HOSPITAL NETWORK FINDER

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HOSPITAL NETWORK FINDERThis listing of OMNIA Health Plan Tier 1 and Tier 2 hospitals is complete as of October 2017. The list is subject tochange, so always verify hospital network participation status prior to making your selection. Check for the mostcurrent information by: Using the online Doctor & Hospital Finder located on our website at HorizonBlue.com/doctorfinder Contacting the physician, health care professional or department directly Calling the Customer Service telephone number listed on your ID cardSelect the OMNIA Health Plan Tier 1 or Tier 2 hospital that’s right for you to maximize your coverage benefit.Hospital NameCountyTier 1AtlantiCare Regional Medical CenterAtlantic Shore Medical Center*Atlantic Englewood HospitalBergen Hackensack UMC at Pascack Valley (Hackensack Meridian Health)Bergen Hackensack University Medical Center (Hackensack Meridian Health)Bergen Holy Name HospitalBergen The Valley HospitalBergen St. Luke’s Hospital - QuakertownBucks Deborah Heart and Lung CenterBurlington Lourdes Medical Center of Burlington CountyBurlington Virtua – Memorial Hospital of Burlington CountyBurlington Cooper Hospital University Medical CenterCamdenKennedy Memorial HospitalCamden Our Lady of Lourdes Medical CenterCamden Virtua - West Jersey Hospital SystemCamden Cape Regional Medical CenterCape May Inspira Medical Center – VinelandCumberland * Hospital will be TIER 2 effective 1/1/2018Tier 2

HOSPITAL NETWORK FINDERHospital NameCountyDelaware County Memorial HospitalDelaware, PAClara Maass Medical Center (RWJBarnabas Health)EssexEast Orange General HospitalEssexHackensack UMC at Mountainside (Hackensack Meridian Health)Essex Newark Beth Israel Medical Center (RWJBarnabas Health)Essex St. Barnabas Medical Center (RWJBarnabas Health)Essex St. Michael’s Medical CenterEssex University HospitalEssex Inspira Medical Center – WoodburyGloucesterBayonne Medical Center (CarePoint Health)Hudson Christ Hospital (CarePoint Health)Hudson Hackensack UMC Palisades (Hackensack Meridian Health)HudsonHoboken University Medical Center (CarePoint Health)HudsonJersey City Medical Center (RWJBarnabas Health)HudsonMeadowlands Hospital Medical CenterHudsonHunterdon Medical CenterHunterdonCapital Health System – Fuld**Mercer Capital Health System – Regional/Hopewell**Mercer Robert Wood Johnson – Hamilton (RWJBarnabas Health)MercerSt. Francis Medical CenterMercer JFK Medical CenterMiddlesex University Medical Center of Princeton at Plainsboro *Middlesex Raritan Bay Regional Medical Center (Hackensack Meridian Health)Middlesex Robert Wood Johnson - New Brunswick (RWJBarnabas Health)Middlesex ** Hospital will be TIER 1 effective 1/1/2018* Hospital will be TIER 2 effective 1/1/2018Tier 1Tier 2

HOSPITAL NETWORK FINDERHospital NameCountyTier 1Tier 2St. Peter’s University HospitalMiddlesexBayshore Community Hospital (Hackensack Meridian Health)MonmouthCentraState Medical CenterMonmouthJersey Shore Medical Center (Hackensack Meridian Health)Monmouth Monmouth Medical Center (RWJBarnabas Health)Monmouth Riverview Medical Center (Hackensack Meridian Health)Monmouth St. Luke’s Hospital – MonroeMonroeChilton Medical Center (Atlantic Health System)Morris Morristown Medical Center (Atlantic Health System)Morris St. Clare’s Denville/DoverMorris AI duPont Hospital for ChildrenNew Castle St. Luke’s Hospital – AndersonNorthhampton St. Luke’s Hospital – BethlehemNorthhampton Community Medical Center (RWJBarnabas Health)Ocean Monmouth Medical Center Southern Campus (RWJBarnabas Health)Ocean Ocean Medical Center (Hackensack Meridian Health)Ocean Southern Ocean Medical Center (Hackensack Meridian Health)Ocean St. Joseph’s Hospital and Medical CenterPassaic St. Mary’s – PassaicPassaic Children’s Hospital of PhiladelphiaPhiladelphia Crozer-Chester Medical CenterPhiladelphia Fox Chase Cancer CenterPhiladelphia Hahnemann University HospitalPhiladelphia Hospital of the University of Pennsylvania (UPHS)Philadelphia Jeanes HospitalPhiladelphia Pennsylvania Hospital (UPHS)Philadelphia

