1. Click Claims.
2. Click Statements of Payment.
3. Locate the appropriate claim, and click the claim number hyperlink.
4. Click View Explanation of Benefits.

If you see an in-network doctor for care, you may not get a medical bill. However, you should expect one if you owe a copayment or coinsurance, get services that aren’t covered under your plan, or if you use an out-of-network provider.

If you get a bill for services that should be covered by your Horizon BCBSNJ plan, complete the appropriate claim form, include an itemized bill and mail it to the address printed on the form. An itemized bill includes: 

• Patient name
• Member ID number
• Date of service
• Diagnosis code(s)
• Procedure code(s)
• Place of service
• Total charge
• For Medicare claims, please ensure that a Medicare Explanation of Benefits (EOB) is included.

I am enrolled in a commercial individual or group plan (including the OMNIA^SM Health Plan, Horizon HMO, Horizon POS, Horizon PPO, Horizon Direct Access plans or other). Which claim form do I use?

Please complete the Horizon Health Insurance Claim Form (ID: 7190).

I am enrolled in the New Jersey State Health Benefits Program (SHBP) or School Employees’ Health Benefits Program (SEHBP). Which claim form do I use?

Please complete the NJ DIRECT Medical Claim Form (ID: 2642).

For more information, visit state.nj.us/treasury/pensions/member-guidebooks.shtml.

I am enrolled in Horizon Blue Medicare Advantage or a Medicare Supplement plan. Which claim form do I use?
You can find the appropriate claim form here:

1. Visit HorizonBlue.com/Medicare.
2. Select Member Quick Links.
3. Scroll down to Medicare Advantage Plans and select Additional Plan Documents.
4. You may need to scroll down to click Claim and Additional Forms.

I have dental, vision or other non-medical coverage with Horizon BCBSNJ. Which claim form do I use?
Visit HorizonBlue.com/members/forms/search-by-form-type for additional forms and mailing address information.

For claims that are sent by mail to Horizon BCBSNJ, there is a 30-day processing period. If the claim you are looking for was mailed within the last 30 days, please allow Horizon BCBSNJ the full time frame for processing.

If it has been over 30 days since you mailed your claim, please call Member Services at the phone number on the back of your member ID card. Depending on your plan, you may also be able to sign in and email or chat with a Member Services Representative.