Horizon Blue Cross Blue Shield of New Jersey and Spravato.
Horizon is New Jersey’s largest insurer, and a lot of our patients have it. Horizon covers Spravato with a prior authorization, which we prepare, submit and follow up for you.
Yes, Horizon covers Spravato.
- Covered with a prior authorization. Horizon wants to see your diagnosis and the antidepressants you’ve already tried. We put that together.
- Up to $40 a treatment for most patients with a Horizon commercial plan, after the manufacturer’s SpravatoWithMe savings program, for those who are eligible. Your own plan sets the details, and we confirm your cost before you start.
- Horizon NJ Health is different. It’s a Medicaid plan, and patients pay $0, with help setting up covered rides to treatment. How we handle Medicaid plans.
$0 to $40 a treatment
- NJ Medicaid: $0. Initial denials are common, and we’re incredibly persistent about appealing.
- Commercial insurance: up to $40 after Janssen’s SpravatoWithMe program, for patients who are eligible. Your own plan sets the details.
- We check before you commit. Insurance verification starts the moment you reach out.
From your Horizon card to your first treatment.
- You reach outSend the short form, with your Horizon card handy if you can.
- We check your planHorizon has many plan types. We confirm how yours covers Spravato and what your share is.
- Your evaluationUsually within one business day of your first call.
- We get the approvalWe submit the prior authorization to Horizon and follow it through. If it’s denied, we appeal.
Have Horizon? Find out your cost today.
Send us your plan details and we’ll check your Spravato coverage, usually before your evaluation.
Name, date of birth and insurer. We check your plan and call you back. No commitment.
Check my coverageRegister once, and our team starts your insurance check and reaches out to schedule your evaluation.
Request an evaluationWe appeal, and we keep going.
Most of our requests are approved on the first try: 95% in our most recent internal review. When an insurer does say no, we appeal through each level available, up to an independent external review. In that same review, 34 of 36 denials were overturned.
Close to most Horizon members.
Our offices are in Bridgewater, Morristown, Nutley and Hoboken, all on one phone number.
What Horizon members ask us.
Is Spravato covered by Horizon Blue Cross in NJ?
Yes. Horizon Blue Cross Blue Shield of New Jersey covers Spravato for treatment-resistant depression with a prior authorization. We prepare and submit it for you.
How much will Spravato cost me with Horizon?
Most of our patients with a Horizon commercial plan pay up to $40 a treatment after the manufacturer’s SpravatoWithMe savings program, for those who are eligible. We confirm your exact cost before your first treatment.
Is Horizon NJ Health the same as Horizon Blue Cross?
No. Horizon NJ Health is a Medicaid (NJ FamilyCare) plan. It also covers Spravato with a prior authorization, and patients pay $0. Initial denials are common, and we appeal. Its policy does exclude Spravato for anyone with a history of bipolar disorder.
What if Horizon denies my Spravato request?
We appeal, through each level the plan allows. You won’t have to write the letters or make the calls.