How can we help?

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

1. Under Doctors & Care, click Prescriptions.
2. 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.

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.

1. Click Vision under Doctors & Care.
2. Follow the instructions on screen to be redirected to the appropriate vendor’s website, where you can locate information about submitting vision claims.