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Dental Benefit Reimbursement

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.

Mail to:
Horizon Blue Cross Blue Shield of New Jersey
P.O. Box 1609
Newark, NJ 07101-1609

*The $250 reimbursement and any amounts paid out-of-pocket for Non-Medicare Covered Comprehensive Dental Allowance do not count toward your maximum out-of-pocket amount.
Please note that some plans have a $175 annual reimbursement for Non-Medicare Covered Comprehensive Dental Allowances.
*Verify in your Evidence of Coverage (EOC) if this benefit is covered under your plan.

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