A network change for services provided outside Horizon Blue Cross Blue Shield's service area. In compliance with a mandate set forth by the Blue Cross and Blue Shield Association, effective January 1, 2009, members seeking behavioral health and substance abuse services outside of Horizon Blue Cross Blue Shield of New Jersey’s local service area have access to the BlueCard® network of participating physicians, other health care professionals and facilities – the largest health care network in the nation. Members no longer have access to Magellan Behavioral Health’sTM participating network for behavioral health and substance abuse services provided outside Horizon BCBSNJ’s local service area.

If your clients’ employees are currently receiving behavioral health or substance abuse care outside Horizon BCBSNJ’s local service area that was authorized by Magellan Behavioral Health, they may continue to receive that care until the authorized course of treatment is completed.

In addition, your clients’ employees may use a behavioral health or substance abuse care professional or facility that does not participate with the BlueCard network, however, doing so may result in higher out-of-pocket expenses.

To locate a participating BlueCard physician, other health care professional or facility, your clients’ employees may access the Provider Directory on our Web site, www.HorizonBlue.com, and click BlueCard Doctor and Hospital Finder or call 1-800-810-BLUE (2583). As always, in the event of an emergency, your clients’ employees should go to the nearest facility or seek immediate care without regard to participation status.

This requirement does not apply to Pharmacy Services or to self-funded groups who have
negotiated and contracted directly with a vendor to administer their behavioral health benefits.
Horizon BCBSNJ members receiving behavioral health and substance abuse services in Horizon
BCBSNJ’s service area may continue to use the Magellan Behavioral Health network.

Horizon BCBSNJ is responsible for providing eligibility and benefit information to physicians
and other health care professionals on behalf of your clients’ employees. They may call us directly at the telephone number indicated on your clients’ employees’ ID cards to confirm eligibility and benefits or to obtain prior authorization for certain services as appropriate.

Download the PDF: Horizon Brief Notes 3.18.09