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Braven Medicare Freedom (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Braven Medicare Freedom (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Braven Medicare Freedom (PPO) in 2025, please refer to our full plan details page.
Braven Medicare Freedom (PPO) is a PPO plan offered by Horizon Mutual Holdings, Inc available for enrollment in 2025 to people living in Eastern New Jersey. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Braven Medicare Freedom (PPO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Braven Medicare Freedom (PPO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Braven Medicare Freedom (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $30.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $200.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $10500.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $10500.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The Braven Medicare Freedom (PPO) plan has a $200 deductible for prescription drugs. During the initial coverage phase, after you meet your deductible, your cost will vary depending on the drug tier and the pharmacy you use. For example, in the initial coverage phase, you will pay $8.00 for preferred generic drugs at a standard pharmacy, but only $4.00 if you use preferred mail order. Specialty tier drugs have no copay. After your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Braven Medicare Freedom (PPO) plan offers a wide range of benefits with varying costs. You'll find coverage for inpatient hospital stays with a copay, outpatient services with copays, and emergency services with a $110 copay. Primary care visits have no copay, and the plan also covers preventive, hearing, vision, and dental services. This plan provides additional benefits such as home health services with no copay, and coverage for medical equipment and diagnostic services with coinsurance or copays. The plan also includes coverage for acupuncture, over-the-counter items, and meal benefits for chronic illnesses. However, certain services like cardiac rehabilitation, and some vision, dental, and medical equipment services are not covered by this plan.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a $350 copay for days 1-5 and no copay for days 6-90 for Inpatient Hospital-Acute. Inpatient Hospital Psychiatric has a $374 copay for days 1-5 and no copay for days 6-60.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services and observation services with a $300 copay, Ambulatory Surgical Center (ASC) Services with a $240 copay, and Outpatient Substance Abuse Services with a $20 copay for both individual and group sessions. Outpatient blood services are also covered, with a waived three-pint deductible.
Partial Hospitalization See details
Partial Hospitalization is covered by the Braven Medicare Freedom (PPO) plan, but requires prior authorization. You will have a $60 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the Braven Medicare Freedom (PPO) plan. Ground and air ambulance services have a $250 copay, and there is no coinsurance. Transportation services to any health-related location are covered, but transportation services to a plan-approved health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services and Worldwide Emergency Coverage and Urgent Coverage have a $110 copay, while Worldwide Emergency Transportation has a $250 copay; all have no coinsurance.
Primary Care See details
The Braven Medicare Freedom (PPO) plan covers primary care physician services with no copay, chiropractic services with a $15 copay, occupational therapy services with a copay between $20 and $35, physician specialist services with a $20 copay, and mental health specialty services with a $20 copay. The plan also covers physical therapy and speech-language pathology services with a copay between $20 and $35.
Preventive Services See details
Preventive Services are covered, including Medicare-covered preventive services, annual physical exams, and additional preventive services. Some services are not covered, including Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Home-Based Palliative Care, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, and Counseling Services.
Hearing Services See details
Hearing Services include routine hearing exams with a $20 copay, fitting/evaluation for hearing aids, and prescription hearing aids with a copay between $299 and $1199, but not prescription hearing aids for the inner ear, outer ear, or over the ear. OTC hearing aids are not covered.
Vision Services See details
Vision Services include eye exams with a copay of $0-$20, and coverage for eyewear including eyeglasses, contact lenses, and upgrades. Contact lenses have a maximum plan benefit coverage amount of $200 per year, and eyeglass frames have a maximum plan benefit coverage amount of $200 per year.
Dental Services See details
The Braven Medicare Freedom (PPO) plan covers dental services with a 20% coinsurance for Medicare dental services. Other dental services include oral exams (3 per year), dental x-rays (2 bitewing x-rays every 6 months, full mouth x-rays every 3 years), prophylaxis (cleaning) (3 per year), fluoride treatment (2 every 6 months), restorative services (50% coinsurance), adjunctive general services (50% coinsurance), endodontics (50% coinsurance), periodontics (50% coinsurance), and oral and maxillofacial surgery (50% coinsurance). Orthodontic services are covered up to a maximum of $1000 per year. Prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Braven Medicare Freedom (PPO) plan, including Medicare Part B Insulin Drugs with a copay between $0 and $35, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with coinsurance between 0% and 20%. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered by the Braven Medicare Freedom (PPO) plan with a coinsurance between 20% and 20%.
Medical Equipment See details
Medical equipment is covered, with a 20% coinsurance for durable medical equipment, prosthetic devices, and medical supplies; however, durable medical equipment for use outside the home and diabetic therapeutic shoes/inserts are not covered. Diabetic supplies have a 0-20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for diagnostic procedures and tests with a copay between $0 and $50, and diagnostic radiological services with a copay up to $200. Therapeutic radiological services have a 20% coinsurance, and outpatient X-ray services have no copay.
Home Health Services See details
Home Health Services are covered by the Braven Medicare Freedom (PPO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Braven Medicare Freedom (PPO) plan. While the plan states that Cardiac Rehabilitation Services are covered, the plan does not cover Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Braven Medicare Freedom (PPO) plan, but require prior authorization. There is no copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The Braven Medicare Freedom (PPO) plan covers acupuncture with no copay and no limit to the number of treatments. Over-the-counter items are covered up to $85 every three months, and meal benefits are also covered for chronic illnesses. However, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and other services are not covered.
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