Health Benefits

Reminder

Always verify that your physician(s) and pharmacy have your current health coverage information.

Please note that change forms must be submitted for the following events:
Address Change
Name Change
Addition of Dependent (Spouse, Child)
Deletion of Dependent
Change of Benefit Plan

If you wish to waive coverage, you must submit an enrollment waiver, along with a waiver of coverage form. If you previously waived coverage and wish to be reinstated, you must also complete an enrollment form and provide required documentation.

Open Enrollment

The open enrollment period begins on October 1st for any changes that will become effective on January 1st. (All change requests must be submitted during the month of October and are due into the State on November 1st) While you have the option to switch to another plan please note that equal to or better than will only apply to NJ Direct 10. This is most closely associated with our previous coverage.

Horizon Blue Cross/Blue Shield Customer Service

1-800-414-7427

Horizon

Visit the Horizon Link to set up an account and search for providers: CLICK HERE

When you set up your account, you will be able to:

Request additional ID Cards
Print temporary cards
Download forms
Elect to have your EOB's (Explanation of Benefits) sent to you electronically and not to your home.

We currently participate in the following Health Benefit plans:

Direct Access Design 7 - 10
Direct Access Design 7 - 15
Direct Access Design NJEH
Direct Access Design Garden State

Prescription coverage will be provided by Prime Therapeutics. Mail order will be fulfilled through Amazon Prime Pharmacy.

Click here to access Horizon Claim Forms

This is to be used for out of network reimbursement
It is more efficient if you are able to print this form to a color printer.
Claims submitted on black and white copies have to be entered manually, thus delaying the processing.

Page updated

Report abuse