17
December
2020
|
09:56 AM
America/New_York

COVID-19 Vaccines Will Be Covered at No Cost to Members

2 MINUTE READ

Summary

Horizon BCBSNJ is also extending zero out-of-pocket costs for COVID-19 treatment and testing.


All Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) health plan members are covered for the COVID-19 vaccine with no out-of-pocket cost for any vaccine provider.

Please follow the instructions issued by the NJ Department of Health, your local health department or your physician for receiving a vaccine. At this time, Horizon BCBSNJ has no additional information regarding where the vaccine is available or when individuals in different priority groups will be eligible for vaccination. While we are all excited that the vaccine is becoming available, please remember it is important to continue the public health measures of maintaining social distance, wearing a mask, frequent hand washing and avoiding others when sick even if you have received the vaccination.

Horizon BCBSNJ is also extending the waiver of member out-of-pocket costs for COVID-19 treatment until at least March 31, 2021. This means that members will pay no deductible, co-pay or coinsurance for inpatient and outpatient care such as hospital stays or office visits when their claim indicates treatment was related to COVID-19.

This extension is in addition to our continuing cost-sharing waivers for testing and diagnosis of COVID-19 and covered telemedicine services. These policies are part of our ongoing efforts to see that members get the care they need while helping to reduce the spread of the virus and the burden on our health care system during this recent crush of COVID-19 cases.

What Members Should Know About the COVID-19 Vaccines

  • Members will not need any prior authorization for the COVID-19 vaccine.
  • The State of New Jersey has a phased-plan for distributing the vaccine and is making it available first to our frontline health professionals and workers and those at highest risk from health complications. Learn more about that plan here. 
  • Although developed on an accelerated timeline, the vaccines are safe and Horizon BCBSNJ encourages all members to speak with your doctor discuss any concerns you have about being vaccinated. Vaccines are important to your health and essential to the public health effort to contain and stop the pandemic. In the United States, all vaccines – including those approved for COVID - must follow strict, scientific FDA guidelines. The COVID-19 vaccine was developed based upon years of existing research and work developing other vaccines. Learn more about how the FDA and CDC are ensuring the safety of COVID-19 vaccines.

Continued Coverage of COVID-19 Testing

With a doctor’s order, members can get a COVID-19 test covered with no out-of-pocket costs.

  • Members can visit an in-network primary care physician or urgent care center or an in-network or out-of-network emergency room.
  • Cost-sharing waivers for COVID-19 testing will continue for at least 90 days after the end of the public health emergency and the State of Emergency.
  • Many options exist for testing including for those without a prescription and who will be paying out-of-pocket for their test. To learn where you can obtain a test visit the State of New Jersey’s COVID-19 Information Hub section on testing.

Continued Coverage of Telemedicine Visits

Members will also incur no out-of-pocket costs for telemedicine visits, including telephone care, when delivered by an in-network health professional or through Horizon BCBSNJ’s telemedicine platform (HorizonCareOnline℠).

  • This applies to all covered services including diagnosis or treatment of COVID-19, routine care, therapy, mental health and substance use care.
  • Members seeking care from out-of-network providers remain responsible for out-of-network cost-sharing payments according to the terms of their individual policy.
  • This waiver continues through the public health emergency and State of Emergency declared by the Governor in Executive Order 103 of 2020.

All of these policies apply to all fully insured members including those covered by individual and small group policies, Medicare, and Medicaid. The State Health Benefits Program (SHBP) and School Employee Benefits Program (SEHBP), which Horizon BCBSNJ administers for the State of New Jersey, have also agreed to this policy change. Other self-insured health plans are responsible for the specific plan designs they choose to offer to their employees, and Horizon BCBSNJ will continue to work with them to administer their plan designs as directed.