Monitoring the Coronavirus
Horizon NJ Health continues to monitor the latest updates related to the novel coronavirus (COVID-19) provided by these credible resources:
- World Health Organization (WHO)
- Centers for Disease Control and Prevention (CDC)
- National Institutes of Health
- New Jersey Department of Health
As a Horizon NJ Health member, you will continue to have access to the services and support you need. We have a detailed plan in place to reduce any service disruptions, if needed.
Below are answers to some questions you may have.
Coronavirus (COVID-19) is a respiratory disease caused by a specific strain of coronavirus. Coronaviruses are a large family of viruses, several of which often cause mild to moderate upper-respiratory tract illnesses, like the common cold or flu. For the latest information, please visit the CDC website.
Patients typically have symptoms such as a cough, difficulty breathing and fever. As with other viruses that cause flu-like illness, seniors and those who have underlying health conditions are at greater risk for severe complications. Symptoms of COVID-19 may appear two to 14 days after exposure.
According to the CDC, it spreads when someone with the virus coughs or sneezes and droplets land on the surfaces around them. When your hands touch surfaces, they can pick up the virus. From there, your hands can transfer the virus to your eyes, nose or mouth, where it enters your body and makes you sick. Washing your hands regularly, using hand sanitizer and avoiding touching your face are good preventive steps that can help protect you.
The best way to prevent illness is to avoid being exposed to this virus. There is currently no vaccine to prevent it. It’s important to follow these common-sense steps to improve your chances of avoiding exposure:
- Avoid close contact with people who are sick.
- Do not touch your eyes, nose and mouth with unwashed hands.
- Stay home when you are sick.
- Cover your cough or sneeze with your arm or a tissue. If you use a tissue, throw it in the trash.
- Clean and disinfect often-touched objects and surfaces using a regular household cleaning spray or wipe.
- Wash your hands often with soap and water for 20 seconds, or use an alcohol-based hand sanitizer with at least 60% alcohol.
- Follow government travel restrictions.
If you begin to experience symptoms, call your Primary Care Provider (PCP). If you don’t know your doctor’s phone number, you can find it on your member ID card or look it up using our online Doctor & Hospital Finder. It is important to call your PCP’s office or other health care facility before you go there. When you call, you can inform them of your concerns, and they will give you further directions.
You can also download the CDC’s information sheet about what to do if you are sick with COVID-19.
Questions about coverage
We will cover, at no cost to you, diagnostic services related to COVID-19. If you are experiencing symptoms, please call your PCP for further instruction.
At this time, there is no specific antiviral treatment or vaccine for coronavirus. Members should call their PCP to ask about care to help relieve symptoms, like for any other viral respiratory infections. Horizon NJ Health will continue to cover health care costs to treat infectious diseases.
We cover vaccines recommended by CDC’s Advisory Committee on Immunization Practices (ACIP) and the U.S. Preventive Health Services Task Force (USPSTF).
Q. Will Horizon NJ Health cover medical supplies such as masks, gloves or disinfectants for members?
These supplies are not currently covered.
Q. Will Horizon NJ Health waive prior authorization requirements for testing and treatment of COVID-19?
Horizon NJ Health will waive prior authorization for:
- Diagnostic tests and covered services that are medically necessary and consistent with CDC guidance; and
- Lab or diagnostic testing required during an ER evaluation or inpatient hospital stay.
Q. If my coverage with Horizon NJ Health requires a copay, will it be waived for costs related to COVID-19 testing or treatment?
We are waiving the copay for a visit to an in-network PCP or urgent care center or an in-network or out-of-network emergency room for:
- Evaluation of symptoms identified by the CDC as possible indicators of COVID-19 infection (fever, cough and shortness of breath).
- COVID-19 testing for members who know they have been exposed to an individual diagnosed with COVID-19.
Also, we are waiving copays at in-network and out-of-network labs for charges associated with the delivery of services connected to CDC-approved lab studies or tests for COVID-19 for members who:
- Know they have been exposed to an individual diagnosed with COVID-19 or;
- Have symptoms identified by the CDC as possible indicators of COVID-19 infection (fever, cough and shortness of breath).
Q. Will Horizon NJ Health waive referral requirements for members who need tests or treatment for COVID-19?
If you have symptoms, please call your PCP. You do not need a referral to call or visit your PCP. Your PCP can arrange testing to diagnose COVID-19 and treat the symptoms associated with COVID-19.
Q. Does Horizon NJ Health have any resources that can connect me to a health care professional by phone?
Members can call our 24/7 Nurse Line to get reliable health information. The nurses are experienced professionals who can provide doctor-approved information to help you make informed health care decisions. To access the 24/7 Nurse Line by phone, please call 1-800-711-5952 (TTY 711).
Member can continue to use LogistiCare for transportation services. To make a reservation, call LogistiCare at 1-866-527-9933 (TTY 1-866-288-3133) or visit njmedicaidride.net. If you are experiencing issues with transportation services, please let us know.
Yes, members will continue to receive PCA services as normal. If you have any concerns or issues with your PCA service, please call your Care Manager.
We will work closely with our members to make sure needs are met. If your Adult Medical Day Care Program is closed and you need assistance with services you normally receive when you are attending that program, please contact us at 1-844-444-4410 (TTY 711).
Members should not see any disruption in services. In the event that you are not receiving services according to your care plan, please call 1-844-444-4410 (TTY 711) to speak to your MLTSS Care Manager.
Yes. You will still receive your approved DME equipment. If you are experiencing any issues, we can connect you to your Care Manager for assistance in receiving your needed supplies. To access the 24/7 Nurse Line by phone, please call 1-800-711-5952 (TTY 711).