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Download the COVID-19 (Coronavirus) Resource Guide (as of June 28, 2021), created especially for our valued customers.

Claim

PDF  Claim Form - Medical - Traditional (SHBP)

New Jersey SHBP members with a Traditional plan use this form to file claims. ID: 0704

PDF  Horizon Health Insurance Claim Form

Horizon HMO, Horizon POS, Horizon Direct Access, Horizon EPO, Horizon PPO, Traditional, National Accounts and OMNIA Health Plan members use this form for medical claims. ID: 7190

PDF  Prescription Drug/COVID-19 At-Home Test Kit Claim Form

Use this claim form to submit eligible pharmacy expenses for reimbursement, including COVID-19 at-home test kits you paid out of pocket for. You have to submit one claim form for each person and each prescription. Full instructions can be found on page 2. ID: 3272 NJ 03/22