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Overview

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Horizon Medicare Blue Value
Pay less than you would with some "no premium" health plans* with our Medicare Advantage HMO plan!

Yes, it is possible to pay less than some "no premium" health plans and still get all the benefits you deserve. When you choose Horizon Medicare Blue Value, you pay no health plan premium and we reduce your Medicare Part B premium by $28* a month! If you choose Horizon Medicare Blue Value with built-in prescription drugs, your total premium in 2008 can be as low as $7.50 a month!*

Horizon Medicare Blue Access
Our Medicare Advantage POS plan gives you freedom of choice!

Horizon Medicare Blue Access gives you the freedom to go to any health care provider. Coverage is typically greater when you stay in the network, but the choice is yours to make. And you don't need a referral.

Our Medicare Advantage plans provide more coverage than Original Medicare and most Medicare Supplement plans combined!

  • Inpatient hospitalization
  • Outpatient hospital services
  • Doctor office visits
  • Diagnostic tests, x-rays and lab services
  • Emergency room care
  • Urgently needed care
  • Skilled nursing facility care
  • Outpatient mental health care
  • And more!

PLUS...these preventive health care services to help keep you healthy...

  • Optional built-in prescription drug coverage — with $0-deductible options and generics as low as $0 — even in the coverage gap!
  • Annual physical exams
  • Immunizations
  • Chiropractic services
  • Hearing services
  • Vision services
  • Podiatry services
  • And more!

Get greater value with this exclusive membership feature!
Here's your opportunity to get fit, make new friends, and participate in fun events with the SilverSneakers® Fitness Program. SilverSneakers® includes:

  • Free membership at a warm and friendly fitness center in your area
  • A fun group exercise class designed to increase strength, flexibility, and energy
  • Social events where you can make new friends with people just like you
  • Personalized, friendly service from your Senior AdvisorSM at the fitness center

For more information, you can visit www.silversneakers.com. (Please check with your physician before starting a fitness program.)

If you qualify for extra help with your Medicare Prescription Drug Plan costs, your premium and drug costs will be lower. When you join a Horizon Healthcare of NJ, Inc. Medicare Advantage - Prescription Drug Plan, Medicare will tell us how much extra help you are getting. Then, we will let you know the amount you will pay. If you aren't getting any extra help, you can see if you qualify by calling:

  • 1-800-MEDICARE (1-800-633-4227). (TTY/TDD users should call 1-877-486-2048, 24 hours a day/7 days a week), or
  • Your state Medicaid office or
  • The Social Security Administration at 1-800-772-1213 between 7 am and 7 pm, Monday through Friday. (TTY/TDD users should call 1-800-325-0778.)

To contact Horizon Healthcare of New Jersey, Inc., call customer service at 1-800-224-1234 (TTY/TDD users: 1-800-852-7899) Monday - Friday, 8:30 am - 5:00 pm.

All health plans in the Medicare program agree to stay with the program for a full year at a time. Each year, the plans decide whether to continue for another year. Even if a Medicare health plan leaves the program, you will not lose Medicare coverage. If a plan decides not to continue, it must send you a letter at least 90 days before your coverage will end. The letter will explain your options for health care coverage in your area and give you information about your right to get Medicare supplemental insurance coverage. You can choose another health plan if one is available, or you can receive care from the Original Medicare Plan.

If Horizon Healthcare of New Jersey, Inc. ever denies your claim, or a service, we will explain our decision to you. You always have the right to appeal and ask us to review the claim or service that was denied. If a decision was not made in your favor, your appeal will be reviewed by an independent organization that works for Medicare.

Horizon Medicare Blue Value and Horizon Medicare Blue Access are managed care plans issued by Horizon Healthcare of New Jersey, Inc., which is a MA organization with a Medicare contract with the Centers for Medicare & Medicaid Services (CMS). Availability of coverage beyond the end of the current contract year is not guaranteed. Horizon Healthcare of New Jersey, Inc., is a subsidiary of Horizon Blue Cross Blue Shield of New Jersey. Both companies are independent licenses of the Blue Cross and Blue Shield Association.

*The no monthly health plan premium applies only to the Horizon Medicare Blue Value HMO plan.

You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party.

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Last Updated: November 14, 2008