Horizon Blue Cross Blue Shield

Does anyone have this insurance company? I started a new job and this is the health insurance company that is offered. I am trying to decide what plan to go with as I have two options. It doesn’t give me any info on the website nor the info I was given if pump supplies are covered. Can anyone help me? I do 3 months supplies for the infusion sets, reservoirs, sensors for my dexcom. I know I should know this stuff as I was a medical biller but its been a LONG time since I had insurance that wasnt state. Thanks!

Sorry, can’t help you. Your best bet would be to talk to HR (or whoever takes care of the health insurance). Better yet, just find out the differences between the two plans. I think at my current job (city employee) the only difference between the two options are that the more expensive plan covered out of network doctors. I BELIEVE all the co-pays were the same.

Your other option is to call Animas and Horizon and see what they say

I am going to email animas rep that I’ve been dealing with and see what he says. Perhaps he can shed some light for me. But thought I ask for those who have the health insurance who can assist as well.

The thing is pump supplies can be in various places, and just about no customer service reps have a clue where they are.

That’s why I fired my broker.

You would never know from my coverage booklets where they are placed, but they are under Home health care and paid 100 percent. Most other items are detailed, not them.

So you need to locate an informed person somehow.
Make the Animas insurance dept do the footwork if you can.

Thanks laura…I keep looking at the website to see if I can figure it out and nope. it seems like its all a secret

I’m pretty good at studying plans now, and that’s why I fired my broker. I make them send packages to us (hubby and I ) for small business coverage and then I select the best I can find for what I can afford.
I can tell you, pump stuff isnt in there very often.
Our HMO finally bothered to put in the actual pump, and that took years. Supplies, no.
But I really think Animas can locate the info or may even already know.
Best wishes!

Horizon has multiple plans, State workers, different plans to offer companies, etc They cover the Federal BCBS plans in NJ. Asking other people will give you general good/ bad dealing with Horizon, but their plan might be totally different than yours.
I would talk to the person that handles insurance in your company and call your companies number for Horizon and ask them the differences, specifically about durable medical equipment ( what insulin pumps and supplies are usually covered under) Animas might be able to help you

thanks for letting me know that pumps and supplies are durable medical equipment! So if I am reading this right, Plan 1 is 90% (2,500 max benefit combined in network and out of network) whereas out of network is 70% after deductible (2500 max benefit combined in network and out of network), plan 2 deductible, then 80%, $500 max combined. and the out of network is 60% no deductible, $500 max combined.

Maybe, but check.
Remember my HMO calls them (supplies) Home health care disposables and pays 100 percent.

I will…When I have a moment to talk to the benefits manager I’ll ask her…She may not know the exact answer as I may be the only one on a pump that works there. But I hope she can get the answer before the open enrollment closes.

Did you give Animas insurance dept a try? That still might work too.
Good luck!

I emailed the rep that I deal with at Animas as i dont hear on the phone that well. Hopefully he can assist

Great, I hope you get your answer very soon!!!