COVID-19 vaccines will be covered at 100%

Horizon BCBSNJ is committed to doing our part to combat the COVID-19 public health emergency. That’s why, our members can get COVID-19 vaccines that are authorized through an Emergency Use Authorization (EUA) and recommended by the Advisory Committee on Immunization Practices (ACIP) at no cost. During the COVID-19 public health emergency, the COVID-19 vaccines will be covered 100% through in- and out-of-network doctors, hospitals, pharmacies and other health care professionals, as well as through vaccine administration sites.

This information applies to all fully insured members, including those covered through Medicaid, Medicare Advantage, Individual and Small Group policies, as well as members covered by the State Health Benefits Program (SHBP) and the School Employees’ Health Benefits Program (SEHBP). Horizon BCBSNJ will continue to work with other self-insured customers that provide coverage for their employees on their specific plan designs.

Information on billing and coding

For more information on billing and coding, please visit the Centers for Medicare & Medicaid Services (CMS) took kit.

Medicare Advantage patients

For Medicare Advantage members, COVID-19 vaccine serums and vaccine administration costs will be covered under Original Medicare throughout 2020 and 2021. Please submit claims for administering COVID-19 vaccines to Original Medicare through your Medicare Administrative Contractor (MAC).

Medicaid

For Horizon NJ Health members, COVID-19 vaccine serums and vaccine administration costs will be covered for at least as long as there is a public health emergency.