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Commonly Asked Questions
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Top 10 Questions Asked by New Members Can I go to a Primary Care Physician (PCP) or dentist who is not part of Horizon NJ Health? 
You must use a Horizon NJ Health PCP or dentist. They will coordinate all of your health care needs. Horizon NJ Health does not bill members for services provided by your PCP and dentist. If you visit a doctor who is not in the Horizon NJ Health network, or without a referral, the Physician's claim would be denied payment.  Back to Top
Do I need a referral to see a specialist, and will Horizon NJ Health provide a list of specialists?
All visits to a specialist must be coordinated with your PCP. Your PCP will give you a Referral Form that you will need to bring with you when you see the specialist. You do not need a referral to visit an Ob/Gyn or for dental care, routine eye care, or a mammogram. Back to Top
If I have an emergency, and the nearest hospital is not part of Horizon NJ Health, will I have to pay the bill?
No, in case of an emergency, always go to the nearest hospital for care. Emergencies include, but are not limited to, chest pains, broken bones, difficulty breathing, difficulty moving or speaking, poisoning, heavy bleeding, drug overdose, car accident, or any situation involving severe illness or injury. In the event of an emergency, you do not need to get approval from Horizon NJ Health or your PCP to go to the emergency room. Back to Top
Where can I send bills that I have received?
You should not receive bills for any authorized services or covered benefits. If you do, call Member Services 24 hours a day, seven days a week, and representatives will assist you. The toll-free number is 1-877-7NJ-HEALTH (1-877-765-4325) (TDD/TTY 1-800-654-5505). Back to Top
Do I have dental coverage?
Dental benefits are determined by your age and how you are covered under Medicaid or in which NJ FamilyCare Plan you are enrolled. If you have dental coverage, it will be shown on your member ID card. Back to Top
If I need to change my Primary Care Physician, how long will it take to become effective?
Call Member Services toll free at 1-877-7NJ-HEALTH (1-877-765-4325) (TDD/TTY 1-800-654-5505), and representatives will help you choose a new Primary Care Physician (PCP). It will take about seven to 10 days until you receive your new member ID card with the change. If you need to visit the PCP before you receive your new card, let Member Services know, and they will make arrangements for you. You do not need to notify Horizon NJ Health to change your dentist. Back to Top
How do I know if my doctor or dentist is a Horizon NJ Health Physician?
All Horizon NJ Health physicians and dentists in your area are listed in your Physician Directory. If you would like a new directory or a directory for another area, call Member Services toll free at 1-877-7NJ-HEALTH (1-877-765-4325) (TDD/TTY 1-800-654-5505), and they will send you one. Member Services can also help you select a doctor or dentist. Back to Top
What do I need to do to maintain my coverage?
Contact your caseworker or NJ FamilyCare Health Benefits Coordinator for your renewal dates. Membership is subject to approval by the Division of Medical Assistance and Health Services (DMAHS). Back to Top
My children are enrolled with Horizon NJ Health. How do I become a member myself?
Contact the state's Health Benefits Coordinator to see if you are eligible. They can be reached toll free at 1-800-701-0710 (TDD/TTY 1-800-701-0720). Back to Top
What are the phone numbers for Medicaid and/or NJ FamilyCare?
The state's Health Benefits Coordinators for Medicaid and/or NJ FamilyCare can be reached toll free at 1-800-701-0710. Hearing-impaired members can call the TDD/TTY number at 1-800-701-0720. Member Services is available 24 hours a day, seven days a week, to help answer any questions about your Horizon NJ Health benefits. Call toll free 1-877-7NJ-HEALTH (1-877-765-4325) (TDD/TTY 1-800-654-5505) to speak with a representative today. Back to Top
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