don Liss, MD, Vice President and Chief Medical Officer, is leading Horizon BCBSNJ’s cross-functional Executive Response Team and Risk Group focused on the Company’s preparedness and response efforts to COVID-19.

Effective immediately, Horizon BCBSNJ is taking the following steps for their fully insured members, as well as members covered by the State Health Benefits Program (SHBP) and the School Employees’ Health Benefits Program (SEHBP). They will continue to work with other self-insured customers that provide coverage for their employees on their specific plan designs.
Horizon BCBSNJ will waive prior authorization requirements for diagnosis of COVID-19, including:

• Waiving prior authorization for a visit to a primary care physician, urgent care center or Emergency Room (ER) for evaluation of possible indicators of COVID-19 infection (fever, cough and shortness of breath).
• Waiving prior authorization for the diagnostic test for SARS-CoV-2, the etiologic agent of COVID-19.
• Waiving prior authorization for lab studies or diagnostic testing required during an ER evaluation or inpatient hospital stay.

Horizon BCBSNJ will waive cost sharing for all services associated with the diagnosis of COVID-19 per Centers for Disease Control and Prevention (CDC) guidelines, including:

• Waiving cost-sharing obligations for all charges associated with a visit to an in-network primary care physician or urgent care center or an in-network or out-of-network Emergency Room (ER) for evaluation of symptoms identified by the CDC as possible indicators of COVID-19 infection (fever, cough and shortness of breath).
• Waiving cost-sharing obligations for all charges associated with a visit to an in-network primary care physician or urgent care center or an in-network or out-of-network ER for COVID-19 testing for members who know they have been exposed to an individual diagnosed with COVID-19.
• Waiving cost-sharing obligations at in-network and out-of-network labs for charges associated with the delivery of services connected to CDC-approved lab studies or tests for COVID-19 for members who know they have been exposed to an individual diagnosed with COVID-19 or with symptoms identified by the CDC as possible indicators of COVID-19 infection (fever, cough and shortness of breath).

Horizon BCBSNJ will increase access to prescription medications

We will waive early medication refill limits on 30-day prescription maintenance medications (consistent with a member’s benefit plan) and/or encourage members to use their 90-day mail order benefit. Horizon BCBSNJ will also ensure formulary flexibility if there are shortages or access issues and not hold patients liable for additional charges stemming from obtaining a non-Preferred medication resulting from shortages or access issues.

Learn more about what Horizon BCBSNJ is doing to ensure our members have continued access to the care they need.

Cosmo Insurance Agency is an independent insurance agency serving surrounding communities in New Jersey. Cosmo keeps its promise to assure an efficient and creative approach to the services we offer. Each of our clients experience a personalized and long-term relationship with us. Our New Jersey based team of health brokers guides our clients in helping them choose the most cost-effective options. By incorporating the latest in technology-based tools and laws on healthcare, employee benefits, life insurance and finance, we keep our clients up-to-date with the plans that encompass all of their needs, whether it is individual or group insurance.

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