Plans

NJ DIRECT ZERO

NJ DIRECT ZERO offers the same benefits as NJ DIRECT, but encourages members to use in-network doctors, hospitals and other health care professionals by offering a zero copayment for primary care and specialist visits!

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NJ DIRECT ZERO is offered to School Employees’ Health Benefit Program (SEHBP) active members and retirees who are not Medicare-eligible and are enrolled in an SEHBP plan. The plan offers the same benefits as NJ DIRECT, but encourages members to use in-network doctors, hospitals and other health care professionals by offering a zero copayment for primary care and specialist visits!

Members also have lower out-of-pocket costs when using in-network doctors and facilities in the BlueCard® PPO network nationwide.

Out-of-network benefits are included, but at comparably higher out-of-pocket expenses versus other NJ DIRECT plans¹.

Members enrolled in NJ DIRECT ZERO can also receive $500 annually if they participate in NJWELL and complete the required activities.

Other features include:

  • 100% coverage for preventive services (physical exams, well-child care, immunizations) in network.
  • No requirement to select a Primary Care Physician (PCP).
  • See a specialist without a referral.
  • No claims to file when accessing care in network
  • Access to more than 1.3 million doctors, hospitals, facilities and other health care professionals in the U.S. through BlueCard®.
  • Blue Cross Blue Shield Global℠ Core coverage for eligible services when you and your covered dependents travel abroad.
  • Dedicated nurses for additional support in managing a condition or an episode of care..
  • Precious Additions®, a prenatal education and information program.
  • Online servicesto manage your personal benefit and claim information.
  • My Health Manager, powered by WebMD®, for a range of health and wellness tools and resources online.

Some services require prior authorization.

¹Out-of-network cost basis: 200% of CMS for NJ DIRECT ZERO; 90% of FAIR Health for all plans with an out-of-network benefit.