Medical Forms
Claim Form - HMO / POS / Direct Access / EPO / OMNIA Health Plans
Horizon HMO, Horizon POS and Horizon Direct Access, Horizon EPO and OMNIA Health Plan members use this form for medical claims. ID: 0834
Claim Form - BlueCard
Members use this form to file a claim if they received covered medical services outside the U.S., Puerto Rico, and the U.S. Virgin Islands. ID: N-12-420
Claim Form - PPO / Traditional Plans
Members of Horizon BCBSNJ PPO or Traditional plans use this form to file claims. ID: 7190
Claim Form - National Accounts
National Account members use this form to file a medical claim. ID: 6044
