How can we help?

While supplies last, you can order four at-home COVID-19 test kits per household for free from the federal government.

The flu shot is covered at no additional cost to members enrolled in a Horizon medical plan, when you go to your in-network doctor, pharmacy or other healthcare provider.

If you live in New Jersey: In-network pharmacies include the following.

• ACME Savon Pharmacies
• CVS/MinuteClinic®
• Garden State Pharmacy Organization
• Rite Aid
• ShopRite
• Stop & Shop
• Walgreens
• Wegmans

If you live outside of New Jersey: Go to a MinuteClinic® at select CVS locations. 

You can also use the Doctor & Hospital Finder to find an in-network doctor, pharmacy or other health care professional.

Durable Medical Equipment, or DME, is equipment or supplies that help you at home. They are usually ordered by your doctor when you have certain medical conditions or illnesses. Examples of DME include breast pumps, sleep apnea machines, diabetic supplies like blood testing strips and monitors, orthotics, wheelchairs, and more.

Find out if you have coverage for DME by following these steps:

1. Click What’s Covered under Benefits & Coverage.
2. Under the Medical tab, go to the dropdown menu titled Services you may need. Select Durable Medical Equipment, Durable Medical Equipment Purchase, or Durable Medical Equipment Rent, and click Show Coverage Details. Note: Some DME can be rented, while others must be purchased. The decision to rent or purchase depends on several factors, including, but not limited to, the type of equipment, length of need and information provided by your doctor.
3. Check the chart(s) to see if the benefit is covered, how much your plan will pay, and if prior authorization is required. You may need to scroll down to view all the information you need.

To find an in-network durable medical equipment supplier, visit our Doctor & Hospital Finder and choose Medical for the type of care you are looking for. After you choose your plan and enter a location to search in, you can type Durable Medical Equipment Supplier.

The Centers for Disease Control and Prevention (CDC) recommends getting a flu shot every year to lower your risk from seasonal flu and the impacts it could have on your health.

Talk to your doctor about when the best time would be to get the flu shot.

To locate your coverage effective date, select Benefits & Coverage, then Benefits Overview.

Be sure to choose the appropriate coverage, if applicable, and the Medical, Dental or Prescription tab.

Then, view the information under Plan Effective Date.

Some in-network medical services are covered only if your doctor or other health care professional gets approval in advance from your plan – this is called prior authorization, prior approval, or pre-certification.

To see if a specific service requires a prior authorization, follow the steps below:

1. Select Benefits & Coverage, then What’s Covered.
2. Under the Medical tab, go to the dropdown menu titled Service you may need.
3. Select the type of service you are looking for.
4. Check the chart(s) to see if prior authorization is required. You may need to scroll down to view all of the information you need.

Your primary care physician or specialist may obtain prior authorization for you by calling us at 1-800-664-2583 (TTY 711).

Visit the Blue Cross® Blue Shield® National Doctor and Hospital Finder to find an in-network doctor or hospital nationwide.

Find out if you are covered for mental health services by following these steps:

1. Select Benefits & Coverage, then What’s Covered.
2. Under the Medical tab, go to the dropdown menu titled Service you may need.
3. Select the type of service you are looking for, such as Psychotherapy, Psychiatric-Outpatient, or Cognitive Therapy. Then, select Show Coverage Details.
4. Check the chart(s) to see if the benefit is covered, how much your plan will pay, and if prior authorization is required. You may need to scroll down to view all of the information you need.

To find an in-network mental health provider in New Jersey, visit the Horizon Behavioral Health website.

To find an in-network mental health provider nationwide, visit the Blue Cross® Blue Shield® National Doctor and Hospital Finder.

To view the status of a referral that your doctor or other health care professional submitted, select Benefits & Coverage then Authorizations & Referrals.

To view the status of a prior authorization that your doctor or other health care professional submitted, select Benefits & Coverage then Authorizations & Referrals.