There are three ways you can send the completed application.

By mail:
Horizon Blue Cross Blue Shield of New Jersey
Away From Home Care Program
Three Penn Plaza East, PP-08F
Newark, NJ 07105-2200

Email: AwayFromHomeCare@HorizonBlue.com
 
Fax: 1-973-274-4275

Please be sure to sign the completed application, and allow 10 business days for processing. The effective date of Away From Home Care Program coverage will be determined once Horizon BCBSNJ receives and processes your completed application.

If your enrollment is approved, you will receive welcome materials, including a member ID card, from the Blue Cross and/or Blue Shield Plan in the state where you will be temporarily living.

If the Blue Plan in the state or county you are traveling to does not participate in the Away From Home Care Program, Horizon BCBSNJ will notify you by mail.

The Away From Home Care Program gives members access to coverage for medical care only.

There may be some states and counties in which the local Blue Plan does not offer the Away From Home Care Program.

Horizon BCBSNJ members in the following plans may be eligible to enroll in the Away From Home Care Program, if their health plans do not already include coverage for services outside of New Jersey (BlueCard^® coverage) and the plans are not Health Savings Account (HSA) eligible:

• Horizon HMO
• Horizon EPO
• OMNIA^SM Health Plans

Members with health plans that include out-of-network benefits or BlueCard coverage are not eligible for the Away From Home Care Program. Medicare Advantage and Medicare Supplement members are also not eligible.Eligible members must also meet one of the conditions below to be eligible for the Away From Home Care Program:

• Must be away from home for a period of 90 consecutive days, but not more than 180 days
• Student away at school¹
• Long-term traveler within the United States and not traveling for the sole purpose of receiving medical care
• Family apart due to a separation, long-term job assignment, etc.

There may be some states and counties in which the local Blue Plan does not offer the Away From Home Care Program.

Additionally, the Blue Plan in the state you are traveling to may require you to select a Primary Care Physician (PCP) who participates in that Blue Plan’s network.