2025 Medicare Advantage Plans
Welcome
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Agenda
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01 | 2025 Braven Health Medicare Advantage Plans |
02 | Extra Benefits and Savings |
After the presentation, a Braven Health representative will be available to help you.
Our 2025 Medicare Advantage Plans
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Who is eligible?
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You must have Medicare
Part A and Part B.
You must reside in the service area for the
Braven Health Medicare Advantage plan you wish to enroll in.
Large PPO Network
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Providers Nationwide
Hospitals
*Based on physician data as of 8/14/24 and is subject to change. National Medicare Advantage PPO network coverage current as of 8/14/24.
States Included in our National PPO Network
5,800*
940,000*
48*
See the doctors you want.
Braven Medicare Choice (PPO)
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Plans are available in the following counties: |
Atlantic, Bergen, Burlington, Camden, Cape May, Cumberland, Essex, Gloucester, Hudson, Hunterdon, Mercer, Monmouth, Middlesex, Ocean, Passaic, Salem and Union |
Braven Medicare Choice (PPO)
Braven Medicare Choice (PPO)
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Monthly
Premium
$0
Medical Deductible
+
Braven Medicare Choice (PPO)
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* The benefits mentioned are a part of a special supplemental program for the chronically ill. Not all members qualify. To be considered for these benefits, they must meet the CMS definition of chronically ill and have been diagnosed with one or more of these chronic conditions: diabetes, chronic heart failure (CHF), cardiovascular disorders, chronic obstructive pulmonary disease (COPD). Other eligibility and coverage criteria apply.
Braven Medicare Choice (PPO) | Medical
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Plan Coverage | | In-Network | Out-of-Network |
Monthly Premium | | $0 | |
Annual Deductible | | $0 | |
PCP Visit | | $0 copay | $10 copay |
Specialist Visit | | $30 copay | $40 copay |
Annual Physical Exam | | $0 copay | $10 copay |
Annual Routine Hearing Exam | | $0 copay | $40 copay |
Annual Routine Eye Exam | | $0 copay | 50% coinsurance |
Routine Dental* | | $0 | |
Expanded Dental* | | 50% coinsurance up to $1,000 max coverage per year | |
Telehealth (through Braven Health’s Care Online program) | | $0 | |
Inpatient Hospital | $390 copay (per day) days 1-5 $0 copay (per day) days 6+ | ||
Worldwide Emergency and Urgent Care | | $110 copay | |
Bergen, Essex, Hudson, Middlesex, Monmouth, Ocean, Passaic and Union counties
*You may pay more if you use OON dental providers.
Braven Medicare Choice (PPO) | Prescription
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Deductible | | $200 (Tiers 3, 4, 5 only) | ||
Level | | Standard Retail �(30-day) | Preferred Mail Order (90-day) | Standard Mail Order (90-day) |
Tier 1: Preferred Generic | | $0 copay | $0 copay | $0 copay |
Tier 2: Generic | | $10 copay | $15 copay | $30 copay |
Tier 3: Preferred Brand | | $47 copay | $141 copay | $141 copay |
Tier 4: Non-Preferred Drug | | $100 copay | $300 copay | $300 copay |
Tier 5: Specialty Tier | | 30% coinsurance | Not Available | Not Available |
Tier 6: Select Care Drugs (includes generic drugs that support conditions related to diabetes, hypertension, osteoporosis and high cholesterol) | | $0 copay | $0 copay | $0 copay |
**Coverage Gap has been eliminated for 2025. Once your out-of-pocket costs for covered Part D
prescriptions reach $2,000, you’ll pay $0 for all covered prescriptions for the rest of the year**
Braven Medicare Choice (PPO)
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Plans are available in the following counties: |
All 21 counties in New Jersey! |
Braven Medicare Freedom (PPO)
Braven Medicare Freedom (PPO)
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In-network
Primary Care
Physician
(PCP) Visits
$0
Medical Deductible
+
Braven Medicare Freedom (PPO)
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* The benefits mentioned are a part of a special supplemental program for the chronically ill. Not all members qualify. To be considered for these benefits, they must meet the CMS definition of chronically ill and have been diagnosed with one or more of these chronic conditions: diabetes, chronic heart failure (CHF), cardiovascular disorders, chronic obstructive pulmonary disease (COPD). Other eligibility and coverage criteria apply.
