Non-Medicare Covered Comprehensive Dental Allowance
Reimbursement up to $250 each calendar year for dental non –routine services, diagnostic services, restorative services, endodontics, periodontics, extractions, prosthodontics, other oral/maxillofacial surgery, and other services. Excludes Orthodontics. Excludes silver and/or composite fillings.
Download and fill out the reimbursement form and mail it to the us with an itemized receipt.
Horizon Blue Cross Blue Shield of New Jersey
P.O. Box 1609
Newark, NJ 07101-1609