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About Horizon HMO...
A health maintenance organization (like Horizon HMO) allows you to enjoy minimal costs out of your own pocket
by receiving your health care services through your Primary Care Physician (PCP). Your PCP guides and
coordinates your health care, including filing your claims. When needed, your PCP refers you to specialists,
hospitals, and other health care professionals available to you through your Horizon HMO plan.
As a Horizon HMO member, you have access to many health care services and programs, as well as access to
one of the largest participating physician networks in the state. We offer preventive care benefits, an
easy-to-use referral system, direct access to your Ob/Gyn, emergency medical care, and value-added programs.
Good Health Begins With Your Primary Care Physician
Your Horizon HMO plan starts with your Primary Care Physician (PCP). Your PCP is a duly licensed
practitioner who has entered into an agreement with us to participate in the Horizon BCBSNJ Managed Care
Network and is responsible for coordinating all aspects of your medical care, including referrals to
specialists, ancillary providers, or inpatient facilities. Your PCP:
- understands your medical history;
- determines the best treatment for you; and
- refers you to the right specialist in our participating network.
Easy Service — No Hassles
When using Horizon HMO doctors and hospitals, members have no claim forms to file and virtually no paperwork.
All Horizon HMO providers handle all of the paperwork for members. Horizon BCBSNJ offers toll-free customer service Monday through Friday,
8 a.m. to 6 p.m., Eastern Standard Time, so members can get the help they need. Members also can access our
interactive Member Web site, where they can look up claim status and enjoy other online services to make their health care experience more satisfying.
How to Locate a Horizon HMO Provider
Members can locate Horizon HMO network providers by using this Web site feature. Just
click here to access the Physician Finder. Members can also
call Member Services at 1-800-355-BLUE (2583) to locate participating HMO providers.
Portable Benefits Coverage
Horizon HMO covers you and your family no matter where you travel or reside temporarily — whether away
for business or vacation, or for dependent children away at college. Use a nationwide network of health
care professionals, the largest HMO network in the country, serving more than 250 major cities, all 50
states, and Puerto Rico. Just call the 24-hour hotline at 1-800-810-BLUE(2583). If you're away
from home for an extended time (90 consecutive days or longer), you and your family can enroll in a Blue
Cross and Blue Shield-sponsored HMO in another state as a guest membership. The Guest Membership benefit
allows you and your family to receive health care from a host HMO, which includes emergency care, urgent
care, and routine care offered by the host HMO. The Guest Membership benefit is available in most states,*
including the District of Columbia, and is comparable to your Horizon HMO plan. Just call Member Services
at the number on your ID card for information and ask about Guest Membership.
* Excludes Alaska, Mississippi, Montana, South Dakota, Tennessee, Utah, Vermont, West Virginia, and Wyoming.
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