Skip to main content
Horizon Blue Cross Blue Shield of New Jersey
Bancroft

For Member Services call 1-800-355-2583

Sign in
Horizon Blue Cross Blue Shield of New Jersey Bancroft

Desktop Navigation

Show — Desktop Navigation Hide — Desktop Navigation
  • Plans
      • Medical Plans
      • Annual Member Notifications
        • A photo of a woman kissing her son on his cheek. Horizon Behavioral Health

        We are focused on making sure our members get the right care when you need it.
  • Tools & Services
      • Member ID Cards
      • Horizon Blue App
      • Find a Doctor
      • Horizon CareOnline (Telemedicine)
      • 24/7 Nurse Line
      • Lab Services
      • Treatment Cost Estimator
      • My Health Manager
      • ID Protection Services
      • ERISA Update
        • A photo of a woman kissing her son on his cheek. Horizon Behavioral Health

        We are focused on making sure our members get the right care when you need it.
  • Forms
      • Medical
      • Manage Private Information
        • A photo of a woman kissing her son on his cheek. Horizon Behavioral Health

        We are focused on making sure our members get the right care when you need it.
  • Health Programs
      • Horizon Behavioral Health
      • Cancer Care Support
      • Case Management
      • Horizon Transplant Programs
      • Blue365 Discounts
  • Your Health
      • Aging
      • Asthma & Allergies
      • Children & Teens
      • Diabetes
      • Digestive Health
      • Emotional Health
      • Fitness
      • Flu Prevention and Care
      • Heart Health
      • Lifestyle
      • Nutrition
      • Pain Management
      • Prenatal and Newborn Care
      • Substance Abuse
      • Vision
      • Wellness Messages
      • Preventive Health
Medical
Manage Private Information
Horizon Blue App Icon

24/7 Care and Support

Text GETAPP to 422-272 to download.
Breadcrumb
  1. Home
  2. Forms
  3. Manage Private Information

Manage Private Information

Pdf Image

Request for Appointment of Limited Personal Representative

Pdf Image

Request for Appointment of Limited Personal Representative - Spanish

Disclaimer for Third Party Web Sites

Please be aware you have clicked on a link to a visit another site operated by a third party. Horizon Blue Cross Blue Shield provides such links for your convenience and reference only. Horizon Blue Cross Blue Shield, and its subsidiary companies do not control these sites, and are not responsible for their content or the products and services offered therein.

Please be aware when you travel from the Horizon Blue Cross Blue Shield site to another site, whether through links we provide or otherwise, you will be subject to the privacy policies (or lack thereof) of those sites. Horizon Blue Cross Blue Shield cautions you to use good judgment and to determine the privacy policy of such sites before you provide any personal information.

Click "I Agree" to continue to the third party site. If you do not wish to visit this site, click "Cancel" to close this window.

I Agree link
The Horizon Blue Cross Blue Shield Logo with JD Power#1 in Member Satisfaction among
Commercial Health Plans in NJ, 4 out of 5 Years
  • ‌
  • ‌
  • ‌
  • ‌
  • ‌
  • ‌

Horizon Blue Cross Blue Shield of New Jersey is an independent licensee of the Blue Cross Blue Shield Association.

Tied in 2021. For J.D. Power 2021 award information, visit jdpower.com/awards.

Information in other Languages

  • Español
  • Polski
  • عربي
  • 中文
  • Italiano
  • اردو
  • 한국어
  • Русский язык
  • Português
  • Tagalog
  • हिंदी
  • Kreyòl ayisyen
  • ગુજરાતી
  • Français
  • Tiếng Việt

Additional Links

  • Privacy Center
  • Claims Payment Policies and Other Information
  • Notice of Non-Discrimination
  • Contact Us
  • FAQs

Disclaimer for Short Bio

Short Bio Sample Body Description

NCQA opens in a new window

Applicable Products:
Commercial PPO/EPO &
Exchange POS/EPO

NCQA opens in a new window

Applicable Products:
Commercial HMO & POS

CAQH opens in a new window