What is the coverage for prescription medications?

Horizon BC/BS of New Jersey typically provides coverage for prescription medications as part of its health insurance plans, but the specifics can vary based on the individual plan selected. Generally, prescription drug coverage includes a list of medications, often referred to as a formulary, which categorizes medications into tiers. Each tier often has different co-pay amounts, with generic medications usually being the least expensive and specialty drugs often falling into a higher tier with higher out-of-pocket costs for members. It is important to note that not all prescription medications may be covered. Some may require prior authorization or may not be included in the plan’s formulary at all. Additionally, certain plans might include specific conditions or limitations regarding the medication, such as quantity limits or step therapy protocols. Members of Horizon BC/BS of New Jersey are encouraged to review their specific plan documents for comprehensive details about prescription coverage, including cost-sharing details and any exclusions or limitations that may apply. For the most accurate and updated information regarding prescription medication coverage, it would be advisable to refer to the official Horizon BC/BS of New Jersey website, where you can find resources and potentially contact information if needed. This will ensure you have the latest information pertinent to your health plan.