Is Horizon NJ Medicare or Medicaid?

Q: Is Horizon NJ Health part of Medicaid?

Horizon NJ Health, New Jerseys largest managed healthcare company serving the publicly insured, provides quality healthcare services for more than 500,000 children and adults in the Medicaid and NJ FamilyCare programs. Horizon NJ Health provides benefits for New Jersey residents enrolled in the Medicaid program.

This website is operated by Horizon Blue Cross Blue Shield of New Jersey and is not New Jersey’s Health Insurance Marketplace. This website does not display all Qualified Health Plans available through Get Covered NJ. To see all available Qualified Health Plan options, go to the New Jersey Health Insurance Marketplace at Get Covered NJ.

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Our PlansNJ FamilyCare
One of the Largest Provider Networks in New Jersey
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Member Handbooks
NJ FamilyCare
Horizon NJ TotalCare (HMO D-SNP)
Managed Long Term Services & Supports (MLTSS)
Is Horizon NJ Health part of Medicaid?
What type of insurance is Horizon NJ Direct?
Is Horizon NJ Health NJ FamilyCare Medicaid?
Is Horizon NJ Health the same as NJ FamilyCare?

Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, Braven Health, and/or Horizon Healthcare Dental, Inc., each an independent licensee of the Blue Cross Blue Shield Association. Communications may be issued by Horizon Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its companies. The Blue Cross® and Blue Shield® name and symbols are registered marks of the Blue Cross Blue Shield Association. The Horizon® name and symbols are registered marks of Horizon Blue Cross Blue Shield of New Jersey. The Braven Health℠ name and symbols are service marks of Braven Health.

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Our PlansNJ FamilyCare

NJ FamilyCare allows eligible children, single adults and families to get affordable, quality health care through Horizon NJ Health.

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One of the Largest Provider Networks in New Jersey

We have one of the largest networks of doctors, hospitals and specialists in New Jersey.

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Member Handbooks

Find important information about your benefits.

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Our Plans

All families deserve affordable, quality health care. You may qualify for the NJ FamilyCare program. It allows eligible children, single adults and families to become members of Horizon NJ Health for a low cost, or in some cases, no cost at all.

NJ FamilyCare

Uninsured? Help is here. The NJ FamilyCare program allows eligible children, single adults and families to get affordable, quality health care through Horizon NJ Health. You can apply for NJ FamilyCare online. We can also help you complete your application. Call 1-800-637-2997(TTY 711).

Horizon NJ TotalCare (HMO D-SNP)

If you qualify for both Medicaid and Medicare, Horizon NJ TotalCare (HMO D-SNP) is the plan that is right for you. It covers all Medicare and Medicaid benefits, plus additional features and services all at no cost to you. With one easy plan, from a name you trust, you get a team of doctors, specialists and Care Managers working together just for you.

Managed Long Term Services & Supports (MLTSS)

The Managed Long Term Services & Supports (MLTSS) program promotes independence, dignity and choice. Horizon NJ Health’s MLTSS program helps members who need support services to remain in their homes and communities as long as possible.

Choosing an MLTSS Medicaid Managed Care Health Plan

You can choose from a selection of NJ FamilyCare Managed Care Organizations (MCOs) in New Jersey for Managed Long Term Services and Supports (MLTSS). Another option is the Program of All-Inclusive Care for the Elderly (PACE) program:

NJ FamilyCare MCOs provide the full range of coordinated health services, long-term services and supports and prescription drug benefits. If you have both NJ FamilyCare and Medicare coverage and you select an NJ FamilyCare MCO, your Medicare health and prescription plans won't change. Medicare will be your primary insurance and NJ FamilyCare will be secondary.
Not all MCOs operate in all counties, so you must choose an MCO operating in the county where you live.
Click Here for a List of NJ FamilyCare Health Plans.
A PACE organization coordinates and provides all Medicare and NJ FamilyCare services, including nursing facility care and prescription drugs. Many participants are transported to a PACE center to receive services in addition to receiving services in the home as needed. To participate in the PACE program, you must be 55 years of age or older and able to live safely in the community at the time of enrollment. There are currently four PACE organizations in seven counties. To be eligible to enroll, you must live in the PACE provider service area.

