HEALTH CRISIS: Lakewood Families Set To Be Shut Out From Hackensack Meridian Health Hospital Network

Thousands of Lakewood families who rely on Horizon health insurance could soon face major disruptions in their healthcare options. Hackensack Meridian Health (HMH) has announced it will remove its hospitals from the Horizon network effective June 1, 2025, unless an agreement is reached on pricing. This decision could have devastating consequences for many local families, as it would cut these families out of major New Jersey hospitals – including Jersey Shore University Medical Center and Ocean University Medical Center.

For the past year, Horizon has been negotiating with HMH to keep its hospitals in-network. However, HMH has demanded significant price increases for services and care, which Horizon says would lead to higher out-of-pocket costs and rising insurance premiums for members.

“Horizon has offered a fair and reasonable price increase,” the insurer stated. “However, HMH is demanding an increase that is much higher than the rate of inflation.” Over the past five years, HMH’s prices have already risen beyond inflation, making it one of the most expensive hospital systems in New Jersey.

With a large percentage of Lakewood residents insured through Horizon, the termination of HMH hospitals could force families to find alternative hospitals for emergency care, maternity services, and specialized treatments.

Jersey Shore University Medical Center thousands of local patients each year. Losing access to this hospital could mean longer travel times for care, increased medical costs, and disruptions in treatment for those with ongoing conditions.

While HMH’s physician groups—including primary care and specialists—will remain in-network, hospital services, surgeries, emergency care, and inpatient treatments will become out-of-network after May 31, 2025, unless an agreement is reached.

Patients who are undergoing critical treatments—such as cancer therapy, pregnancy, or major surgeries—may be eligible for up to 90 days of continued in-network care at HMH hospitals. However, they will need to apply for Continuity of Care through Horizon with their doctor’s approval.

For all other services, starting June 1, 2025, HMH hospital visits will be considered out-of-network, resulting in significantly higher out-of-pocket costs for patients.

Access remains in place until May 31, 2025 – Horizon members can continue using HMH hospitals at in-network rates until then.

Medicaid, DSNP, and Braven Health members are not affected – These plans will continue to cover HMH hospitals.

Emergency care is still covered – Regardless of network status, emergency visits to HMH hospitals will be billed at in-network rates.

Alternative hospitals may be needed – Patients should discuss switching to an in-network hospital with their doctors.

Horizon has stated that negotiations are still ongoing in an effort to avoid disruptions for thousands of New Jersey families. However, if no agreement is reached, many Lakewood residents will need to seek care at alternative hospitals, impacting both routine and emergency medical services.

In a statement, Hackensack Meridian Health responded to the news and included a fact sheet:

“Hackensack Meridian Health, the leading not-for-profit healthcare organization in New Jersey, is here for our patients, team members, and physicians when and where they need us. We value the trust they put in us every day. Hackensack Meridian Health has been unable to reach an agreement on our hospital contract with Horizon Blue Cross Blue Shield of New Jersey despite lengthy negotiations. We have been and remain committed to reaching an agreement but must receive fair care reimbursements from Horizon to continue to invest in the care, medical technology, and locations that the local communities we serve rely on and expect.

Horizon’s proposal includes inadequate reimbursement rates and demands significant changes to previously agreed-upon contract terms. HMH remains committed to working with Horizon to reach a mutually beneficial agreement prioritizing high-quality patient care and access.”

“Hackensack Meridian Health, the leading not-for-profit healthcare organization in New Jersey, is here for our patients, team members, and physicians when and where they need us. We value the trust they put in us every day. Hackensack Meridian Health has been unable to reach an agreement on our hospital contract with Horizon Blue Cross Blue Shield of New Jersey despite lengthy negotiations. We have been and remain committed to reaching an agreement but must receive fair care reimbursements from Horizon to continue to invest in the care, medical technology, and locations that the local communities we serve rely on and expect.

Horizon’s proposal includes inadequate reimbursement rates and demands significant changes to previously agreed-upon contract terms. HMH remains committed to working with Horizon to reach a mutually beneficial agreement prioritizing high-quality patient care and access.”

- Advertisement -

1 COMMENT

  1. Why is everything in Lakewood called a “Crisis”
    Life isn’t simple for anyone. Just live and figure out how to navigate.

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Most Popular

WATCH: New Jersey Democratic Candidates Face Off In First Gubernatorial Debate

Six Democratic candidates vying to be New Jersey’s next...

Six Flags Great Adventure Announces Thrilling New Attractions for 2025 and 2026

Six Flags Great Adventure is gearing up for a...

New Jersey Assembly Passes Asm. Schnall’s Bill to Streamline Construction Inspections

In a major victory for builders, contractors, and foremen...

BD”E: Jewish Surgeon Niftar After Suffering Medical Episode On Garden State Parkway In Lakewood

Dr. Jarrod P. Kaufman, a prominent surgeon from Toms...