Benefits and Coverage
Enrollment
Miscellaneous
Benefits and Coverage
What is the BHealthy Care medical plan?
The BHealthy Care medical plan is sponsored by RWJBH and administered by Horizon BCBS of New Jersey. There are three different plan designs available to our benefits-eligible employees.
What services do our medical plans cover? How much will I have to pay for care?
Visit the BHealthy Care medical plans page for more information about our plan designs and the services covered.
How do I access my ID Card?
ID cards may be accessed several ways:
Access via App:
The fastest way to get your card on the go is to use the Horizon Blue app. Horizon Blue is your 24/7 resource for all of the ins and outs of your plan, and it connects you to care and support wherever you are.
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To get the app, text GetApp to 422-272 or download it from the App Store® or Google Play™.
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Once you have signed in to the Horizon Blue app, select ID Cards and follow the on-screen instructions to view or print your member ID card, or request a new one. If you request a new one, you will receive a new card in approximately five to 10 business days.
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You can also show your member ID card at your doctor’s office, or share it directly from the app. To print a copy of your member ID card, click Print below the image.
Access online:
You can also sign in online to access your member ID card.
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Once you have signed in, just choose ID Cards and follow the on-screen instructions to print, download or request a new card. Some members may only be able to view and print a proof of coverage letter, which includes the same information as an ID card.
No card? If the image of your member ID card does not appear once you have signed in, your enrollment has not yet been processed. Your member ID card will automatically be mailed to you after your enrollment is processed. However, the quickest way to get your cards when you first enroll is via the app or online.
How do I find a doctor?
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To find a provider or facility, visit www.horizonblue.com/rwjbarnabashealth. You can also create a MyChart account to schedule directly with a RWJBH provider.
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Did you know…OMNIA members receive care at no cost when using a RWJBH Premier facility or provider! Direct Access members can also save. You and your family will always get the highest quality care when seeking care within the RWJBarnabas Health system.
What is BHealthy Care Navigation?
BHealthy Care Navigation is a free resource available for all medical plan-enrolled employees and their eligible family members for free. BHealthy Care Navigation can help you find a doctor, make an appointment, navigate an insurance issue, figure out a new diagnosis, and more! They can be reached by phone at 844.424.2628.
I received an explanation of benefits from Horizon BCBS. What is this?
An Explanation of Benefits, or EOB, is a document you’ll receive when your claim is processed. Part of making the most of your health coverage is understanding how your plan pays your claims and what your role is in that process. The EOB provided by Horizon BCBS is a straightforward way to see this information in one place and use it to track your health care services or expenditures. To further understand what each of the codes mean, visit BCBS’ Explanation of Benefits guide.
NOTE: The EOB is NOT a bill. If the EOB shows that you owe money for the care you received, you will receive a separate bill from your healthcare provider.
Who do I call if I have a claims or prior authorization issue?
For Horizon BCBS Member Services, call 844.209.4715 or click here.
How do I find out what medications are covered? How do I fill my prescriptions?
Visit the Prescription Benefits page for more information.
How do I find an in-network mental health provider?
We understand that now, more than ever, you may be feeling stressed, anxious, or depressed. We have 100% confidential resources to support you and your family through every challenge you may be facing. All resources are completely free to you and your family.
The RWJBH BHealthy Care medical plans include comprehensive behavioral health coverage for you and your enrolled family members. All in-network behavioral health copays are waived for employees and their family members enrolled in an RWJBH medical plan. Click here for more information.
In addition, BHealthy Care also provides additional free mental health resources, including:
Employee Assistance Program (EAP)
The EAP provides 100% confidential counseling services for those times when you and your family are faced with difficulties in life. Licensed, professional staff are available to consult with you many issues including family concerns or conflicts, marital issues, stress, addition issues, job issues, lifestyle changes, bereavement, and more. Call the EAP at 1.800.300.0628.
AbleTo
Up to 8 Weeks of Teletherapy with a Dedicated Coach - AbleTo offers 100% confidential, personalized programs to help you manage stress, anxiety and depression. With AbleTo, you work one-on-one with a licensed therapist from the comfort of your home for up to eight weeks to learn proven techniques to help you take control of your emotional health. AbleTo is available at no cost for those enrolled in RWJBH’s medical plan and can be accessed here.
How do I use my FSA or HSA dollars to pay for my out-of-pocket expenses on a pre-tax basis?
Visit the FSA page for more information.
Enrollment
I need to enroll a new dependent or change coverage. What do I do?
If you have experienced a life-changing event (such a marriage, birth, adoption, divorce, relocation) since your last enrollment and need to explore new coverage options, first visit our Benefits Decision Support Guide. Then, login to the RWJBarnabas Health Benefits Center portal and make your coverage changes.
How do I find out what my paycheck contributions for health insurance are?
Login to the RWJBarnabas Health Benefits Center portal to view your health insurance paycheck contributions.
Miscellaneous
I'm traveling overseas. How will my benefits apply?
BHealthy Care medical plans cover care for emergencies overseas. You would need to pay for the emergency care upfront, then submit a claim to Horizon BCBS for reimbursement. Click here and then click “Blue Cross Blue Shield Global Core Forms” to find the international claim form. Below is a list of documentation that you will need to include with the claim form:
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International claim form
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Medical records (any documents from hospital/doctor that can show this was an emergency)
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Proof of payment/itemized invoice
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Provider information (where services were rendered, etc.)
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Note that Horizon BCBS has translation services if any of the documentation is submitted in a foreign language.
My family is growing. What do I do next?
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Contact your local Human Resources to discuss your leave benefit options.
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Download the BHealthy Mom App and access health tips and trackers for moms-to-be, new parents and those planning for pregnancy. To download the app, search for BHealthy Mom in your app store or click here.
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Don’t forget to add your baby (if eligible) to your health benefits within 31 days of the birth, and add money to your Dependent Care FSA if you anticipate having childcare expenses.
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Check out Bright Horizons child care assistance to care for your family
How does the BHealthy Wellness program work?
Visit the BHealthy Wellness page for more information.
I or my partner will be 65 soon. What are my Medicare options?
You can receive one-on-one guidance from a Medicare expert by calling SmartConnect at 855.984.5833.