Braven Medicare Freedom (PPO) | Medical
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Bergen, Essex, Hudson, Middlesex, Monmouth, Ocean, Passaic and Union counties
*You may pay more if you use OON dental providers.
Plan Coverage | | In-Network | Out-of-Network | |
Monthly Premium | | $30 | ||
Annual Deductible | | $0 | ||
PCP Visit | | $0 copay | 30% coinsurance | |
Specialist Visit | | $20 copay | 30% coinsurance | |
Annual Physical Exam | | $0 copay | 30% coinsurance | |
Annual Routine Hearing Exam | | $0 copay | 30% coinsurance | |
Annual Routine Eye Exam | | $0 copay | 50% coinsurance | |
Routine Dental* | | $0 | ||
Expanded Dental* | | 50% coinsurance up to $1,000 max coverage | ||
Telehealth (through Braven Health’s Care Online program) | | $0 | ||
Inpatient Hospital | | $350 copay (per day) days 1-5, $0 copay (per day) days 6+ | 30% coinsurance | |
Worldwide Emergency and Urgent Care | | $110 copay | ||
Braven Medicare Freedom (PPO) | Prescription
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Deductible | | $200 (Tiers 3, 4, 5 only) | ||
Level | | Standard Retail �(30-day) | Preferred Mail Order (90-day) | Standard Mail Order (90-day) |
Tier 1: Preferred Generic | | $0 copay | $0 copay | $0 copay |
Tier 2: Generic | | $8 copay | $12 copay | $24 copay |
Tier 3: Preferred Brand | | $47 copay | $141 copay | $141 copay |
Tier 4: Non-Preferred Drug | | $100 copay | $300 copay | $300 copay |
Tier 5: Specialty Tier | | 30% coinsurance | Not Available | Not Available |
Tier 6: Select Care Drugs (includes generic drugs that support conditions related to diabetes, hypertension, osteoporosis and high cholesterol) | | $0 copay | $0 copay | $0 copay |
**Coverage Gap has been eliminated for 2025. Once your out-of-pocket costs for covered Part D
prescriptions reach $2,000, you’ll pay $0 for all covered prescriptions for the rest of the year**
Bergen, Essex, Hudson, Middlesex, Monmouth, Ocean, Passaic and Union counties
Braven Health Prescription Drug Coverage
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Part D Prescription Drug Coverage
Supplemental Prescription Drug Coverage
Prescription Delivery
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Amazon Pharmacy
Walgreens Mail Service
Express Scripts® Pharmacy
More Benefit Highlights
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Annual Physical Exam & Annual Wellness Visit
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$0
Copay
for in-network Annual Physical Exam
& Annual Wellness Visit
Annual Physical Exam includes:
Annual Wellness Visit includes:
Dental Benefits
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$0
Copay
for in-network routine
dental services
Covered benefits include:
*Members will pay more when they see out-of-network dentists
Expanded Dental Coverage
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Expanded dental coverage includes:
*Excludes crowns, onlays, prosthodontics, implants, orthodontia, other �oral/maxillofacial surgery, dentures, inlays, sealants, space maintainers and missing teeth. Coverage max does not apply to Preventive and Diagnostic services.
Hearing Benefits
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Covered benefits include:
$0 copay |
In-network routine hearing exam and hearing aid evaluation/fitting |
In-network Prescription Hearing Aid |
$299 copay for level 1 aid (Value technology) $599 copay for level 2 aid (Advanced technology) $1,199 copay for level 3 aid (Premium technology) |
Out-of-network Hearing Aid |
Members are responsible for 100% of the charges for a hearing aid purchased outside of the HearUSA network |
Members must coordinate with HearUSA for the above benefits.
Vision Benefits
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Covered benefits include:
$0 copay* |
For basic lenses and routine annual eye exam |
$0 copay |
For eyeglasses or contacts after cataract surgery |
Annual Eyewear Allowance |
In- or out-of-network for frames or contact lenses not associated with cataract surgery |
*In-network through Davis Vision
Extra Benefits �& Savings
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Braven Health Smart Card
What’s included:
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Braven Health Smart Card
A flexible way to use your extra benefits!
* The benefits mentioned are a part of a special supplemental program for the chronically ill. Not all members qualify. To be considered for these benefits, they must meet the CMS definition of chronically ill and have been diagnosed with one or more of these chronic conditions: diabetes, chronic heart failure (CHF), cardiovascular disorders, chronic obstructive pulmonary disease (COPD). Other eligibility and coverage criteria apply.
