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Choose the type of claim you'd like to submit.
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You can submit out-of-network medical and behavioral claims using the Horizon Blue App or by mail.
Horizon Blue App:
To submit these claims using the Horizon Blue App, sign in to the Horizon Blue App and tap Claims, then Submit a Claim. Please note that this option is available on the Horizon Blue App only, not our website.
By Mail:
To submit these claims by mail, please include the appropriate claim form 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
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- Under Doctors & Care, click Prescriptions.
- If you see Go to Prime Therapeutics: Mail the Prescription Drug Claim Form, and the required information listed on the form, to the address on the form. If you do NOT see Go to Prime Therapeutics: Follow the instructions on screen to be redirected to the appropriate vendor’s website, where you can find information about submitting prescription claims.
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Complete the Claim Form - Dental and mail it, and the required information listed on the form, to the address on the form. You can submit out-of-network dental claims by mail only.
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- Click Vision under Doctors & Care.
- Follow the instructions on screen to be redirected to the appropriate vendor’s website, where you can locate information about submitting vision claims.
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Last updated:
Sep 29,2023
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Yes. The Horizon Blue app provides you with 24/7 access to care, support and plan information 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 an option.
With the Horizon Blue app, you can:
- Submit out-of-network medical and behavioral health claims.
- Display, download, print and share your member ID card.
- Quickly connect with health care professionals.
- View your claims, see how much your health plan paid, and any amount you may owe.
- Find doctors and hospitals.
- 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 purchased insurance for yourself or your family directly through Horizon or through the NJ state-based exchange (SBE), you can pay your premium bill online and set up Auto Pay.
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Last updated:
Jan 20,2023
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You must download and use the Horizon Blue app to submit an out-of-network claim electronically.
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Last updated:
Jan 07,2022
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Related FAQs
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- Sign in to your account.
- Click Horizon MyWay under My Accounts.
- Scroll down and click View More Activity.
- Scroll down. Under "I Want To" (the blue menu on the left-hand side), click Get Reimbursed.
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Last updated:
Nov 10,2022
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Submit your claim with the Horizon Blue App in a few easy steps:
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When using the Horizon Blue App to submit a claim, you do not need to submit a claim form. However, you will need to photograph and submit an itemized bill or receipt.
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When you open the Horizon Blue App, tap Claims, then Submit a Claim.
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Upload photos of your itemized bill or receipts.
You can also upload any other supporting documents. You can submit multiple images per claim.
Please note: You cannot use the Horizon Blue App to take pictures. You’ll need to import them from another source, such as your phone’s photo library.
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Before you submit your claim, you'll be asked to confirm the photos you selected. See the example below:
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Last updated:
Nov 03,2022
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The easiest way to submit out-of-network medical 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.
If you prefer to submit out-of-network medical 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
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Last updated:
Dec 20,2022
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Eligible members have access to a convenient, confidential telemedicine service, Horizon CareOnline℠. Members eligible for this service can talk with a licensed, board-certified doctor via video 24 hours a day, seven days a week, with no appointment needed. Your plan may also include behavioral health as part of your Horizon CareOnline service. Appointments can be made to see a behavioral health specialist from 7 a.m. to 11 p.m.
If the telemedicine feature is available to you, you will see Telemedicine under Doctors & Care and be able to access the feature from there. Horizon CareOnline does not replace your relationship with your Primary Care Physician (PCP) or personal doctor. You can use Horizon CareOnline when:
- Your doctor’s office is closed.
- You feel too sick to drive.
- You are traveling and need medical care.
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Last updated:
Jun 09,2023
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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
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Last updated:
Dec 20,2022
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Can't Find an Answer to Your Question?
Browse our Help Center categories and topics. For questions about your medical plan or technical support, sign in to send us an email or start a live chat. For other questions, visit the Contact Us information page on HorizonBlue.com.