1. Click Benefits & Coverage.
2. Click What’s Covered.
3. Under the Medical tab, go to the dropdown menu titled Service you may need to select the correct type of diagnostic service (Diagnostic X-Ray or MRI/Cat Scan) and click Show Coverage Details.
4. Then check the chart(s) to see if the benefit is covered, how much your plan will pay, and if prior authorization is required. You may need to scroll down to view all the information you need.

Check the column titled “Prior Authorization” if it is required for this benefit. Your in-network doctor or other health care professional or hospital will be responsible for requesting prior authorization for you.

You can also get help scheduling your test at a participating facility by calling 1-866-969-1234.

1. Click Benefits & Coverage.
2. Click What’s Covered.
3. Under the Medical tab, go to the dropdown menu titled Service you may need to select Chiropractic and click Show Coverage Details.
4. Then check the chart(s) to see if the benefit is covered, how much your plan will pay, how many sessions are covered and if prior authorization is required. You may need to scroll down to view all the information you need.

1. Click Benefits & Coverage.
2. Click What’s Covered.
3. Under the Medical tab, go to the dropdown menu titled Service you may need to select Physical Therapy and click Show Coverage Details.
4. Then check the chart(s) to see if the benefit is covered, how much your plan will pay, how many sessions are covered and if prior authorization is required. You may need to scroll down to view all the information you need.

1. Click Benefits & Coverage.
2. Click What’s Covered.
3. Under the Medical tab, go to the dropdown menu titled Service you may need to select Diagnostic Lab and click Show Coverage Details.
4. Then check the chart(s) to see if lab services are covered and if you need prior authorization. You may need to scroll down to view all the information you need.

To find a participating lab near you, use our Doctor & Hospital Finder and click Medical. Then type Laboratory – Patient Centers.

Pathology services provided in a hospital setting to members enrolled in Horizon BCBSNJ managed care plans by a practice that participates in the Horizon Managed Care Network are allowed as an exception to the LabCorp/Quest Diagnostics network use requirements.

No-cost flu shots are available to Horizon BCBSNJ members with medical benefits who are enrolled in a fully insured1 plan or a self-insured2 plan. 

1 Fully insured members will see the following statement on the back of their member ID card: Insured by Horizon Blue Cross Blue Shield of NJ.

2 Self-insured members will see the following statement on the back of their member ID card: Horizon BCBSNJ provides administrative services only and does not assume and financial risk for claims.

MinuteClinic® is a registered mark of CVS Caremark Corporation.

1. Click Benefits & Coverage.
2. Click What’s Covered.
3. Under the Medical tab, go to the dropdown menu titled Services you may need. Select Durable Medical Equipment, Durable Medical Equipment Purchase, or Durable Medical Equipment Rent, and click Show Coverage Details. Note: Some DME can be rented, while others must be purchased. The decision to rent or purchase depends on several factors, including, but not limited to, the type of equipment, length of need and information provided by your doctor.
4. Check the chart(s) to see if the benefit is covered, how much your plan will pay, and if prior authorization is required. You may need to scroll down to view all the information you need.

• Vaccinations (flu, measles and hepatitis)
• Cancer screenings (colorectal screenings, mammograms and Pap tests)
• Adult well care (cholesterol and blood pressure)
• Newborn care (hearing and blood tests)
• Children well-visits (obesity, evaluation, measurements)
• Pregnancy care (gestational diabetes, screenings)

1. Click Benefits & Coverage.
2. Click What’s Covered.
3. Under the Medical tab, go to the dropdown menu titled Service you may need. Choose the appropriate preventive service. For routine physicals, select Routine Physical. For vaccinations, select Flu Vaccination or Immunizations.
4. Click Show Coverage Details.

To help you get the care you need during the COVID-19 public health emergency, Horizon BCBSNJ is waiving out-of-pocket costs for covered services received through telemedicine, including Horizon CareOnline, Horizon BCBSNJ’s telemedicine service, for members enrolled in a fully insured plan¹. Members enrolled in a self-insured plan² should check with their benefits administrator. This waiver is in place now and will continue for at least 90 days after the end of the public health emergency and State of Emergency, as declared by Governor Murphy.

Many Horizon BCBSNJ members with medical coverage also have free, 24/7 access to registered nurses. Nurses are available to answer your questions about COVID-19 symptoms, as well as other health questions or concerns. If you are located in New Jersey, a nurse can connect you to a doctor for a telemedicine visit, if needed.  If these features are available to you, you can access them by signing in, going to the home screen, and clicking Chat. Then, scroll down and click Nurse Chat & Telemedicine.

Learn about other telemedicine options that may be available to you.

¹ Fully insured members will see the following statement on the back of their member ID card: Insured by Horizon Blue Cross Blue Shield of NJ.

² Self-insured members will see the following statement on the back of their member ID card: Horizon BCBSNJ provides administrative services only and does not assume and financial risk for claims.