Glossary

O

Obstetrics/Gynecology — 

A specialty that uses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system focusing on the care of women and the fetus during pregnancy and delivery.

Occupational Therapy — 

Treats any physical or mental problems that may interfere with a person’s ability to perform activities of daily living. Therapy can be provided from young children to older adults.

OMNIA TIER 1 — 

OMNIA Health Plan members enjoy lower deductibles, lower copayments, and lower out-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 care professional in Horizon BCBSNJ’s broad Managed Care Network for a higher out-of-pocket cost.

OMNIA℠ Health Alliance — 

The OMNIA Health Alliance connects patients with doctors and hospitals throughout New Jersey, working together to enhance the patient experience, deliver high-quality care and drive down costs in the process.

OMNIA℠ Health Plans — 

OMNIA Health Plans provides members the flexibility to visit any New Jersey health care professional in Horizon BCBSNJ’s broad Managed Care Network. Members save the most with OMNIA Tier 1 doctors, hospitals, and other health care professionals—including lower deductibles, lower copayments and lower out-of-pocket costs.

Oncology — 

A specialty focusing on the diagnosis and treatment of cancers or tumors.

Ophthalmology — 

A specialty focusing on the diagnosis and treatment of disorders of the eye.

Optometry — 

A specialty focusing on the diagnosis and nonsurgical treatment of disorders of the eye and vision care.

Oral and Maxillofacial Surgeon — 

Oral and maxillofacial surgeons are responsible for treating dental problems—including the removal of impacted teeth, reconstructive facial surgery, and the treatment of diseases, injuries, and defects of the hard and soft tissues of the oral and maxillofacial region.

Oral Surgery — 

A specialty focusing on the diagnosis and surgical treatment of disorders of the mouth and lower jaw.

Orthodontist — 

Orthodontists are dentists who specialize in the development, prevention, and correction of irregularities of the teeth, bite, and jaws. Orthodontists also have specialized training in facial abnormalities and disorders of the jaw.

Orthopedics — 

A specialty focusing on the restoration and preservation of form and function of the extremities and associated structures.

Orthotics & Prosthetics — 

Orthotics involves the design, fabrication and fitting of orthoses (braces or splints) intended to protect a painful part of the body or improve the function of a weakened extremity. Prosthetics involves the design, fabrication and fitting of prosthetics (artificial limbs) intended to replace a portion of the body that has been lost through amputation or was absent at birth.

Osteopathic Medicine — 

A distinct form of medical practice in the United States. Osteopathic medicine provides all of the benefits of modern medicine including prescription drugs, surgery, and the use of technology to diagnose disease and evaluate injury. Osteopaths receive special training in the musculoskeletal system, your body's interconnected system of nerves, muscles and bones.

Osteopathic Neuromusculoskeletal Medicine — 

A specialty focusing on the diagnosis and nonsurgical treatment of disorders of the musculoskeletal system, nervous system and related structures; utilizing all accepted medical management including the use of manipulative treatment.

Otolaryngology — 

A specialty focusing on the diagnosis and treatment of disorders of the ear, nose and throat.

Out of Network — 

A provider, or the services and supplies furnished by a provider, who does not have an agreement with Horizon BCBSNJ to provide covered services and/or supplies, depending on the context in which the term is used.

Out-of-Network Benefits — 

The coverage shown in the covered services and/or Supplies which is provided if (a) an out-of-network provider provides the service or supply or (b) the provider does not authorize or coordinate the care, treatment, services, and supplies.

Out-of-Network Coverage — 

The option to see health care professionals who do not have a contract or arrangement with Horizon BCBSNJ. When health plans include this option, a member generally shares more of the cost when receiving care from out-of-network (or non-participating) health care providers.

Out-of-Pocket Costs — 

The part of health care costs that a member is responsible for, including copayments, coinsurance, deductibles and charges for noncovered services.

Out-of-Pocket Maximum — 

The maximum amount that a member or family would have to pay in cost sharing for covered services and/or supplies during a specified period of time, usually a calendar year or benefit period. After the maximum is reached, most, if not all, covered services are paid at 100% for the rest of the specified period.

Member Services

Get things done on the go. Try our mobile services anytime from anywhere.