Blue Cross: Primary Auto-Medical Insurer?

Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) is the largest health insurance company in the state, serving over 3.6 million members. It is a not-for-profit, tax-paying health insurer, providing affordable health insurance products and services to New Jersey residents. While Horizon Blue offers a range of health insurance plans, it is important to understand the role of health insurance and auto insurance in the event of a car accident. In New Jersey, a no-fault state, individuals injured in an auto accident with auto insurance coverage are required to go through their auto insurer's Personal Injury Protection (PIP) to get their medical bills paid. This means that, regardless of who is at fault, the injured party's auto insurer will cover their medical expenses. As such, while Horizon Blue can offer health insurance, it cannot be the primary auto medical insurer in the event of a car accident.

Horizon Blue Cross Blue Shield of New Jersey is the largest health insurer in the state

One of the key advantages of Horizon Blue Cross Blue Shield is its extensive network of healthcare providers. The company boasts one of the largest networks of doctors, hospitals, and specialists in the state, ensuring that its members have convenient access to quality medical care. This comprehensive network provides members with a wide range of options for their healthcare needs, giving them peace of mind and confidence in their choice of insurer.

In addition to its broad network, Horizon Blue Cross Blue Shield prioritises affordability and accessibility. The company offers a selection of affordable health care plans, ensuring that individuals and families can find a plan that fits within their budget. Horizon Blue also recognises the importance of staying up-to-date with the latest advancements in healthcare. They provide members with tools and resources to make informed decisions about their health, such as their online app and helpful health news and tips on their website.

Furthermore, Horizon Blue Cross Blue Shield is dedicated to serving the community and fulfilling its responsibilities as a corporate citizen. The company actively engages with community health advocates and leaders to find ways to improve member services and health education. By prioritising the well-being of its members and the community at large, Horizon Blue demonstrates its commitment to making a positive impact beyond just providing insurance coverage.

While Horizon Blue Cross Blue Shield is a prominent health insurer in New Jersey, it's important to note that health insurance and auto insurance are separate entities. In the event of an auto accident, individuals typically rely on their auto insurance policy's Personal Injury Protection (PIP) to cover their medical expenses. However, in certain cases, individuals can choose to designate their health coverage provider, such as Horizon Blue, as the primary source of medical care after an auto accident, with their auto insurer providing secondary coverage. This option allows for flexibility and coordination between health and auto insurance providers to ensure individuals receive the necessary medical care and financial protection.

Horizon Blue offers affordable health insurance plans to meet your budget and health care needs

Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) is the state's largest health insurance company, serving over 3.6 million members. It offers a range of affordable health care plans to meet your budget and health care needs.

Horizon BCBSNJ is a not-for-profit, tax-paying health insurer, headquartered in Newark, New Jersey. The company has been serving generations of New Jersey families and businesses for 80 years and is committed to providing financial protection and peace of mind through its products and services.

Horizon BCBSNJ offers a variety of health insurance plans, including individual plans, Medicare, and NJ FamilyCare. They also have a Medicaid managed care plan called Horizon NJ Health, which is designed for individuals with Medicaid/NJ FamilyCare.

In addition to health insurance, Horizon BCBSNJ provides access to professional medical advice through their 24/7 Nurse Line, prenatal and chronic care programs, case management services, behavioural health services, and lifestyle improvement resources.

When it comes to auto accidents in New Jersey, your health insurance policy can be designated as your primary source of medical care. This means that your health insurer will pay first, and your auto insurer will provide secondary coverage through Personal Injury Protection (PIP). PIP covers medical expenses and other costs like lost wages, regardless of who is at fault for the accident.

While choosing your health insurer as the primary source can save you money on auto insurance premiums, it may not always be in your best interest. Health insurance policies often have deductibles, copayments, and sometimes even co-insurance, which can result in higher out-of-pocket expenses compared to auto coverage. Additionally, health coverage may have restrictions on medical provider choice, whereas PIP does not have network restrictions and usually covers medically necessary treatments.

In New Jersey, you can choose to designate your health insurer as your primary source of medical care after an auto accident

In New Jersey, if you have health insurance, you can choose to designate your health insurer as your primary source of medical care after an auto accident. This is known as the "Health Care Primary" option. If you opt for this, your health insurance provider will be the primary payer for medical expenses incurred from a motor vehicle accident, and your auto insurance will provide secondary coverage through Personal Injury Protection (PIP).

