Horizon NJ DIRECT Coverage for Residential Treatment
NJ DIRECT members may be able to use their out-of-network benefits for treatment on Maui.
NJ DIRECT plans for New Jersey school, state and local government employees include out-of-network benefits, which may help cover part of residential treatment at Maui Recovery. Horizon Blue Cross Blue Shield of New Jersey administers these plans, and residential stays need approval before admission. Send us your plan details or call (877) 317-8260, and we’ll check what your plan covers.
Who has NJ DIRECT
NJ DIRECT is offered through the State Health Benefits Program (SHBP) and the School Employees’ Health Benefits Program (SEHBP). Members include:
- Teachers and school staff at participating boards of education and county colleges
- New Jersey State employees, including CWA-represented employees on CWA Unity DIRECT
- Employees of participating local governments
- Eligible retirees, spouses, partners and dependents
Which plans include out-of-network benefits
- NJ DIRECT plans, including NJ DIRECT10, NJ DIRECT15, NJ DIRECT1525 and NJ DIRECT2030, the NJ DIRECT high-deductible plans, CWA Unity DIRECT and the NJ Educators Health Plan, include out-of-network benefits (2026 member guidebook, 2026 SHBP overview).
- Some Horizon plans, such as OMNIA and Horizon HMO, don’t include out-of-network benefits. If you’re not sure which plan you have, call us and we’ll check your options.
- Have a Horizon plan through a private employer? See our Horizon Blue Cross Blue Shield of New Jersey page.
How out-of-network benefits work on NJ DIRECT
- Maui Recovery is out-of-network with Horizon.
- Out-of-network care is subject to the plan’s deductible, coinsurance and allowed amounts. The amounts depend on your plan and are listed in your plan documents.
- Residential mental health and substance use stays need precertification. Our team handles this with Horizon.
- Plan designs for state employees changed on July 1, 2026, so it’s worth checking your current benefits.
Key facts
| Licensed | Residential treatment center |
| Accredited | The Joint Commission |
| Location | Lahaina, Maui, Hawaii |
| Setting | 20 acres overlooking the Pacific |
| Size | 8 beds, plus private villas |
| Care | Medical detox and residential treatment |
| Treats | Substance use and mental health |
| Typical stay | 30 to 90 days |
| Insurance | Out-of-network with all plans |
| Admissions | (877) 317-8260 |
Using NJ DIRECT at Maui Recovery
Benefits check
Send your insurance card or call us. We check your out-of-network benefits and explain them.
Approval
With your permission, our team works with Horizon on approval and provides the clinical information it needs.
Arrival
Once approved, our admissions team helps coordinate your arrival on Maui.
Claims
Our billing team submits claims and works with your plan directly, so you don’t have to.
Why New Jersey educators and public employees choose Maui
Teachers, school staff and public employees often know many people in their community. Treatment far from home offers privacy away from colleagues, students and neighbors, and real distance from the routines and stress tied to substance use.
Maui Recovery is a licensed luxury residential treatment center with only 8 beds, set on 20 acres overlooking the Pacific in Lahaina. Clients receive medical detox and residential treatment for substance use and mental health, with a typical stay of 30 to 90 days.
NJ DIRECT FAQ
Does NJ DIRECT cover rehab outside New Jersey?
NJ DIRECT plans include out-of-network benefits, and those benefits aren’t limited to New Jersey. Whether a stay is covered depends on approval and your plan’s terms. A benefits check confirms yours.
What if I’m on OMNIA or an HMO plan?
OMNIA and HMO plans generally don’t include out-of-network benefits, but every situation is different. Call us and we’ll look at your options with you.
Is Maui Recovery in the Horizon network?
No. Maui Recovery is an out-of-network provider for NJ DIRECT and other Horizon plans.
Do I need approval before I go?
Yes. Residential stays need precertification from Horizon. Our team handles this for you.
What will I pay?
That depends on your plan’s out-of-network deductible and coinsurance and on any amount above what the plan allows. We’ll go over this with you after your benefits check.
Will my employer find out?
Your health information is protected by federal privacy law, and we don’t contact your employer.
Find out what your plan covers
Send us your insurance details and our admissions team will contact your plan, then walk you through what we find. Our billing team works directly with your insurance company, so you don’t have to handle claims or paperwork.
Prefer to talk? Call (877) 317-8260.
Maui Recovery is not affiliated with or endorsed by Horizon Blue Cross Blue Shield of New Jersey, the State of New Jersey, the SHBP or the SEHBP. Plan details come from published 2026 plan documents and vary by plan and year; your plan documents control. We cannot guarantee coverage or payment. Updated October 27, 2026.