State of New Jersey - (Horizon BCBS)
The State of New Jersey welcomes you to Paladina Health!
The State of New Jersey is pleased to now offer access to the Paladina Health benefit. Paladina Health is available only to active employees and dependents covered under the SHBP/SEHBP NJ DIRECT plans, SHBP OMNIA plans and Non-Medicare eligible retirees.
Take a Tour of a Paladina Health Office.
Clients: Convenient Care-Small
Get access to your physician around the clock for urgent needs by phone. Plus, get same- or next-day appointments for urgent needs.
Clients: Save Money-Small
Get care with low or no co-pays. Plus, save money on things like specialists and urgent care visits with our broad scope of services.
Clients: Experienced Physicians-Small
Sign up to get direct access to an experienced physician—your physician—whose goal is to help you be the healthiest you can be.
Client Splash Page: Benefits
Get These Benefits & More
Sign up for Paladina Health to:
- Partner with an experienced primary care physician who delivers a broad scope of care, including primary and preventive care, chronic disease management, urgent care, and coordination with specialists and hospitals.
- Access your physician 24/7 via phone for urgent needs, or email or visit your physician at a convenient location.
- Save money. Most services are free, with no co-pays or co-insurance.*
*For those contributing to an HSA, some fees may be required for non-preventive services.
Client Splash Page: Dependents
Learn About Your Benefit
Imagine the doctor’s office, the way it used to be… where doctors knew their patients and their families, and took great care of them all.
With your Paladina Health benefit, you get a modern approach to the way healthcare used to be. Watch this short video to learn how Paladina Health works differently for our patients.
Paladina Health is a provider of primary care services that is at the forefront of innovation in healthcare.Â It operates patient-centered medical homes where patients can get most of the medical services they need from an experienced doctor at no out-of-pocket cost. Paladina Health doctors are dedicated to serving an employerÂ’s population, are highly accessible at convenient office locations and are held accountable for delivering great care and service. These doctors provide a personal level of service and are available around the clock via phone for urgent health matters.
Q:Â How are you different from an Urgent Care Clinic?
As a primary care doctors office, we donÂ’t have the long wait times that you may experience when going to a walk-in clinic. Scheduling your appointment for same or next day urgent needs allows you to get in at your scheduled appointment time instead of waiting behind the people in front of you.
Q:Â Who is eligible to sign up for Paladina Health?
As an active member of the State Health Benefits Program (SHBP) or School EmployeesÂ’ Health Benefits Program (SEHBP), you are eligible to enroll in Paladina Health services. You may choose to enroll yourself and/or any of your eligible family members. Employees retain the same access to their insurance-contracted providers through Horizon and the same benefits as offered in their current SHBP or SEHBP health plan.
Q: Why is the SHBP/SEHBP offering this benefit?
The SHBP/SEHBP are offering this choice to address the cost of the healthcare you receive through this collaboration with Paladina Health. Through this program, you will receive high-quality primary care with no co-pays through your Paladina Health doctor. Ultimately, this innovative approach to primary care is designed to help you be healthier and to lower your overall out-of-pocket healthcare costs.
Q: Does choosing the Paladina Health option increase my healthcare costs?
No, it should do just the opposite. Services are provided at no out of pocket costs and you do not have co-pays. There is also
no charge for phone, email or other remote interactions with your doctor. Paladina Health services cover a wide array of the
most common tests and procedures.
Q: What is different about Paladina Health compared to my current primary care provider?
Paladina Health provides primary care services for you andÂ your family, but is not just another primary care provider.Â As a Paladina Health patient, you get access to your doctor via phone 24/7 for urgent needs. For urgent after hours needs, simply call the office scheduling number whichÂ will allow you to have yourÂ call directly and securely routed to your doctor. YouÂ’ll also get help and assistance in navigating the healthcare system when you need specialist services or care that cannot be provided at the Paladina Health office.
Q: How experienced are Paladina Health doctors?
Paladina Health doctors are dedicated, board-certified or board-eligible, usually with a minimum of eight to ten years of experience as a practicing doctor. Our doctors have 70 percent fewer patients than a typical primary care doctor, allowing them to spend more time with you when you need it, start appointments on time and provide you with appointment availability in the timeframe that meets the urgency of your health issue.
Q: I already have a long-standing PCP, why would I change?
Paladina Health is an additional option to your existing health plan. If you choose to enroll, we recommend that your Paladina Health provider become your first point of contact. Due to the limited number of patients managed by Paladina Health doctors, you will experience a meaningful patient-doctor relationship, excellent care, and easy access to your personal doctor. This means that rather than going directly to a specialist to receive care, you take advantage of the many convenient access points to your Paladina Health doctor and you may even be able to avoid a visit with a specialist. As such, we recommend that immediately after signing up, you schedule your first appointmentÂ—the comprehensive patient evaluation.
Q: What if I have a pediatrician for my children I already like?
Most Paladina Health doctors are fully trained in pediatrics and can be another option for your childrenÂ’s healthcare. Typically, it takes less time to get an appointment at the Paladina Health doctorÂ’s office than it does in a pediatricianÂ’s office. Also, your Paladina Health doctor is available 24/7 via phone for urgent needs, including nights and weekends.
Q: What happens if I am experiencing an urgent health issue after hours or I am away from home?Â
For urgent after hours needs, simply call the office scheduling number whichÂ will allow you to have yourÂ call directly and securely routed to your doctor. YourÂ doctor will respond to your concerns no matter where youÂ are or when you call. He or she is directly available to you for urgent situations 24 hours a day, every day of the week, including holidays.
Q:Why should I sign up now if IÂ’m not sick currently?Â Why not wait until I am sick?
Injuries and illnesses happen on weekends and evenings when most doctor practices are closed. That is usually the time you most need access to a trusted medical professional. With Paladina Health, youÂ’ll receive your doctorÂ’s phone number for just this reason. However, it is important to first build a relationship with your care provider. You will want your doctor to know you, your medical history and your health concerns long before you get sick. Plus, Paladina Health employs screening protocols that may catch a health issue that can be treated early, preventing something from becoming an urgent situation.
Q: How do I enroll my dependents?
Signing up your dependents is easyÂ—and no cost to you. Just visit paladinahealth.com/newjerseyinfo. Your dependents will get the same 24/7 doctor access for urgent needs and patient-first care from Paladina Health. You can check or change your and/or your familyÂ’s enrollment status at any time by calling Paladina Health Member Services at 1-866-808-6005.
Q: Can I visit any Paladina Health location? Am I only allowed to see my selected doctor?
Your selected Paladina Health doctor will be your primary point of contact and the medical professional overseeing your care. However, you may make an appointment at any of our Paladina Health doctorÂ’s offices that are open to the public and choose to see another provider as needed. You may also email or call your doctor with your questions, or for consultation. In this situation, contact your Paladina Health doctor first and they will advise on the best option for you. The services, convenience and costs at a Â“publicÂ” location will be the same as at your established Paladina Health location. In the event your selected Paladina Health doctor is not available (for example: on vacation or unplanned absence), Paladina Health will provide coverage to ensure your healthcare needs are met.
Q: What if IÂ’m not ready to sign up now, but may want to later?
You may enroll in Paladina Health at any time by visiting www.paladinahealth.com/enroll.