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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 West and South 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 $35.00. 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 $150.00 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 $12000.00 (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 $12000.00 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 $150 deductible for prescription drugs. After the deductible, you will pay a copay for each drug, depending on the tier and where you get your prescription. For example, in the initial coverage phase, you'll pay $8 for a preferred generic at a standard pharmacy, and $47 for a standard generic at a preferred pharmacy. For specialty tier drugs, there is no copay.
Additional Benefits
The Braven Medicare Freedom (PPO) plan offers a variety of benefits, including inpatient hospital care with a copay, outpatient services with copays, and coverage for emergency services. This plan also covers primary care, preventive services, and home health services. Additional benefits include hearing, vision, and dental services, with varying copays and coinsurance amounts. The plan also covers medical equipment, diagnostic services, and other services such as acupuncture and an over-the-counter allowance.
Inpatient Hospital See details
Inpatient Hospital coverage includes acute and psychiatric care. For acute care, you pay a $340 copay for days 1-5, and no copay for days 6-90, with no coinsurance. For psychiatric care, you pay a $385 copay for days 1-5 and no copay for days 6-60, with no coinsurance. Additional days for inpatient psychiatric are not covered, and non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a $325 copay. Observation Services also have a $325 copay, and Ambulatory Surgical Center (ASC) Services have a $240 copay. Outpatient Substance Abuse Services have a $15 copay for both individual and group sessions. Outpatient Blood Services are 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. The plan has 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. Transportation Services to any health-related location are covered, including bus and subway.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Braven Medicare Freedom (PPO) plan. Emergency Services and Worldwide Emergency Coverage, and Worldwide Urgent Coverage have a $110 copay, and Worldwide Emergency Transportation has a $250 copay; all services have no coinsurance.
Primary Care See details
The Braven Medicare Freedom (PPO) plan covers Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits and Opioid Treatment Program Services. Chiropractic services have a $15 copay, occupational therapy services have a copay between $15 and $25, and physician specialist services have a $15 copay.
Preventive Services See details
Preventive Services are covered, including Medicare-covered preventive services, annual physical exams, and other preventive services. Some services, like Health Education, In-Home Safety Assessment, and Counseling Services are not covered.
Hearing Services See details
Hearing Services include hearing exams with a $15 copay, and routine hearing exams and fitting/evaluation for hearing aids, both covered once per year. Prescription hearing aids (all types) are covered with a copay between $299 and $1199, but inner ear, outer ear, and over the ear hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
The Braven Medicare Freedom (PPO) plan covers vision services, including eye exams with a copay of $0-$15. Eyewear, including eyeglasses, lenses, and frames, are covered with a maximum plan benefit coverage amount, and contact lenses are covered up to $250 every year.
Dental Services See details
Dental Services are covered by the Braven Medicare Freedom (PPO) plan, including Medicare Dental Services with 20% coinsurance. Other dental services include oral exams (3 per year), dental x-rays (bitewing x-rays covered once every 6 months, full mouth x-rays covered once every 3 years), prophylaxis (cleaning) (3 per year), fluoride treatment (2 every 6 months), restorative services with 50% coinsurance, adjunctive general services with 50% coinsurance, endodontics with 50% coinsurance, periodontics with 50% coinsurance, and oral and maxillofacial surgery with 50% coinsurance. Orthodontic services have a maximum benefit of $1000 per year, and prosthodontics, removable, maxillofacial prosthetics, implant services, prosthodontics, fixed, 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, Medicare Part B Chemotherapy/Radiation Drugs with 0-20% coinsurance, and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for this benefit.
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 by the Braven Medicare Freedom (PPO) plan, with no copay. Durable Medical Equipment (DME) has a 20% coinsurance, while Diabetic Supplies have a 0-20% coinsurance, and Prosthetic Devices and Medical Supplies have a 20% coinsurance. Durable Medical Equipment for use outside the home and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Braven Medicare Freedom (PPO) plan. Diagnostic Procedures/Tests have a maximum copay of $50, while Lab Services are not covered. Diagnostic Radiological Services have a maximum copay of $175, 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 covered under the Braven Medicare Freedom (PPO) plan, but the plan does not cover Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. There is a copay for some Cardiac and Pulmonary Rehabilitation Services, but the specific amount is not listed.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered under the Braven Medicare Freedom (PPO) plan, with prior authorization required. 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, over-the-counter (OTC) items up to $85 every three months, and a meal benefit for chronic illnesses. However, the plan does not cover Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, or a variety of other services.
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