Monitoring the Coronavirus
Horizon NJ Health continues to monitor the latest updates related to the novel coronavirus (COVID-19) provided by these credible resources:
- World Health Organization (WHO)
- Centers for Disease Control and Prevention (CDC)
- National Institutes of Health
- New Jersey Department of Health
As a Horizon NJ Health member, you will continue to have access to the services and support you need. We have a detailed plan in place to reduce any service disruptions, if needed.
Below are answers to some questions you may have.
Coronavirus Basics
WHAT IS COVID-19?
COVID-19 is a respiratory disease caused by a specific strain of coronavirus (SARS-CoV-2). Coronaviruses are a large family of viruses often causing mild to moderate upper-respiratory tract illnesses, similar to the common cold or flu.
WHAT ARE THE SYMPTOMS?
Respiratory symptoms, such as a cough, difficulty breathing and fever. People who are elderly and/or have underlying health conditions are more at risk for severe complications. Symptoms of coronavirus may appear two to 14 days after exposure.
HOW DOES IT SPREAD?
The virus is thought to spread from person-to-person through droplets produced when someone with the virus coughs or sneezes. This can happen when people are in close contact with one another (within six feet), usually for a prolonged period of time.
HOW CAN I PROTECT MY FAMILY?
There is currently no vaccine to prevent COVID-19, so the best way to prevent illness is to follow common-sense steps to help improve your chances of avoiding exposure.
If you begin to experience symptoms, call your Primary Care Provider (PCP). If you don’t know your doctor’s phone number, you can find it on your member ID card or look it up using our online Doctor & Hospital Finder. It is important to call your PCP’s office or other health care facility before you go there. When you call, you can inform them of your concerns, and they will give you further directions.
You can also download the CDC’s information sheet about what to do if you are sick with COVID-19.
Questions about coverage
We will cover, at no cost to you, diagnostic services related to COVID-19. If you are experiencing symptoms, please call your PCP for further instruction.
Horizon NJ Health covers FDA-authorized antibody testing performed by a lab that has appropriate Clinical Laboratory Improvement Amendments (CLIA) certification when testing is performed consistent with the Centers for Disease Control and Prevention’s (CDC’s) Interim Guidelines for COVID-19 Antibody Testing.
The test must be for a diagnostic purpose consistent with CDC guidelines and ordered by your licensed doctor or other health care professional. These CDC guidelines specifically note Serologic testing should not be used to determine immune status in individuals until the presence, durability, and duration of immunity is established. Currently, the clinical use of serologic or antibody testing for COVID-19 is to support a diagnosis of COVID-19 in patients who are seeking care late in their course of illness or in patients who are seeking care for late complications, such as multisystem inflammatory syndrome in children.
Antibody tests should not be used as a sole basis for diagnosis. When antibody testing is covered, members will have no cost sharing during the COVID-19 public health emergency.
Watch this video from the FDA about antibody testing.
At this time, there is no specific antiviral treatment or vaccine for coronavirus. Members should call their PCP to ask about care to help relieve symptoms, like for any other viral respiratory infections. Horizon NJ Health will continue to cover health care costs to treat infectious diseases.
We cover vaccines recommended by CDC’s Advisory Committee on Immunization Practices (ACIP) and the U.S. Preventive Health Services Task Force (USPSTF).
Q. Will Horizon NJ Health cover medical supplies such as masks, gloves or disinfectants for members?
These supplies are not currently covered.
Q. Will Horizon NJ Health waive prior authorization requirements for testing and treatment of COVID-19?
Horizon NJ Health will waive prior authorization for:
- Diagnostic tests and covered services that are medically necessary and consistent with CDC guidance; and
- Lab or diagnostic testing required during an ER evaluation or inpatient hospital stay.
Q. If my coverage with Horizon NJ Health requires a copay, will it be waived for costs related to COVID-19 testing or treatment?
We are waiving the copay for a visit to an in-network PCP 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 (fever, cough and shortness of breath).
- COVID-19 testing for members who know they have been exposed to an individual diagnosed with COVID-19.
Also, we are waiving copays 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 who:
- Know they have been exposed to an individual diagnosed with COVID-19 or;
- Have symptoms identified by the CDC as possible indicators of COVID-19 infection (fever, cough and shortness of breath).
Q. Does Horizon NJ Health have any resources that can connect me to a health care professional by phone?
Members can call our 24/7 Nurse Line to get reliable health information. The nurses are experienced professionals who can provide doctor-approved information to help you make informed health care decisions. To access the 24/7 Nurse Line by phone, please call 1-800-711-5952 (TTY 711).
Member can continue to use LogistiCare for transportation services. To make a reservation, call LogistiCare at 1-866-527-9933 (TTY 1-866-288-3133) or visit njmedicaidride.net. If you are experiencing issues with transportation services, please let us know.
Yes, members will continue to receive PCA services as normal. If you have any concerns or issues with your PCA service, please call your Care Manager.
We will work closely with our members to make sure needs are met. If your Adult Medical Day Care Program is closed and you need assistance with services you normally receive when you are attending that program, please contact us at 1-844-444-4410 (TTY 711).
Members should not see any disruption in services. In the event that you are not receiving services according to your care plan, please call 1-844-444-4410 (TTY 711) to speak to your MLTSS Care Manager.
Yes. You will still receive your approved DME equipment. If you are experiencing any issues, we can connect you to your Care Manager for assistance in receiving your needed supplies. To access the 24/7 Nurse Line by phone, please call 1-800-711-5952 (TTY 711).