How can we help?

Sign in to find out if you are covered for mental health services. In the Service You May Need menu, select the type of service you are looking for. Mental health services include things like Psychotherapy, Psychiatric-Outpatient, and Cognitive Therapy.

Sign in to find out if you are covered for substance abuse services. In the Service You May Need menu, select the type of service you are looking for. Mental health services include things like Substance Abuse, Substance Abuse Facility – Inpatient, and Substance Abuse Facility – Outpatient.

The easiest way to submit out-of-network mental health and SUD claims is through the Horizon Blue app. When you use the Horizon Blue app, you don’t need to submit a claim form by mail.

When you submit out-of-network mental health and SUD claims by mail, you will need to include the appropriate claim form listed below and mail it, and the required information listed on the form, to the address on the form:

• Merck members: Merck Health Insurance Claim Form
• Organon members: Organon Health Insurance Claim Form
• State Health Benefit Program (SHBP) and School Employees’ Health Benefits Program (SEHBP) members: SHBP/SEHBP Medical Plan Claim Form
• All other members: Horizon Health Insurance Claim Form

Visit the Horizon Behavioral Health website to find an in-network substance abuse disorder provider or facility.

You can appeal our decision on your mental health or substance abuse claim. To file an appeal, your request must be made in writing and include the following information:

• Member name and address
• Member ID number
• Patient’s name and address (if different from member)
• Provider of service
• Date(s) of service
• Claim number(s)
• Reason for appeal

Your appeal must be filed within one year of your receipt of the Explanation of Benefits (EOB) statement.

Your duly authorized representative, your doctor or other health care professional acting for you and with your consent can also file an appeal.

You will not be disenrolled, discriminated against or penalized if you submit an appeal.

For mental health and substance abuse claims, except for Medicare Supplement plans, send your appeal to:

Horizon BCBSNJ
Attn: Behavioral Health Appeals
PO Box 10191
Newark, NJ 07101-3189

For mental health and substance abuse claims for Medicare Supplement plans, send your appeal to:

Appeals Department
Horizon Blue Cross Blue Shield of New Jersey
P. O. Box 317
Newark, NJ 07105