Under the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation (HCR) Acts, certain preventive care, such as immunizations (age and population restrictions may apply), certain screenings (blood pressure, cholesterol, depression, newborn, etc.), FDA-approved contraceptive methods, and well-baby care, will be covered by all of the SHBP medical plans without member cost sharing.Īs a result, primary care well visits (annual exams) will no longer require a copayment or coinsurance by the member for certain wellness services provided by an in-network provider. Preventive Services, Immunizations and Certain Screenings $300 employer funded Health Savings Account.$1,000 In-Network Individual Out-of-Pocket Maximum ($2000 Family).$3000 In-Network deductible Employee + 1 or more dependents.$1,000 In-Network Individual Out-of-Pocket Maximum.20% coinsurance after deductible is satisfied.$8000 In-Network deductible Employee + 1 or more dependents.*The Horizon HMO plan has a limited service area of New Jersey, Delaware, New York and bordering counties in Pennsylvania. $30 Specialist Care copay ($20 copay for children up to the 26th birthday). Members hired after July 1, 2019, will be enrolled in NJ DIRECT 2019.
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