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Medical
Under Age 65 Participants
When you obtain care from providers who participate in your carrier's network, you generally do not have to file claim forms. If you obtain care from providers who do not participate in your carrier's network, you must submit a claim for reimbursement.
- Call your carrier directly to determine if a claim form is required. If so, they will provide it to you electronically or through the mail.
- Follow the carrier's instructions for reimbursement, which will include sending an itemized receipt that includes the following information: your name and Social Security number, Northeast Utilities as the employer and the plan number, patient name, diagnosis, date services or supplies were incurred, and the specific services or supplies provided.
Participants Age 65 or Older
Your claim must first be submitted to Medicare for reimbursement. If you are enrolled in Medicare Crossover, your claim will automatically be sent to your carrier by Medicare, so you do not have to file a claim for reimbursement. If you do not have Medicare Crossover, or you would like to enroll for it, contact your carrier directly at the toll-free number on your medical ID card.
Dental
When you obtain care from providers in the Delta Dental of New Jersey network, you do not need to file a claim. If you obtain care from providers who do not participate in the network, you or your dental provider must submit a claim form. Your dental provider can submit his/her standard form or you may call Delta Dental of New Jersey (Group Number 5480) at 1-877-305-9486 for a claim form.
Prescription Drugs through Express Scripts
When you obtain a prescription drug from a pharmacy that participates in the Express Scripts' network, you do not have to file a claim. Prescription drugs purchased from non-participating pharmacies are generally not covered except in emergencies. Claim forms are available by calling Express Scripts at 1-800-825-4879.
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