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Horizon enrollment change

Horizon enrollment change 2026

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The document is a Non-Group Enrollment/Change Request form for Horizon Blue Cross Blue Shield of New Jersey. It outlines the process for individuals to add or remove subscribers, dependents, or make other changes to their health insurance coverage. The form includes sections for applicant information, plan options, primary care provider selection, and eligibility requirements. It also details the necessary documentation and reasons for enrollment changes, as well as instructions for submission.

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Click ‘Get Form’ to open the horizon enrollment change document in the editor.
Begin with Section A, where you will select the type of activity: ADD, REMOVE, or OTHER CHANGE. Check all applicable boxes and provide the date of the event.
In Section B, fill out your personal information including your last name, first name, date of birth, and contact details. Ensure accuracy for a smooth process.
Proceed to Section C to choose your desired medical plan option. Remember that selecting a pediatric dental plan is mandatory.
In Section D, identify any additional individuals you are adding or removing from coverage. Provide their details as required.
Complete Sections E through I by providing any additional information requested and signing where indicated. Make sure to review all entries for completeness.

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Versions	Form popularity	Fillable & printable
2023	4.2 Satisfied (49 Votes)
2022	4.8 Satisfied (55 Votes)
2020	4.8 Satisfied (247 Votes)
2020	4.8 Satisfied (117 Votes)
2020	4.8 Satisfied (101 Votes)
2020	4.7 Satisfied (51 Votes)
2020	4.3 Satisfied (26 Votes)
2020	4.8 Satisfied (261 Votes)
2020	4.2 Satisfied (36 Votes)
2020	4.4 Satisfied (134 Votes)
2019	4.5 Satisfied (54 Votes)
2019	4.8 Satisfied (130 Votes)
2019	4.8 Satisfied (171 Votes)
2019	4.8 Satisfied (35 Votes)
2019	4.8 Satisfied (142 Votes)

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Is Horizon, NJ Medicare or Medicaid?

Horizon NJ TotalCare (HMO D-SNP) combines all your Medicare and Medicaid benefits and more into one plan all at no cost to you!

Is Ozempic covered by Horizon NJ Health?

Coverage for Ozempic Horizon Blue Cross Blue Shield of New Jersey generally covers Ozempic under its prescription drug plan for those diagnosed with type 2 diabetes. Coverage is often subject to plan-specific guidelines, including requiring prior authorization from your healthcare provider.

What does change in enrollment mean?

A time outside the yearly Open Enrollment Period when you can sign up for health insurance. You qualify for a Special Enrollment Period if youve had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child.

Can you make changes after open enrollment?

A company can switch plans or add new things in the middle of the year, they just must give proper notice AND allow you to basically have open enrollment again, including the option to join if you waived in April or drop if you no longer want to participate.

Are Horizon NJ Health referrals no longer needed?

Were making it easier than ever for you to get access to quality health care. Effective immediately, Horizon NJ Health members no longer need a referral from their Primary Care Provider () to visit an in-network specialist. Now, you can make an appointment with a specialist without getting a referral from your .

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Are NJ FamilyCare and Horizon the same?

As a member of Horizon NJ Health, you get the benefits and services you are entitled to with the NJ FamilyCare Program. The medical care and services you get through Horizon NJ Health are free or low cost.

Does Horizon NJ family care require referrals?

No Referrals Needed: See any of our in-network providers, not just limited to primary care, dentists and OB/GYNs. 24-Hour Nurse HelpLine: Get medical advice and information from a nurse 24 hours a day, 7 days a week, 833-731-2147 (TTY 711).

Horizon enrollment change 2026

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