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    Horizon Medicare Prescription Drug Plans

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Introduction
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Drugs that Require Prior Auth, Step Therapy and Quantity Limits (Part D)
LIS Premium Summary Sheet
Drug Management
Program (Part D)

Coverage Determination Process
Disenrollment Rights and Responsibilities
Exceptions Request
Appeals and Grievances
Drug Exception Request Form
Quality Assurance Policies and MTM
Part D - Out of Network
Information for Pharmacists
Good Medicine
Best Available Evidence Policy
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Enroll

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You may enroll by printing the enrollment form and mailing it to:

Horizon Blue Cross Blue Shield of New Jersey
PO Box 10138
Newark, NJ 07101-9633

Remember: If you are a member of a Medicare Advantage (MA) plan and you enroll in a Medicare prescription drug plan, you will be automatically disenrolled from your MA plan. You may only receive your Medicare prescription drug benefits through your MA plan.

Click here to Enroll online.     Click here to Print form.

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Last Updated: July 22, 2010