How can we help?

Medical and Behavioral Health Claims

When you submit out-of-network medical 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.

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

Prescription Claims

Select Prescriptions, then Pharmacy Benefits¹ to go to your pharmacy’s website, where you can find information about submitting prescription claims. Members with Prime Therapeutics as their pharmacy manager can mail the Prescription Drug Claim Form, and the required information listed on it, to the address on the form.

Dental Claims

Complete the Dental Claim Form and mail it, and the required information listed on it, to the address on the form.

Vision Claims

Select Get Care, then Vision. Follow the instructions on screen to be redirected to the appropriate vendor’s website, where you can find information about submitting vision claims.