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Medical Claims

You can submit out-of-network medical claims by mail or use the Horizon Blue App. This includes claims for behavioral health, prescriptions, eyeglasses, and durable medical equipment like breast pumps, sleep apnea machines, diabetic supplies, orthotics, etc.

Dental Claims

You can submit out-of-network dental claims by mail. Dental claims are not accepted on the Horizon Blue app.

Submitting a Claim

1. Download and complete the appropriate claim form.
2. Include an itemized bill. An itemized bill includes:
   • Patient name
   • Member ID number
   • Date of service
   • Diagnosis code(s)
   • Procedure code(s)
   • Place of service
   • Total charge
3. Submit your claim by mail to the address printed on the form or use the Horizon Blue App.

For Medicare claims, you must include a Medicare Explanation of Benefits (EOB). An Explanation of Benefits (EOB) is the notice that your Medicare Advantage Plan or Part D prescription drug plan typically sends you after you receive medical services or items. You only receive an EOB if you have Medicare Advantage or Part D. An EOB is not the same as a Medicare Summary Notice. It is also important to remember that an EOB is not a bill.

Yes, with the Horizon Blue app, you get 24/7 access to your plan information, care and support from your smartphone or other mobile device.

To get the app, text GetApp to 422-272 or visit the App Store® or Google Play™. There is no cost to download the Horizon Blue app, but rates from your wireless carrier may apply.

To sign in to the app, enter the username and password that you used to register for HorizonBlue.com and click Sign In. Biometric sign in (fingerprint or facial recognition) is also available on the Horizon Blue app.

With the Horizon Blue app, you can:

• Display, download, print and share your member ID card.
• Quickly connect with health care professionals.
• Check your notifications.
• View your claims to see how much your health plan paid and any amount you may owe.
• Find doctors and hospitals, and even schedule appointments.
• Check if a specific treatment or service is covered.
• Track your deductible, if applicable, and maximum out-of-pocket costs.
• Email or Chat with a Member Services Representative to get answers to your questions.
• If you are an Individual, Medicare Supplement or Medicare Advantage member who purchased insurance for yourself or your family directly through Horizon BCBSNJ or through the NJ State Based Exchange (SBE), you can pay your premium bill online and set up Auto Pay.

For website or app-related questions or technical issues, please contact the eService Desk by:

1. Calling 1-888-777-5075, weekdays between 7 a.m. and 6 p.m., Eastern Time (ET); or
2. Signing in and clicking Email Us or Chat then Technical Support. (Please note: Some members may not have access to all support options.)

You must download and use the Horizon Blue app to submit an out-of-network claim electronically.