Horizon Blue - Health plan access & tools

The Horizon Blue application simplifies the process of accessing your health insurance details. 

Additionally, it allows you to locate healthcare services and get in touch with member assistance. This app is designed specifically for individuals who are members of Horizon. Horizon Blue Cross Blue Shield of New Jersey operates as an independent entity under the Blue Cross Blue Shield Association.

The Horizon Blue app comes at no cost and offers features such as:

• Reviewing your benefits and coverage information.

• Consulting with a physician.

• Accessing, downloading, and sharing your ID card.

• Finding doctors, hospitals, and other healthcare providers within the network.

• Monitoring your out-of-pocket expenses.

• Submitting medical claims.

Target Audience：

1. **Horizon Health Insurance Members**

Core user group; individuals and families with insurance can conveniently manage insurance-related matters.

2. **Those Who Need to Quickly Check Insurance Coverage**

Users who want to confirm reimbursement rates and deductibles before medical treatment can do so without having to flip through paper policies or make phone calls.

3. **Those Who Often Forget Their Physical Health Insurance Card**

Can directly present their electronic health insurance card without affecting medical treatment or insurance settlement.

4. **Those Who Need to Find Partner Medical Institutions**

When traveling for business or leisure, can quickly filter nearby partner hospitals and doctors to avoid being unable to claim reimbursement.

5. **Those with Non-Emergency Medical Consultation Needs**

Minor ailments and medication questions can be asked to doctors online, saving the trouble of offline medical visits.

6. **Those Who Need Convenient Claims Processing**

Submit claims and track progress online without visiting offline branches; receiving progress notifications is more convenient.

7. **Those Who Manage Insurance for Family Members**

After linking a family account and obtaining authorization, can assist elderly people and children in checking insurance and submitting claims.

Related Questions and Answers：

Core Functions and Use Cases

1. Can I use this app to check my insurance coverage? For example, what items are covered?

Yes, this is one of the core functions: you can view your "benefits and coverage information" directly within the app, including key information such as reimbursable medical items (such as outpatient visits, hospitalizations, and examinations), reimbursement rates, deductibles, and more. No need to look up your paper policy or call for inquiries; you can check anytime.

2. What if I forget my physical health insurance card? Can the app replace it?

Yes, it can. It supports "electronic health insurance card management": You can view and download your electronic health insurance card directly within the app, and you can also share it with your doctor or hospital (for example, to present it in person during an appointment). It has the same validity as a physical card, solving the problem of being unable to see a doctor because you forgot your card.

3. I want to find a nearby participating hospital or doctor. How can I find them through the app?

The app's operation is straightforward: It includes a "Medical Resource Lookup" feature that locates and filters in-network doctors, hospitals, and other medical service providers (such as clinics and physical examination centers) to avoid misplacing reimbursement by non-partnered providers. It also allows for filtering by distance, rating, and other factors, making it easier to plan visits.

Featured Features and Details

1. Can the app help with urgent medical needs? For example, quickly contact a doctor?

Yes, it supports "Online Consulting with a Physician": For non-emergency medical issues (such as routine consultations or medication questions), you can directly contact a participating physician within the app for consultation, without having to visit a doctor. This is ideal for minor discomforts or when you need quick medical advice.

2. Besides personal use, can I help my family check insurance or process claims? Family account linking is usually required: If family members are also Horizon members and have linked their family accounts within the app, they may have access to assist in viewing their basic insurance information or submitting claims (determined by the "Family Permission Settings" within the app). However, key personal information (such as medical history) may be restricted to the individual themselves, in compliance with medical information protection regulations.

3. After submitting a claim through the app, how do I know if it's been approved?

Progress feedback is provided. You can generally view the claim status in the "Claim History" section (e.g., "Under Review," "Approved," or "Requires Additional Documentation"). In some cases, you may receive in-app notifications or text message reminders, eliminating the need for repeated phone calls and providing a more transparent process.