Horizon Medicare Insurance Review & Complaints: Health Insurance (2024)

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Horizon is a New Jersey Blue Cross Blue Shield (BCBS) licensee offering a full range of health insurance options. In addition to major medical plans for individuals and groups, they also offer Medicare options.

This Horizon Medicare review will tell you everything you need to know to decide if Horizon is right for you. We’ll cover plan options, ratings, and how to get a Horizon Medicare quote.

Before you choose to buy Horizon Medicare insurance, compare all of your options. Enter your ZIP code for free quotes from top companies now.

About Horizon

Horizon BlueCross BlueShield of New Jersey was born out of the merger of two older companies. The first was founded in 1932 under the name First Hospital Service Plan. The second, Medical-Surgical Plan of New Jersey, was founded in 1942. Both companies took on BCBS licensing and branding before their eventual merger in 1986; they operated as Blue Cross Blue Shield of New Jersey until 1998 when they took on the name Horizon.

Over the decades Horizon expanded into neighboring states, but eventually pulled their operations back and now serve solely New Jersey residents. Their products include PPO and HMO health plans, dental and vision, and a full range of Medicare plans as well.

Horizon still operates as an independent insurance company with a BCBS license. That means that although they use the BCBS name and logo, their plans are their own and may differ from those offered by other licensees.

Horizon Medicare Plans

Horizon writes Medicare Advantage, Medicare Supplement, and Part D plans. In some cases, plan availability differs by county. To obtain plan information, we entered the zip code of the Horizon head office in Newark, NJ (Essex County).

Horizon Medicare Advantage

Although the main page lists several options for Horizon Medicare  Blue Advantage plans, our sample zip code returned only one option for 2021.

The Horizon Medicare Blue Advantage (HMO) plan is the only option listed. There is a $10 copay for primary care visits and a $25 copay for specialist visits on this plan; inpatient hospital stays have a copay of $320 a day for the first five days.

This plan includes prescription drug coverage with a $250 deductible that applies to Tiers 3 and up only. Copays for prescriptions at a preferred pharmacy start at $1 for Tier 1 drugs. Tier 2 has a $9 copay, Tier 3 a $40 copay, and Tiers 4 and 5 have coinsurance percentages at 35% and 28% respectively.

Routine dental and vision, as well as hearing benefits, are also included with this plan.

Other plans, including the Horizon Medicare Blue Choice w/RX (HMO) plan, may be offered in other ZIP codes.

Horizon Medicare Supplement

Horizon offers several of the standard letter-coded Medicare Supplement plans. They write Plan A, C, G, F, K, and N.

Plan A is the base plan and provides coverage for Original Medicare coinsurance amounts as well as the first three pints of blood annually. This base plan is a requirement for all insurance companies to offer, and from there each plan generally adds more coverage – although some plans only cover some of the coinsurance amount.

Plan F is the most comprehensive. It covers all of the out of pocket costs that are not covered by Medicare, including emergency medical care when traveling abroad. This plan is generally the most expensive. There is a high deductible version of this plan that reduces the monthly cost, but Horizon doesn’t offer it.

Note that Plan F is not available to those newly eligible for Medicare on or after January 1, 2020.

Plan N is generally a budget-friendly plan as well as it has copays for some services in return for a lower monthly premium.

While Horizon does not offer the full list of plans, they have a good selection that should meet the needs of most people.

Horizon Medicare Part D

There are three options for Part D prescription drug coverage available from Horizon.

The base plan, called Saver, has a $150 Rx deductible and copays starting at $0.

The Standard plan has an annual deductible of $415; unlike some plans, this deductible does apply to all tiers. After the deductible, preferred pharmacy rates are $1 for Tier 1, $8 for Tier 2, $32 for Tier 3, and a 25% coinsurance for Tiers 4 and 5.

The Enhanced plan had no deductible. Copays and coinsurance amounts at a preferred pharmacy are the same with the exception of Tier 5, which has a 33% coinsurance amount.

Horizon Medicare Rates

We ran quotes for 2021 plans based on a 65-year-old female.

The supplement rates varied, with Plan A coming in at $117.89 a month and Plan G at $150.88 a month. The least expensive of the plans is Plan K, with a monthly rate of $54.83.

Rates for the Part D plans are $65.30 for the Standard option and $97.40 a month for the Enhanced option. The Saver plan is the cheapest at$23.50 a month.

As noted above, we only returned one plan option for Medicare Advantage, which has a monthly premium of $31.00. You do still have to pay your regular Part A and Part B Original Medicare premiums, however.

Since these rates only apply to New Jersey, and some only to Essex county, we unable to really provide a good comparison on them to other options. They do appear to be in line with the rates we have seen elsewhere for similar plans.

Horizon Medicare Insurance: A Smooth Journey Through the Claims Process

Ease of Filing a Claim

Horizon Medicare offers multiple channels for filing insurance claims to ensure convenience for its policyholders. Customers can file claims through various methods, including online submission, over the phone, or by using the Horizon Medicare mobile app. These flexible options make it easy for individuals to report their medical expenses and initiate the claims process.

Average Claim Processing Time

One critical aspect of any insurance provider is the speed at which they process claims. Horizon Medicare strives to efficiently process claims to provide timely assistance to its policyholders.

While specific processing times may vary depending on the nature of the claim and the documentation provided, Horizon Medicare aims to minimize delays in settling claims and providing necessary benefits to its customers.

Customer Feedback on Claim Resolutions and Payouts

Customer feedback plays a crucial role in assessing the quality of an insurance provider’s claims process. Horizon Medicare values customer satisfaction and continuously seeks feedback on claim resolutions and payouts.

This feedback helps the company make improvements and ensure that policyholders have a positive experience when filing claims. Hearing from customers provides insights into the effectiveness and fairness of Horizon Medicare’s claims handling.

Horizon Medicare Insurance: Pioneering Digital Advancements for Your Coverage

Mobile App Features and Functionality

Horizon Medicare offers a dedicated mobile app designed to enhance the customer experience. The app provides a range of features and functionality, allowing policyholders to manage their insurance on the go. Users can access their policy information, view claims status, and even initiate the claims process directly from the app.

Horizon Medicare’s mobile app aims to simplify insurance management and provide easy access to essential services.

Online Account Management Capabilities

In addition to the mobile app, Horizon Medicare offers robust online account management capabilities through their website. Policyholders can log in to their accounts to access policy details, review claims history, and make payments online. The online portal provides a convenient way for customers to stay informed and in control of their insurance coverage.

Digital Tools and Resources

Horizon Medicare recognizes the importance of providing policyholders with valuable digital tools and resources. These resources may include educational materials, healthcare cost calculators, and access to a network of healthcare providers.

By combining a user-friendly claims process with a suite of digital and technological features, Horizon Medicare strives to offer a seamless and convenient experience for its policyholders. Whether it’s filing a claim or managing insurance through digital platforms, the company aims to provide the necessary tools and resources to meet the diverse needs of its customers.

Horizon Medicare: The Bottom Line

Horizon’s rates are reasonable, although their selection is limited particularly when it comes to Medicare Advantage (at least in our sample area). The complaints listed do not raise a major red flag, but there does seem to be some work to do in terms of the company’s response. Overall, they are worth comparing to the other options out there, but only if you do not mind the limitations of an HMO and aren’t seeking a lot of selection for your Advantage plan.

Even if you find an affordable Horizon Medicare plan, you should always compare your options. Enter your ZIP code now for free quotes.