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When you submit out-of-network mental health and substance use disorder (SUD) claims through your account using our website or the Horizon Blue app, you don’t need to submit a claim form by mail. Simply select Claims, then Submit a Claim.

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