Medicare and Medicaid services, including nursing facility care and prescription drugs. Many participants are transported to a PACE center to receive services in addition to receiving services in the home as needed. To participate in the PACE program, you must be 55 years of age or older and able to live safely in the community at the time of enrollment. There are currently four PACE organizations in seven counties. To be eligible to enroll, you must live in the PACE provider service area.

What are the options?

Beginning July 1, 2014, your Medicaid home and community-based services will be covered and provided by your current NJ FamilyCare managed care organization (MCO). This means that:

If you are in an MCO, all of your NJ FamiyCare health care, community-based long-term services and supports (including assisted living, community residential and mental health and substance abuse services, wellness and recovery programs) and prescription drug benefits will be coordinated by the MCO you choose.
If you are in a Dual Eligible Special Needs Plan (D-SNP), this means all of your Medicare and NJ FamilyCare health care, community-based long-term services and supports and prescription drug benefits can be coordinated by the same MCO that also offers your D-SNP coverage or by another NJ FamilyCare MCO, or by enrolling in the PACE program of your choice.

But there are these options if you want to choose a different type of Medicaid managed health plan. For example:

If you only have NJ FamilyCare, you can choose from one of the NJ FamilyCare MCOs or enroll in a PACE (Program of All-inclusive Care for the Elderly) program.
If you have NJ FamilyCare and Medicare, you can choose from one of the NJ FamilyCare MCOs or enroll in a PACE program.

MEDICAID Managed Care Organization (MCO)
NAME	COUNTIES
Aetna Better Health	All
Amerigroup New Jersey, Inc.	All
Horizon NJ Health	All
UnitedHealthcare Community Plan	All
WellCare Health Plans of New Jersey	All except Hunterdon
To enroll in a Medicaid MCO, call 1-866-472-5338 (TTY: 1-800-701-0720)

Program of All-inclusive Care for the Elderly (PACE)
NAME	COUNTIES
Beacon of LIFE – to enroll, call (732)-592-3400	Most of Monmouth
LIFE at Lourdes - To enroll, call (856) 675-3355	Camden County
Lutheran Senior LIFE - To enroll, call (201) 706-2091	Parts of Hudson
LIFE St. Francis - To enroll, call (609) 599-5433	Mercer and parts of northern Burlington
Inspira LIFE - To enroll, call (856) 418-5433	Parts of Cumberland, parts of Gloucester and parts of Salem
For more information on PACE, call 1-800 MEDICARE (1-800-633-4227), (TTY: 1-877-486-2048), or visit https://www.medicare.gov/your-medicare-costs/help-paying-costs/pace/pace.html or www.npaonline.org on the web

Is Horizon NJ Health part of Medicaid?

Horizon NJ Health, New Jersey's largest managed healthcare company serving the publicly insured, provides quality healthcare services for more than 500,000 children and adults in the Medicaid and NJ FamilyCare programs. Horizon NJ Health provides benefits for New Jersey residents enrolled in the Medicaid program.

What type of insurance is Horizon NJ Direct?

Horizon Direct Access is a managed care plan that gives members referral-free access to many health care services and programs and one of the largest national doctor networks in the nation.

Is Horizon NJ Health NJ FamilyCare Medicaid?

With Horizon NJ TotalCare (HMO D-SNP), members get both Medicare and Medicaid benefits in one plan. To keep these benefits, the member must keep his or her Medicaid (NJ FamilyCare) eligibility up to date and renew annually.

Is Horizon NJ Health the same as NJ FamilyCare?

As a member of Horizon NJ Health, you get the benefits and services you are entitled to with the NJ FamilyCare Program. The medical care and services you get through Horizon NJ Health are free or low cost.