HOSPITAL NETWORK FINDERHospital NameCountyTier 1Tier 2Presbyterian Hospital (UPHS)Philadelphia Rothman Orthopaedic Specialty HospitalPhiladelphia St. Christopher’s Hospital for ChildrenPhiladelphia Temple University HospitalPhiladelphia Thomas Jefferson University and Methodist DivisionPhiladelphia Inspira Medical Center – ElmerSalemMemorial Hospital of Salem CountySalemRobert Wood Johnson – Somerset (RWJBarnabas Health)Somerset Newton Medical Center (Atlantic Health System)Sussex Overlook Medical Center (Atlantic Health System)Union Robert Wood Johnson – Rahway (RWJBarnabas Health)Union Trinitas Regional Medical CenterUnionHackettstown Community Hospital (Atlantic Health System)WarrenSt. Luke’s – WarrenWarren OMNIA Health Plan members enjoy lower premiums, lower deductibles, lower copayments and lowerout-of-pocket costs with OMNIA Tier 1 doctors, hospitals, and other health care professionals,including the OMNIA Health Alliance. Members also have the flexibility to visit any Tier 2 health careprofessional in our broad Managed Care Network for a higher out-of-pocket cost.OMNIA Health Plan members can receive obstetrics services at any hospital in Burlington andMercer counties at an OMNIA Tier 1 level of benefits as a benefit exception, even if the hospital is listedas Tier 2.Horizon Blue Cross Blue Shield of New Jersey is an independent licensee of the Blue Cross and Blue Shield Association.The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.The Horizon name and symbols are registered marks and OMNIASM is a service mark of Horizon Blue Cross Blue Shield of New Jersey. 2017 Horizon Blue Cross Blue Shield of New Jersey, Three Penn Plaza East, Newark, New Jersey.Horizon Blue Cross Blue Shield of New Jersey complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color,gender, national origin, age, disability, pregnancy, gender identity, sex, sexual orientation or health status in the administration of the plan, includingenrollment and benefit determinations. Spanish (Español): Para ayuda en español, llame al 1-866-660-6528. Chinese -6528.C101 201709

Three Penn Plaza EastNewark, NJ 07105-2200HorizonBlue.comNotice of NondiscriminationHorizon Blue Cross Blue Shield of New Jersey complies with applicable Federal civil rights lawsand does not discriminate against nor does it exclude people or treat them differently on the basisof race, color, gender, national origin, age, disability, pregnancy, gender identity, sex, sexualorientation or health status in the administration of the plan, including enrollment and benefitdeterminations.Horizon BCBSNJ provides free aids and services to people with disabilities to communicateeffectively with us, such as qualified sign language interpreters and information written in otherlanguages.Contacting Member ServicesPlease call Member Services at 1-800-355-BLUE (2583) (TTY/TDD 711) or the phonenumber on the back of your member ID card, if you need the free aids and services notedabove and for all other Member Services issues, including: Claim, benefits or enrollment inquiries Lost/stolen ID cards Address changes Any other inquiry related to your benefits or health planFiling a Section 1557 GrievanceIf you believe that Horizon BCBSNJ has failed to provide the free communication aids andservices or discriminated on the basis of race, color, gender, national origin, age or disability youcan file a discrimination complaint also known as a Section 1557 Grievance. Horizon BCBSNJ’sCivil Rights Coordinator can be reached by calling the Member Services number on the back ofyour member ID card or by writing to the following address:Horizon BCBSNJ – Civil Rights CoordinatorPO Box 820Newark, NJ 07101You can also file a civil rights complaint with the U.S. Department of Health and HumanServices, Office for Civil Rights, electronically through the Office for Civil Rights ComplaintPortal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:Office for Civil Rights HeadquartersU.S. Department of Health and Human Services200 Independence Avenue, SWRoom 509F, HHH BuildingWashington, D.C. 202011-800-368-1019 or 1-800-537-7697 (TDD)OCR Complaint forms are available at www.hhs.gov/ocr/office/file/index.html.CMC0008179 A (0817)An Independent Licensee of theBlue Cross and Blue Shield Association.

