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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 Morris, Somerset, Sussex, Warren. 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 $42.00. 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 $300.00 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 $12750.00 (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 $12750.00 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:
Sign up for Braven Medicare Freedom (PPO)
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Drug Coverage
The Braven Medicare Freedom (PPO) plan has a $300 deductible for prescription drugs. Once you meet your deductible, you will pay a copay for your prescriptions. The copays vary depending on the drug tier and the pharmacy you use. For example, you will pay $8 for preferred generic drugs at a standard pharmacy, while specialty tier drugs have no copay.
Additional Benefits
The Braven Medicare Freedom (PPO) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays have a copay, while outpatient services and emergency services have copays as well. You will also have access to no copay for primary care, preventive services, and home health services, as well as dental and vision coverage. This plan also includes additional benefits such as hearing and dental services, with copays or coinsurance requirements. The plan covers ambulance services, with a copay, and offers an over-the-counter benefit. However, some services like cardiac rehabilitation and certain dental and vision services are not covered.
Inpatient Hospital See details
Inpatient Hospital coverage under the Braven Medicare Freedom (PPO) plan includes Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services with a copay of $385 for days 1-5, and no copay for days 6-90; Additional Days for Inpatient Hospital-Acute has no copay for days 91-999. Non-Medicare-covered stay and upgrades are not covered.
Outpatient Services See details
Outpatient services, including outpatient hospital services and observation services, have a $330 copay. Ambulatory Surgical Center (ASC) services have a $265 copay, and outpatient substance abuse services have a copay of $20-$25 depending on the session type. 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 pay a $60 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Braven Medicare Freedom (PPO) plan. Ground and air ambulance services have a $250 copay, while transportation services to a plan-approved health-related location are not covered, but transportation to any health-related location is covered, including bus or subway, with no copay or coinsurance.
Emergency Services See details
Emergency Services, including Worldwide Emergency Services, are covered by the Braven Medicare Freedom (PPO) plan. Emergency Services have a $110 copay, and Urgently Needed Services have a $30 copay, with no coinsurance. Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $110 copay, and Worldwide Emergency Transportation has a $250 copay, with no coinsurance.
Primary Care See details
Primary Care benefits with Braven Medicare Freedom (PPO) include coverage for Primary Care Physician Services, Chiropractic Services with a $15 copay, Occupational Therapy Services with a $25-$35 copay, Physician Specialist Services with a $20 copay, and Mental Health Specialty Services with a $20 copay for individual and group sessions. The plan also covers Physical Therapy and Speech-Language Pathology Services with a $25-$35 copay, Additional Telehealth Benefits, and Opioid Treatment Program Services with a $30 copay. Routine Chiropractic Care and Podiatry Services are not covered.
Preventive Services See details
Preventive Services are covered, including Medicare-covered preventive services, annual physical exams, and other preventive services. This plan does not cover Health Education, In-Home Safety Assessments, Personal Emergency Response Systems (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. Weight Management Programs, Nutritional/Dietary Benefits, In-Home Support Services, Fitness Benefit, Remote Access Technologies, Home and Bathroom Safety Devices and Modifications, Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit are covered.
Hearing Services See details
The Braven Medicare Freedom (PPO) plan covers hearing exams with a $20 copay, and also covers fitting/evaluation for hearing aids, and prescription hearing aids. Prescription hearing aids have a copay between $299 and $1199, while inner ear, outer ear, and over the ear prescription hearing aids, and OTC hearing aids are not covered.
Vision Services See details
Vision services are covered, including eye exams and eyewear. Eye exams have a copay between $0 and $20, and eyewear includes a $150 allowance for contact lenses and frames.
Dental Services See details
Dental Services are covered under the Braven Medicare Freedom (PPO) plan, with a 20% coinsurance for Medicare Dental Services. Other dental services are also covered, including oral exams (3 visits per year), dental x-rays (bitewing every 6 months, full mouth every 3 years), prophylaxis (cleaning) (3 visits per year), fluoride treatment (2 visits 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). Prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, are covered by the Braven Medicare Freedom (PPO) plan. Medicare Part B Insulin Drugs have a copay between $0 and $35, while the coinsurance for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Braven Medicare Freedom (PPO) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment is covered under the Braven Medicare Freedom (PPO) plan, with a 20% coinsurance for durable medical equipment, prosthetic devices, and medical supplies. Diabetic supplies have a coinsurance between 0% and 20%, while diabetic therapeutic shoes/inserts and durable medical equipment for use outside the home are not covered.
Diagnostic and Radiological Services See details
The Braven Medicare Freedom (PPO) plan covers Diagnostic and Radiological Services, including Diagnostic Procedures/Tests with a copay between $0 and $50, and Diagnostic Radiological Services with a copay up to $175. Outpatient X-Ray Services have no copay, and Therapeutic Radiological Services have a coinsurance of at least 20%. Lab Services are not covered.
Home Health Services See details
Home Health Services are covered by the Braven Medicare Freedom (PPO) plan with no copay and no coinsurance, though 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. Although the plan covers Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services, all of these sub-services are not covered.
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 per day 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 limits on treatments, and also provides an Over-the-Counter (OTC) benefit of $65 every three months. The plan also provides a meal benefit for chronic illness, and the following services are not covered: Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services.
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