Securing your future with comprehensive coverage

Find the best plan for you with the #1 health insurance agency in New Jersey
Click Here

cost sharing for telehealth

Member Cost Sharing for Telehealth Visits

Horizon has always been committed to making sure members have access to the care they need. To make it easier for their 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 CareOnline 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.

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.

If you have questions, please contact us at 732-363-3888.

Cosmo Insurance Agency is a full-service independent insurance agency based in Hackensack (Bergen County) and Lakewood (Ocean County), New Jersey that offers an all-encompassing range of insurance options for both individuals and businesses. 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 our knowledge of the insurance guidelines for healthcare, employee benefits, life insurance, self-insurance, dental, disability, and long term care insurance, we keep our clients up-to-date with affordable plans that cover all their specific insurance needs.