Who is eligible?
ASTHMA HEALTH EDUCATION PROGRAM:
All fully insured members 5 years of age and older diagnosed with asthma and are enrolled in the following products: Horizon HMO, Horizon PPO, Horizon POS, Horizon Direct Access, Medicare Advantage (includes Horizon Medicare Blue, Horizon Medicare Blue Plus, Horizon Medicare Value Plus), NJ DIRECT, and eligible national PPO accounts. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) HEALTH EDUCATION PROGRAM:
All fully insured members 30 years of age and older diagnosed with COPD (includes chronic bronchitis and emphysema) and are enrolled in the following products: Horizon HMO, Horizon PPO, Horizon POS, Horizon Direct Access, Medicare Advantage (includes Horizon Medicare Blue, Horizon Medicare Blue Plus, Horizon Medicare Value Plus), NJ DIRECT and eligible national PPO accounts. DIABETES HEALTH EDUCATION PROGRAM:
All fully insured members diagnosed with diabetes and are enrolled in the following products: Horizon HMO, Horizon PPO, Horizon POS, Horizon Direct Access, Medicare Advantage (includes Horizon Medicare Blue, Horizon Medicare Blue Plus, Horizon Medicare Value Plus), NJ DIRECT and eligible national PPO accounts. CORONARY ARTERY DISEASE HEALTH EDUCATION PROGRAM:
All fully insured members 18 years of age and older who have been hospitalized for cardiovascular conditions like Angina, Heart attack (AMI - acute myocardial infarction) or had procedures such as CABG (Coronary Artery Bypass Graft surgery), PTCA (Percutaneous Transluminal Coronary Angioplasty) and Stent and are enrolled in the following products: Horizon HMO, Horizon PPO, Horizon POS, Horizon Direct Access, Medicare Advantage (includes Horizon Medicare Blue, Horizon Medicare Blue Plus, Horizon Medicare Value Plus), NJ DIRECT and eligible national PPO accounts. CHRONIC KIDNEY DISEASE (CKD) AND END STAGE RENAL DISEASE (ESRD) HEALTH EDUCATION PROGRAM:
All fully insured members 18 years of age and older diagnosed with chronic kidney disease (CKD) and End Stage Renal Disease (ESRD) and are enrolled in the following products: Horizon HMO, Horizon PPO, Horizon POS, Horizon Direct Access, Medicare Advantage (includes Horizon Medicare Blue, Horizon Medicare Blue Plus, Horizon Medicare Value Plus), NJ DIRECT and eligible national PPO accounts. HEPATITIS C HEALTH EDUCATION PROGRAM:
All fully insured members 18 years of age and older diagnosed with Hepatitis C, and are enrolled in the following products: Horizon HMO, Horizon PPO, Horizon POS, Horizon Direct Access, Medicare Advantage (includes Horizon Medicare Blue, Horizon Medicare Blue Plus, Horizon Medicare Value Plus), NJ DIRECT and eligible national PPO accounts. HEART FAILURE HEALTH EDUCATION PROGRAM:
All fully insured members 18 years of age and older diagnosed with Heart Failure and are enrolled in the following products: Horizon HMO, Horizon PPO, Horizon POS, Horizon Direct Access, Medicare Advantage (includes Horizon Medicare Blue, Horizon Medicare Blue Plus, Horizon Medicare Value Plus), NJ DIRECT and eligible national PPO accounts. MULTIPLE SCLEROSIS HEALTH EDUCATION PROGRAM:
All fully insured members 18 years of age and older diagnosed with Multiple Sclerosis, and are enrolled in the following products: Horizon HMO, Horizon PPO, Horizon POS, Horizon Direct Access, Medicare Advantage (includes Horizon Medicare Blue, Horizon Medicare Blue Plus, Horizon Medicare Value Plus), NJ DIRECT and eligible national PPO accounts. WEIGHT MANAGEMENT HEALTH EDUCATION PROGRAM:
All fully insured members 12 years of age and older diagnosed with Obesity, and are enrolled in the following products: Horizon HMO, Horizon PPO, Horizon POS, Horizon Direct Access, Medicare Advantage (includes Horizon Medicare Blue, Horizon Medicare Blue Plus, Horizon Medicare Value Plus), NJ DIRECT and eligible national PPO accounts.  Back to Top
How was I identified?
You may have been identified either through claims data, pharmacy data, your doctor's referral, or case management. Back to Top
Are the programs free?
Yes, only to all fully insured members of Horizon Blue Cross Blue Shield of New Jersey. Please see the first question, "Who is eligible?" Participation in the programs will not affect your premium or your status with the plan. Back to Top
What are the program benefits?
The programs provide tools to help members with chronic conditions better manage their health and improve their quality of life in collaboration with their physician's plan of care. Back to Top
What providers can I see?
You should continue to choose providers as you usually do under your Horizon BCBSNJ plan. Back to Top
Do you have a list of preferred providers?
You can search for a provider on our Web site, or we can mail you a paper copy of our latest provider directory. Back to Top
Whom can I contact with questions or to self-enroll?
You may contact us at 1-888-334-9006 for the following Health Education Programs: - Asthma
- Chronic Obstructive Pulmonary Disease (COPD)
- Coronary Artery Disease (CAD)
- Diabetes
- Chronic Kidney Disease
- Heart Failure
- Hepatitis C
- Multiple Sclerosis
- Weight Management
NJ DIRECT members can contact us at 1-888-345-1150. Back to Top
Are DME and drugs covered?
You are covered for DME and prescriptions as outlined in your health benefits plan. Back to Top
How often will I receive information?
All members eligible to participate in the programs will receive an introductory letter and brochure informing them about the programs and how participation can help them better manage their conditions. Back to Top
What if I join the program and then decide to not participate?
Participation in the programs is completely voluntary. At any time, you can contact us and disenroll from the program. Back to Top
I received a Horizon Health and Wellness Education Program mailing in error; can you help me?
Yes. If you have the following products – Horizon HMO, Horizon PPO, Horizon POS, Horizon Direct Access, Medicare Advantage (includes Horizon Medicare Blue, Horizon Medicare Blue Plus, Horizon Medicare Value Plus) – please call the program member line at 1-888-334-9006. If you have NJ DIRECT, please call the program member line at 1-888-345-1150. The staff will take your information and remove you from the mailing list. We apologize for any inconvenience this may have caused. Back to Top
Is my health information kept confidential?
Yes. We always work to ensure that all member personal health information remains confidential. Back to Top
My spouse/friend/family member has a chronic condition and would like to participate in this program. Can they?
If the individual meets the eligibility criteria and is a fully insured member of Horizon BCBSNJ. Please refer to the first question, "Who is eligible?" Back to Top
Who will be answering the phone/email, and what hours are representatives available?
The professional care specialists are registered nurses, social workers, dieticians, or Certified Diabetes Educators. Our Care Specialists will be available to answer the phone when a member calls. Our member telephone numbers will be available between 8:00 a.m. and 7:00 p.m. every working day, Monday through Friday, Eastern Time, and you can leave a voice-mail message after office hours. Back to Top
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