Staying Informed: COVID-19 (Coronavirus)

A Message from Horizon BCBSNJ’s Chief Medical Officer, Don Liss, MD

At Horizon BCBSNJ, our top priorities are the health and well-being of our members and the safety of our employees. We have profound respect for the thousands of health professionals on whom we rely to deliver excellent care, especially as we face an emerging pandemic.

As Horizon BCBSNJ’s Chief Medical Officer, I have the responsibility to lead our Company’s preparedness and response efforts. Working with leaders from across Horizon BCBSNJ, I’m committed to ensuring that Horizon BCBSNJ is ready to play our role in supporting your ability to care for the people of New Jersey.

Effective immediately, Horizon BCBSNJ is taking these steps:

  • Horizon NJ Health will waive Prior Authorization requirements for diagnosis of COVID-19
    • Waiving prior authorizations for a visit to a primary care physician, urgent care center or Emergency Room (ER) for evaluation of upper respiratory symptoms, fever, shortness of breath or other conditions that may represent COVID-19.
    • Waiving prior authorizations for the diagnostic test for SARS-CoV-2, the etiologic agent of COVID-19.
    • Waiving prior authorization for lab studies or diagnostic testing required during an ER evaluation or inpatient hospital stay.

  • Horizon NJ Health will cover the full cost of the COVID-19 test
    • We will cover, with no cost share to the member, the diagnostic test for COVID-19 performed as recommended by the CDC.

  • Horizon NJ Health will increase access to prescription medications
    • Waive early medication refill limits on 30-day prescription maintenance medications (consistent with member’s benefit plan). Horizon BCBSNJ will also ensure formulary flexibility if there are shortages or access issues and not hold patients liable for additional charges stemming from obtaining a non-preferred medication resulting from shortages or access issues.

We encourage you to visit the CDC website regularly to view their Frequently Asked Questions for health care professionals and to follow their guidance to keep you and your staff informed and safe.

We will continue to provide updates and share information about the specific actions we are taking.