Claim
Claim Form - Spending-Savings Accounts - Flexible Spending Account - Medical and Dependent Care
This form is used to file a Horizon BCBSNJ Flexible Spending Account (FSA) claim. ID: 6051
Claim Form - Spending-Savings Accounts - Flexible Spending Account - Transportation
Use this form to file a Horizon BCBSNJ Flexible Spending Account (FSA) transportation expenses claim. ID: 132
Claim Form - Spending-Savings Accounts - Health Reimbursement Account
This form is used to file a Horizon Health Reimbursement Account (HRA MyWay) claim. ID: 2816
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
Prescription Drug Claim Form - Prime Therapeutics
Use this claim form for prescriptions filled by Prime Therapeutics. Prime Therapeutics LLC is an independent company providing pharmacy benefit management services for Horizon BCBSNJ members. ID: 3272
