SHBP Emergency Room Copayment Changes Announced
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Beginning January 1, 2017, (and December 24, 2016 for certain members), the hospital Emergency Room (ER) copayment will increase for some of the Horizon Blue Cross Blue Shield of New Jersey plans offered under the State Health Benefits Program (SHBP).

The chart below shows the new ER copayment amounts by plan.

ER Copayment Chart

Plan Current New
NJ DIRECT10 $50 $75
NJ DIRECT15 $75 $100
NJ DIRECT1525 $100 $100
NJ DIRECT2030 $125 $125
NJ DIRECT2035 $300 $300
Horizon HMO10 $60 $85
Horizon HMO15 $75 $100
Horizon HMO1525 $100 $100
Horizon HMO2030 $125 $125
Horizon HMO2035 $300 $300
OMNIASM Health Plan $100 $100
NJ DIRECT HD1500 Deductible/Coinsurance Deductible/Coinsurance
NJ DIRECT HD4000 Deductible/Coinsurance Deductible/Coinsurance

Any increase to an ER copayment does not apply for dependent children under age 19 years or to ER visits for members referred to the ER by a doctor. In addition, ER copayments are waived if the member is admitted to the hospital via the ER.

There are no ER copayment changes for members in group numbers 93500 or 95300.

New identification cards were not issued as a result of the ER copayment changes. Please refer to the above chart for copayment amounts.