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