If you need help understanding this Horizon Blue Cross Blue Shield of New Jersey information,you have the right to get help in your language at no cost to you. To talk to an interpreter, pleasecall 1-866-660-6528 during normal business hours.Spanish (Español): Si necesita ayuda para comprender esta información de Horizon Blue CrossBlue Shield of New Jersey, usted tiene el derecho de obtener ayuda en su idioma sin costoalguno. Para hablar con un intérprete, sírvase llamar al 1-866-660-6528 durante el horarionormal de trabajo.Chinese 澤西州地平線藍十字藍盾 (HorizonBlue Cross Blue Shield of New 上班時間致電 1-866-660-6528。Korean (한국어): 가입자는 Horizon Blue Cross Blue Shield of New Jersey에 관한 정보를이해하기 위해 주로 사용하는 언어로 무료로 도움을 받을 권리가 있습니다. 통역사의도움을 받으려면 정상 업무 시간 동안에 1-866-660-6528로 전화해 주십시오.Portuguese (Português): Se precisar de ajuda para entender estas informações da HorizonBlue Cross Blue Shield of New Jersey, você tem o direito de receber gratuitamente assistência noseu idioma. Para falar com um intérprete, ligue para: 1-866-660-6528 no horário normal detrabalho.Gujarati ():,,1-866-660-6528Polish (Polski): Jeżeli potrzebujesz pomocy, aby zrozumieć informacje planu HorizonBlue Cross Blue Shield of New Jersey, masz prawo poprosić o bezpłatną pomoc w językuojczystym. Aby skorzystać z pomocy tłumacza, zadzwoń pod numer 1-866-660-6528 podczasnormalnych godzin pracy.Italian (Italiano): Se vi serve aiuto per capire queste informazioni della Horizon Blue CrossBlue Shield of New Jersey, avete diritto ad assistenza gratis nella vostra lingua. Per parlare conun interprete, siete pregati di telefonare al numero 1-866-660-6528 durante le normali ored’ufficio.Tagalog (Tagalog): Kung kailangan mo ng tulong sa pag-unawa nitong impormasyon ng HorizonBlue Cross Blue Shield of New Jersey, may karapatan kang humingi ng tulong sa iyong wikanang walang gastos sa iyo. Upang makipag-usap sa isang taga-interpret, mangyaring tumawag sa1-866-660-6528 sa loob ng karaniwang mga oras ng negosyo.CMC0008602 (0916)An Independent Licensee of theBlue Cross and Blue Shield Association.

Russian (Русский язык): Если вам необходима помощь в разъяснении этой � компанией Horizon Blue Cross Blue Shield of New Jersey, у вас есть правона получение помощи на вашем родном языке бесплатно. Для связи с переводчикомзвоните по номеру телефона 1-866-660-6528 в обычные рабочие часы.Haitian Creole (Kreyòl ayisyen): Si ou bezwen èd pou konprann enfòmasyon sou HorizonBlue Cross Blue Shield of New Jersey, ou gen dwa pou jwenn èd nan lang natifnatal ougratis. Pou pale avèk yon entèprèt, tanpri rele nimewo 1-866-660-6528 pandan lè nòmal biznis.Hindi ():1-866-660-6528Vietnamese (Tiếng Việt): Nếu cần được giúp đỡ để hiểu rõ thông tin này của HorizonBlue Cross Blue Shield of New Jersey, quý vị có quyền được giúp đỡ bằng ngôn ngữ của mìnhmiễn phí. Xin gọi số 1-866-660-6528 trong giờ làm việc để nói chuyện với ngườithông dịch.French (Français): Si vous avez besoin d’assistance pour comprendre ces informations ausujet de Horizon Blue Cross Blue Shield of New Jersey, vous avez le droit d’obtenir de l’aidedans votre langue, sans aucun frais. Pour parler avec un interprète, veuillez appeler le1-866-660-6528 pendant les heures normales de bureau.Navajo (Diné):1-866-660-6528Horizon Blue Cross Blue Shield of New JerseyArabic1-866-660-6528(1-866-660-6528) Urdu

Jan 01, 2018 · The Valley Hospital Bergen St. Luke’s Hospital - Quakertown Bucks Deborah Heart and Lung Center Burlington Lourdes Medical Center of Burlington County Burlington Virtua – Memorial Hospital of Burlington County Burlington Cooper Hospital University Medical Center

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