Update: Cost-share waiver for telemedicine and COVID-19 testing extended

The changes below apply 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.

Telemedicine cost sharing update

To help you provide care to your patients while continuing the social distancing practices that have helped reduce the spread of disease, Horizon BCBSNJ will continue to waive member cost sharing for in-network telemedicine and telehealth visits for at least 90 days after the end of the public health emergency and State of Emergency declared by the Governor. This applies to all covered services.

When telemedicine and telephone visits are provided by in-network health care professionals, member out-of-pocket costs are waived.

When a Horizon BCBSNJ member has out-of-network benefits, and the member chooses to get care from out-of-network health care professionals, telemedicine and telephone visits are available, but the member is responsible for the difference between the plan allowance and the billed amount.

Please refer to our telemedicine policy for more information.

COVID-19 testing update

We are extending the waiver of member cost sharing for COVID-19 testing for at least 90 days after the end of the public health emergency and State of Emergency declared by the Governor. Members will pay no deductible, copay or coinsurance for COVID-19 testing for diagnostic purposes determined to be medically appropriate by the individual’s health care provider, in accordance with CDC guidelines. Testing for public health surveillance purposes or for employment purposes is not covered.