New Jersey Patients Caught in the Middle as Horizon and Hackensack Meridian Face Contract Standoff

the staff of the Ridgewood blog

Hackensack NJ, a looming contract dispute between New Jersey’s largest health insurer and the state’s largest hospital network could leave thousands of patients in limbo this summer.

Horizon Blue Cross Blue Shield of New Jersey (Horizon) and Hackensack Meridian Health have four months to negotiate a new agreement, as current coverage remains in place. However, with both sides standing firm, a resolution seems uncertain.

June 1 Deadline: Patients Face Potential Out-of-Network Costs

Horizon has set a deadline of June 1 to terminate in-network benefits unless Hackensack Meridian agrees to lower its reimbursement rate demands.

“Horizon is offering a fair and reasonable price increase,” said Tom Wilson, a spokesman for the insurer. However, he argued that Hackensack Meridian’s proposed rate hike far exceeds inflation.

On the other hand, Hackensack Meridian officials countered that Horizon’s proposal offers inadequate reimbursements and unfair contract changes.

“Hackensack Meridian must receive fair care reimbursements from Horizon to continue investing in medical technology, facilities, and high-quality care for the communities we serve,” said Jessica Nussman, a spokeswoman for the hospital network.

Why This Hospital-Insurer Battle Matters

Contract disputes between hospitals and insurers are not uncommon, but as healthcare consolidation increases, these standoffs impact more patients than ever.

• Horizon covers over 3 million New Jersey residents.
• Hackensack Meridian operates 18 hospitals statewide, including major medical centers like Hackensack University Medical Center and Jersey Shore Medical Center.
• Out-of-network hospital visits could result in significantly higher costs for patients.

The financial stakes are massive. Hospital networks and insurers can lose millions of dollars daily if a deal isn’t reached. Aetna and Hackensack Meridian narrowly avoided a similar crisis last year, finalizing a contract just two weeks before it was set to expire.

What Happens If a Deal Isn’t Reached?

If the impasse continues beyond June 1:

✅ Hackensack Meridian’s primary care and specialty physician practices will remain in-network.
✅ Patients with Braven Health, Medicaid, or Medicare policies will not be affected.
❌ Hospital services at Hackensack Meridian locations could become out-of-network, leading to higher costs for Horizon customers.

What’s Next?

Neither Horizon nor Hackensack Meridian has disclosed specific sticking points in negotiations. Hackensack Meridian claims its requested rates are in line with recent agreements with other insurers, while Horizon argues that Hackensack’s costs have risen beyond inflation and are already among New Jersey’s most expensive hospital systems.

With the June 1 deadline approaching, thousands of patients are left wondering whether they’ll continue receiving affordable in-network care or face skyrocketing out-of-pocket costs.

💬 Are you a Horizon member concerned about this contract dispute? Share your thoughts below! ⬇

 

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