Members must use participating retailers to access their Smart Card benefits
Over-the-Counter Benefit Allowance
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Quarterly OTC Allowance
Flex Benefit Allowance
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Receive a $275 annual allowance to use for any combination of the following items:
Fitness Benefit Allowance
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Receive a $300 annual allowance towards:
Healthy Journey Rewards Program
Earn up to $375/year in healthy rewards for completing routine health screenings or trainings such as:
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Healthy Journey Rewards
Grocery Allowance
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* The benefits mentioned are a part of a special supplemental program for the chronically ill. Not all members qualify. To be considered for these benefits, they must meet the CMS definition of chronically ill and have been diagnosed with one or more of these chronic conditions: diabetes, chronic heart failure (CHF), cardiovascular disorders, chronic obstructive pulmonary disease (COPD). Other eligibility and coverage criteria apply.
Grocery Allowance*
In-Home Support Services
$0 copay for up to 36 hours per year
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In-Home Support Services with Papa
Home Delivered Meals
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No-cost Meal Delivery Benefit
*Must use contracted vendor. Unlimited occurrences per year. Available based on eligibility.
Telehealth/24-Hour Nurse Line
Unlimited online doctor and therapist visits using your phone, tablet or computer – all for $0 with Braven Health’s Care Online Program (only through AmWell)
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Telehealth Benefit
24-Hour Nurse Line
Braven Health App
Access plan information anytime, anywhere with the Braven Health App
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Members can:
Braven Medicare Salute (PPO)
Works together with TRICARE or VA coverage
Extra Benefits
Braven Medicare Salute (PPO) plans do not include prescription drug coverage.
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A Medicare Advantage plan with Veterans’ needs in mind
*Any individual eligible for Medicare Part A and Part B and who lives in the service area may enroll into a Braven Medicare Salute (PPO) plan.
**Based on data as of 09/01/2024. Some doctors and hospitals covered through out-of-network benefits.
Questions?
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Thank you
<Presenters Name>
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<Presenter’s phone number>
<Presenter’s email address>
<Presenters QR code>
< >
Disclaimers
The Braven Health App is free. Rates from your wireless provider may apply. Out-of-network/non-contracted providers are under no obligation to treat Plan members, except in emergency situations. Other Providers are available in our network. Prime Therapeutics is an independent company that supports Braven Health in the administration of its Part D Prescription Drug program. Prime Therapeutics has an ownership interest in Walgreens Mail Service, a central specialty and home delivery pharmacy. Amazon Pharmacy is an independent company that supports Braven Health in prescription delivery services. Amazon Pharmacy is independent from and not affiliated with Braven Health. Express Scripts® Pharmacy is a pharmacy that is contracted to provide mail pharmacy services to members of Braven Health. Express Scripts® Pharmacy is a trademark of Express Scripts Strategic Development, Inc. Davis Vision, HearUSA, and Papa are independent companies that support Braven Health in administering ancillary benefits. The Braven Health Mastercard® Prepaid Card is issued by Stride Bank, N.A. Member FDIC, pursuant to a license by Mastercard International. Stride Bank is an independent company offering debit card services and is solely responsible for its products. All trademarks, logos and brand names are the property of their respective owners. All company, product and service names used in this document are for identification purposes only. Use of these names, trademarks and brands does not imply endorsement..
Braven Health complies with applicable Federal civil rights laws and does not discriminate against, nor does it exclude people or treat them differently on the basis of race, color, gender, national origin, age, disability, pregnancy, gender identity, sex, sexual orientation or health status in the administration of the plan, including enrollment and benefit determinations.
Spanish (Español): Para ayuda en español, llame al 1-833-272-8360 (TTY 711).
Chinese (中文): 如需中文協助❜請致電 1-833-272-8360 (TTY 711).
Braven Health has a Medicare contract to offer PPO plans. Enrollment in Braven Health depends on contract renewal. Products are provided by Braven Health, an independent licensee of the Blue Cross Blue Shield Association. The Blue Cross® and Blue Shield® names and symbols are registered marks of the Blue Cross Blue Shield Association. The Braven Health℠ name and symbols are service marks of Braven Health. © 2024 Braven Health. Three Penn Plaza East, Newark, New Jersey 07105.
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