There are a few important considerations to keep in mind when making this decision. Firstly, while choosing your health insurer as the primary source can save you money on your auto insurance premiums, there might be negative consequences that outweigh these short-term savings. Health insurance policies often have deductibles, copayments, and sometimes even co-insurance, which can result in a higher out-of-pocket maximum compared to auto coverage. Secondly, health coverage may limit your choice of medical providers, restricting you to only seeing doctors within your network. On the other hand, PIP does not have network restrictions and usually covers medical bills as long as the treatment is deemed medically necessary. Additionally, choosing Health Care Primary may result in paying for a PIP coverage that you cannot use, as health insurance policies generally don't have caps on benefits.

Before selecting the "Health Care Primary" option, it is essential to ask yourself the following questions:

• Does your health coverage provider cover injuries from automobile accidents?
• If your primary and/or secondary health insurer provides coverage, what are the requirements for limits, deductibles, co-payments, and pre-certification?
• Do you have Medicare or Medicaid? (Note: You cannot select Medicare or Medicaid as your primary health insurer for auto accidents.)
• What happens if I lose my health coverage?

It is also important to remember that you need to get medical help as soon as possible after an auto accident, as delaying treatment can worsen your injuries and lead to unnecessary pain.

Horizon Blue is a not-for-profit, tax-paying health insurer

In the state of New Jersey, if you have health insurance, you can choose to designate your health care insurer as your primary source of medical care in the event of injuries sustained in an auto accident. In this case, your health care insurer will pay for your medical bills first, and your auto insurer will provide secondary coverage through Personal Injury Protection (PIP).

Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) is a not-for-profit, tax-paying health insurer and the largest health insurer in the state. As a not-for-profit, Horizon Blue has operated under the same structure since 1932, when it was established as the insurer of last resort, agreeing to cover New Jerseyans who couldn't get insurance in the marketplace. In 2022, the company sought permission to change its corporate structure to a not-for-profit mutual holding company, which would allow it to reduce its tax burden and invest in for-profit subsidiaries. This change was approved by the state, allowing Horizon Blue to act more like its for-profit competitors and pursue options such as investing in technology and buying physicians' practices.

While Horizon Blue has transitioned to a not-for-profit mutual holding company, it remains committed to its provider networks and serving policyholders across all 21 counties in New Jersey. The company has also pledged to continue its charitable mission and maintain its position as a "charitable and benevolent institution." This includes plans to lower prescription drug costs and increase opportunities for mental health and substance use treatment.

It's important to note that even with this transition, Horizon Blue, as a health insurer, may be designated as the primary source of medical coverage in the event of auto accidents, with auto insurance providing secondary coverage through PIP. This decision is up to the individual, and there are pros and cons to consider when choosing a primary source of medical care. While selecting a health insurer as primary coverage can result in savings on auto insurance premiums, it may also lead to higher out-of-pocket expenses and restrictions on medical provider choice.

Horizon Blue has access to $300 million to form for-profit subsidiaries and pursue options like investing in technology

Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) is the largest health insurer in the state, covering nearly one-third of all New Jersey residents. In November 2022, the state granted Horizon permission to broaden its business portfolio and reduce its tax burden, allowing it to operate more like its for-profit competitors. This corporate change gave Horizon immediate access to $300 million to form for-profit subsidiaries and explore new avenues, such as investing in technology and purchasing physicians' practices.

This development is a significant shift for Horizon, which was initially established as a not-for-profit health services corporation. Historically, it was considered the insurer of last resort for individuals with no alternative means of obtaining coverage. However, with this new structure, Horizon will be able to expand its business ventures while still maintaining its commitment to its policyholders.

The $300 million windfall positions Horizon to make strategic investments in technology, which could include enhancing its digital infrastructure, developing innovative healthcare solutions, or even exploring telemedicine options. Investing in technology can improve operational efficiency, streamline processes, and ultimately benefit its extensive customer base.

Additionally, Horizon has the opportunity to form for-profit subsidiaries, which can provide it with greater flexibility and financial advantages. This move enables Horizon to diversify its business portfolio and potentially tap into new markets or services. The formation of subsidiaries can also facilitate a more focused approach to specific areas of interest, such as specialised healthcare services or targeted initiatives.

While this evolution brings Horizon closer to its for-profit competitors, the organisation remains committed to its social responsibilities. As part of the agreement with the state, Horizon has pledged to maintain its provider networks, continue serving policyholders across all 21 counties, and expand the reach of its Medicare Advantage plans. Moreover, Horizon has expressed intentions to lower prescription drug costs and increase access to mental health and substance use treatment services.

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