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About Horizon BCBS
Horizon began as a local health plan called First Hospital Service Plan in Essex County, New Jersey in 1932. By 1936, they had expanded statewide under the name Hospital Service Plan of New Jersey (HSP). In 1942, the Medical-Surgical Plan of New Jersey (MSP) was created. The two companies, as Blue Cross of New Jersey (HSP) and Blue Shield of New Jersey (MSP) merged in 1986, creating Blue Cross and Blue Shield of New Jersey.
In 1998, the company, having abandoned merger plans with Anthem, instead became Horizon BCBS of New Jersey. Expanding over the years into New York, Pennsylvania, and Delaware, Horizon then shifted back, pulling back some of their operations from those states.
Having entered the Medicare market early on under the BCBS license, Horizon has continued to grow in that market, expanding product offerings. Blue Cross Blue Shield offers the licensing of the name, but as with all BCBS companies, Horizon is independent and plans may not match those of other BCBS companies.
Horizon Medicare Products
Horizon BCBS offers a full range of Medicare plans, including Medicare Advantage, Part D prescription drugs, and supplemental coverage. They also offer a Medicare and Medicaid combined policy.
Horizon offers a range of Medicare Advantage HMO policies; all of the policies appear to be HMO plans. Since the company website requires that you enter a zip code in order to obtain plan information – due to the fact that available plans vary across zip codes – we chose a random New Jersey zip code. This zip code is in Jersey City; plans available in other areas may differ.
Three plans are available for our test zip code, each with an increasing premium amount. All are HMO and all include vision coverage. Two out of three plans include Part D coverage.
The Horizon Medicare Blue Patient-Centered w/Rx is the most affordable plan. Visits to a primary care doctor are divided into two tiers, with tier 1 having a $5 co pay and tier 2 a $35 co pay. There are no details offered as to how a visit tier is determined. Specialist visits have a $45 co pay, and emergency visits have a co pay of $75 with worldwide coverage.
The Part D coverage included with this plan has a $400 deductible, and co pays start at $0 for Tier 1 Preferred drugs from a Preferred pharmacy. Other pharmacies carry a $5 co pay for this Tier. Tier 2 is $5 preferred and $10 non-preferred pharmacy, with Tier 3 at $35 and $40 respectively and Tier 4 at $70 and $85 respectively. Tier 5 is covered at 25% co pay for both.
The Horizon Medicare Blue Value Plan has no Part D coverage. Primary care visits are $10 with no tier levels, and specialist visits are $40. Emergency visits remain $75. This plan has lower hospital care co pays as well as lower doctor visit co pays, and is more expensive even though it lacks prescription coverage.
The Horizon Value Medicare Blue Value With Rx offers the same coverage, but includes Part D Prescription Drug coverage for an added premium. Co pays for drugs are slightly higher in most areas, but still start at $0 for Tier 1 drugs at a preferred pharmacy.
We ran a search on a second zip code in Newark, NJ to see what other plans might appear, but the results of the search returned the same three options. The rates are slightly different, but otherwise coverage appears to be the same, including co pays.
Medicare Part D
Horizon offers two Medicare Part D plans; there doesn’t appear to be any difference based on zip code in this category. The plans are Horizon Medicare Blue Rx Standard and Enhanced. Horizon claims to have one of the largest networks of preferred pharmacies in NJ; including CVS and Target.
Standard is the cheaper option. It has a $400 annual deductible and co pays start at $0 for Tier 1 drugs at a Preferred Pharmacy. Tier 2 has a $9 co pay, Tier 3 $35. Tier 4 is 30% coinsurance, and Tier 5 25% coinsurance.
The Enhanced Plan is more costly and it does not have a deductible. Co pays are only slight different – Tier 1 remains $0, Tier 2 $10, Tier 3 a $32 co pay, and Tiers 4 and 5 are 30% and 33% respectively. The main draw of this plan appears to be the lack of a deductible.
Horizon offers several of the standardized Medigap – Medicare Supplement – plans in New Jersey. As with all such companies, they are required to offer Plan A, which is the most basic plan available and is designed to cover coinsurance for medical, hospital, and hospice, as well as covering the first three pints of blood each year.
Additionally, Horizon offers Plans C, G, F, K and N. This is a larger selection than some other small insurance companies, although there are more plans to choose from elsewhere. Horizon does offer the most common plans, which are A, F, and N.
The plan selection allows the choice of what coverage is needed most by each individual, from the basics to the full coverage of Plan F. Plan F covers all coinsurance and deductibles as well as excess medical and foreign travel emergency.
Horizon’s final offering is a combination Medicare and Medicaid plan called NJ TotalCare. This unusual plan debuted for 2017 and covers all of the benefits of both Medicare and Medicaid in one plan. Most covered services have no cost at all to the insured.
New Jersey isn’t a state in which we usually run price comparisons, so we can’t provide a look at how Horizon compares to other companies directly on price. However, their rate of $144.02 for Plan A coverage is high compared to nearly every other such plan we have seen in a variety of states. Plan F coverage is likewise quite expensive compared to other states at $200.77 a month. Again, it’s vital to note that these rates may not be high for New Jersey even if they strike us as being high compared to other states.
Part D coverage is $82.80 for the Standard plan and $121 for Advanced. Again, we can’t do an apples to apples comparison, but these rates fall in line with Part D coverage elsewhere.
Finally, Medicare Advantage rates. We ran these based on a Jersey city zip code, and returned a rate of $15.60 for the Patient-Centered with Rx plan. The Blue Value without Part D came in at $49 a month, while the same plan with Part D was rated at $96.10 a month. We were surprised to see no $0 premium option here, but for what we know of the coverage we did feel that these rates are reasonable – again lacking any direct comparison – just overall compared to other states.
Ratings and Reviews
Horizon BCBS of New Jersey has an A rating with the Better Business Bureau. There are 49 complaints on file within the past three years, and 26 of those have been closed in the past twelve months. For a large statewide insurance company, those numbers are low.
Consumer Affairs has 45 reviews of Horizon, and of those 39 left a star rating, resulting in an overall rating of just over 1 star. Although the number of ratings is not a concern, there are repeated comments stating that customer service routes to a call center outside of the US. While the choice to outsource isn’t our focus in this review, it does reflect poorly on a company that claims to be locally focused and community oriented. It’s also something that many people are bothered by and may impact the decision to purchase a plan from the company.
There are 33 complaints about the company on Pissed Consumer. Complaints center on difficulties between what the insurance marketplace and the company directly have to say as well as general problems with errors and claims being denied. Most of the complaints are similar to those seen for many other companies.
In general, there is a typical amount of complaints for a company this size, and most of them are common to many insurance companies.
The Bottom Line
Horizon has a good selection of products, although in some cases their pricing appears to be on the high side. There are a few concerns in the reviews of the company, but nothing that would strike them off the list unless you feel strongly about issues such as outsourcing. If you are seeking a large, but regional company with a lot of plan options, Horizon is one to consider.
For a list of companies that we recommend, visit our Best Insurance Companies page.