Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) said Wednesday it will waive all cost-sharing for the COVID-19 test for members seeking diagnostic services related to COVID-19 when those services are delivered according to CDC protocols and guidelines.

“This public health emergency is evolving rapidly and Horizon is responding just as swiftly to help ensure that cost is not a barrier to care for our members. The health and well-being of Horizon members is our highest priority, especially for those who know they have been exposed or who have symptoms consistent with COVID-19,” said Kevin Conlin, chairman, president and chief executive officer of Horizon BCBSNJ.  “We applaud Governor Murphy and his administration for taking quick and decisive action to contain the spread of COVID-19 and ensure that those infected get the care they need.”

In line with previously announced cost-sharing changes, these alterations take effect immediately for Horizon BCBSNJ’s fully insured members, including those covered through Medicaid, Medicare, Individual and Small Group policies, as well as members covered by the State Health Benefits (SHBP) and School Employees Health Benefits (SEHBP)Programs. The company will continue to work with other self-insured customers that provide coverage for their employees on their specific plan designs.

Effective immediately, Horizon BCBSNJ is:

• Waiving Cost-Sharing for all services associated with the diagnosis of COVID-19 per CDC guidelines;
• Waiving cost-sharing obligations for all charges associated with a visit to an in-network primary care physician or urgent care center, or an in-network or out-of-network emergency room for evaluation of symptoms identified by the CDC as possible indicators of COVID-19 infection;
• Waiving cost-sharing obligations for all charges associated with a visit to an in-network primary care physician or urgent care center or an in-network or out-of-network emergency room for COVID-19 testing for members who know they have been exposed to an individual diagnosed with COVID-19;
• Waiving cost-sharing obligations at in-network and out-of-network labs for charges associated with the delivery of services connected to CDC approved lab studies or tests for COVID-19 for members fulfilling either of the previous two scenarios;
• Directing that physicians and facilities are prohibited from billing any fully-insured Horizon BCBSNJ member or SHBP/SEHBP member for any services connected to COVID-19 evaluation or testing, provided that the patient meets the CDC criteria.

According to The New Jersey Association of Health Plans, five Medicaid Managed Care Organizations are working closely with the State Department of Human Services and other regulators to ensure that NJ FamilyCare members have access to testing and care.

NJAHP’s commercial insurance carriers are taking steps to provide resources to their members: CVS Health, AmeriHealth New Jersey, CIGNA, Horizon, Oscar Shares, and United Health Group.