Our Verdict
Braven Health Medicare Advantage plans are good options for New Jersey residents enrolled in Medicare Part A and Part B coverage who want to get their care from any in-state Medicare-affiliated doctor or hospital and coverage for dental and vision care, and some out-of-pocket costs. Depending on the county in which they live, eligible enrollees can choose between a $0 monthly premium Braven Medicare Choice plan or a $35 monthly premium Braven Medicare Freedom plan, both of which are preferred provider organization (PPO) plans.
Key Features
- Statewide availability: Braven Health Medicare Advantage plans are available in all 21 New Jersey counties.
- Cost coverage: Braven Health Medicare Advantage plans don’t have any annual deductibles or copays for visits to in-network primary care providers or dental, vision and hearing exams. Plans also cover 100% of treatment costs after a person reaches their out-of-pocket maximum.
- Additional benefits: Braven Health Medicare Advantage plans include extra benefit allowances toward fitness memberships, eyewear expenses and over-the-counter item costs.
Braven Health is a New Jersey-based private health insurance provider jointly founded by Horizon Blue Cross Blue Shield of New Jersey, Hackensack Meridian Health and RWJBarnabas Health.
The company offers two Medicare Advantage plans: Medicare Choice and Medicare Freedom. Both plans give New Jersey residents access to all hospitals and most doctors in the state. Braven Health also offers dental, vision and hearing coverage under the two plans, as well as allowances for fitness memberships, activity trackers, eyewear purchases and OTC health items.
Unlike some insurance companies, Braven Health offers only PPO (Preferred Provider Organization) plans. Generally the main difference between an PPO plan and an HMO (Health Maintenance Organization) plan is that enrollees in an HMO must choose a primary care provider from within the plan’s network and get a referral from that primary care provider to see a specialist. Enrollees in a PPO plan can typically see doctors in or out of the plan’s network and do not need to obtain a referral to see a specialist.
Braven Health Medicare Advantage at a Glance
- Plan options: Braven Health offers two Medicare Advantage PPO plans—Medicare Choice and Medicare Freedom—in New Jersey exclusively.
- Provider network: With Braven Health Medicare Advantage coverage, New Jersey enrollees can receive care from every hospital and most health providers in the state.
- Monthly premiums: The Braven Medicare Choice plan doesn’t have a monthly premium, and Braven’s Medicare Freedom plan has a $35 monthly premium.
Medicare Advantage plans are offered by private health insurance companies and provide the same benefits as Original Medicare (Parts A and Part B). With Medicare Advantage plans like the two offered by Braven Heath, benefits extend beyond those provided by Original Medicare and can include coverage for prescription drugs, vision and hearing care, and travel costs for emergency/urgent care appointments, for instance.
Anyone who signs up for a Medicare Advantage plan still must pay the Part B monthly premium, which is $174.70 in 2024. This is typically deducted from an individual’s monthly Social Security payment. Braven Health’s Medicare Advantage plans then pay 100% of the bill for most covered services after a person reaches a defined out-of-pocket maximum, which is:
- Braven Medicare Choice: $6,650 annually for in-network providers (only) and $10,000 annually for in-network and out-of-network providers
- Braven Medicare Freedom: $6,825 annually for in-network providers (only) and $9,500 annually for in-network and out-of-network providers
Braven Health’s provider network includes more than 55,000 in-network health care providers. Enrollees can see in-network specialists without a referral from their primary care provider. Seeing in-network providers typically costs less than seeing out-of-network providers. Braven Health also contracts with over 66,000 in-network pharmacies, which can help reduce the costs of one’s prescription drugs.
To enroll in any Medicare Advantage plan, individuals must first enroll in Medicare Part A and Part B. The initial enrollment period begins a few months prior to one’s 65th birthday and ends three months after. Eligible candidates who miss this deadline can alternatively sign up during Medicare’s annual open enrollment period, which runs from October 15 to December 7, or Medicare Advantage’s open enrollment period, which runs from January 1 to March 31 each year.
The Cost of Braven Health Medicare Advantage
Some costs of Braven’s two Medicare Advantage plans include the following:
Braven Health’s Medicare Advantage plans’ monthly premiums are either $0 or $35. Neither plan requires prescription drug copays.
Braven Medicare Choice has a $150 annual prescription drug deductible for non-preferred, specialty tier and select care drugs. The Braven Medicare Freedom plan’s annual drug deductible for the same tiers is $100 per year.
Plan costs for Braven Health’s Medicare Advantage plans can also vary by county in New Jersey.
When choosing a plan, consider using Medicare’s plan finder tool to compare plan costs in the New Jersey area. Users can filter search results by insurance provider, singling out available Braven Health Medicare Advantage plans or performing side-by-side comparisons with competing health insurance plans in the state.
Confused About Medicare Coverage Options?
Click Get A Quote or call 855-480-7435 to speak with a licensed insurance agent (Weekdays 9 am – 9 pm and Saturdays 9 am – 8 pm EST).
What Experts Say
California-based independent insurance broker Ryan McEachron is quite fond of Braven Health’s Medicare Advantage plans because of the benefits they offer. “[Braven Health’s] private plans offer more benefits than traditional Medicare Part A and Part B,” he says.
McEachron notes the downsides of the company’s insurance offerings as well, citing accessibility as a top area of concern. “[Braven] typically limits you to a closed network of providers and often requires prior authorizations for certain services, he adds.
Griff Harris, Certified Insurance Counselor, an independent insurance broker serving Connecticut and New York, recommends considering one’s budget and health care needs when choosing a plan. “Braven’s plan[s] seem[s] affordably priced, but know coverage details, available doctors and potential out-of-pocket costs before enrolling,” he advises.
Frequently Asked Questions (FAQs)
Is Braven Health Medicare Advantage the same as Medicare
Braven Health Medicare Advantage plans are not the same as government-funded Original Medicare, but they do provide much of the same coverage in addition to other benefits.
Is Braven Health Medicare considered an advantage plan?
Yes. Braven Health’s two Medicare Advantage plans fall into the category of Medicare Advantage plans, which means they’re offered by a private health insurance company rather than Original Medicare which is provided by the federal government.
What are the downsides of a Medicare Advantage plan?
Downsides of Braven Health’s Medicare Advantage plans are that they’re only available to New Jersey residents and have below-average CMS quality ratings, indicating that they may lack in areas in which competitors offer better solutions.
What’s a CMS rating and what does it indicate?
The Centers for Medicare and Medicaid Services (CMS) established its own star rating system in 2007 to rank the quality of health insurance plans. With 1 star being the worst and 5 stars being the best, star ratings stem from measurement data based on each plan’s level of customer satisfaction and quality of care. Per available 2024 data, weighted by enrollment, Braven Health Medicare Advantage has a 3.5 average star rating, which is below average, according to CMS standards. CMS updates these ratings annually.
What factors should I consider first when selecting a Medicare Advantage plan?
Thoroughly research available plans before making a final decision to ensure that the plan satisfies your individual coverage needs. Factors you may want to consider include the plan’s monthly premium costs, prescription drug coverage benefits and dental coverage options. Most importantly, confirm whether your preferred health providers accept the insurance plan. If additional benefits matter to you as well, review the extra perks provided by the plans.
