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NJ DIRECT HD1500 and NJ DIRECT HD4000 combine a high-deductible health plan with a health savings account (HSA).
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NJ DIRECT HDHP
NJ DIRECT High Deductible Health Plans (HDHPs)
Eligible preventive services are covered at 100 percent if received in network and do not have a deductible. Members are responsible for all other eligible medical and prescription expenses, up to the deductible.
After the deductible is met, the member is responsible for 20% coinsurance in network and 40% coinsurance out of network as well the difference between the allowance and the amount charged by an out-of-network provider, until the out-of-pocket maximum is reached.
Once the out-of-pocket maximum is reached, eligible services will be covered at 100 percent of the allowance, subject to all plan provisions.
Expenses for ineligible services, charges in excess of the allowance, and services not authorized and determined to be ineligible do not count toward the out-of-pocket maximum.
Other features include:
No need to select a PCP.
No referral needed to see a specialist
Certain services require prior authorization.
No claims to file when accessing care in network.
BlueCard®, giving you access to more than 1.3 million doctors, hospitals, facilities and other health care professionals in the U.S.
Blue Cross Blue Shield Global Core, which covers you and your covered dependents for eligible services when abroad.
Dedicated nurses for additional support in managing a condition or an episode of care.
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