12:20 PM

Extending Cost-Sharing Waivers for Telemedicine Visits and COVID-19

Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) is extending the previously announced waiver of all member out-of-pocket costs for covered telemedicine services and for testing, diagnosis, and treatment for COVID-19. This is part of our ongoing effort to ensure our members get the care they need and that their physicians, nurses and others in our networks continue to provide care while helping reduce viral transmission,

Continued Coverage of Telemedicine Visits

Horizon BCBSNJ will continue to waive any out-of-pocket costs for members for a qualified telemedicine visit as we do today through the public health emergency and State of Emergency declared by the Governor in Executive Order 103 of 2020. This includes all in-network telemedicine visits for any covered purposes including for the diagnoses and treatment of COVID-19 along with routine physical or mental health care. This waiver extends the initial 90-day waiver , which was set to expire on June 30th, and continues to include telephonic visits as announced in March.

When a Horizon BCBSNJ member with out-of-network benefits chooses to get telemedicine care from out-of-network health care professionals, the member continues to be responsible for any balance bill due to the difference between the amount billed by the out-of-network provider and the amount allowed by the plan.

Telemedicine will continue to be a covered benefit after the public health emergency and the State of Emergency with flexibility for our members to receive care and our providers to deliver care on telemedicine platforms. Horizon BCBSNJ will evaluate the expansion of coverage for certain services that was offered during the initial stage of the public health emergency once the emergency ends. 

Continued Coverage of COVID-19 Treatment

We are also extending member cost-sharing waivers for COVID-19 testing, diagnosis, and treatment through August 31, 2020. This means that members will pay no deductible, copay or coinsurance for inpatient and outpatient care when claims indicate treatment was related to COVID-19. Additionally, 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.

The extension takes effect immediately and applies to Horizon BCBSNJ’s fully insured members, including those covered through Medicaid, Medicare Advantage, Individual and Small Group policies. The State Health Benefits Program (SHBP) and School Employees’ Health Benefits Program (SEHBP) have also agreed to administer benefits consistent with these changes. Other self-insured health plans are responsible for the specific plan designs they choose to offer to their employees, and we will continue to work with them to administer their plan designs as directed.