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Braven Medicare Salute (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Braven Medicare Salute (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Braven Medicare Salute (PPO) in 2025, please refer to our full plan details page.
Braven Medicare Salute (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 Salute (PPO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Braven Medicare Salute (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 Salute (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $50.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $6700.00 (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 $6700.00 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
Prescription drugs are not covered by Braven Medicare Salute (PPO).
Additional Benefits
The Braven Medicare Salute (PPO) plan offers a wide range of benefits, including inpatient and outpatient hospital services with varying copays. You'll have coverage for primary care, preventive, hearing, vision, and dental services. Additional benefits include ambulance, emergency, and home health services, as well as medical equipment, diagnostic, and dialysis services. This plan provides coverage for prescription hearing aids, and eyewear. You can also expect coverage for home infusion bundled services, skilled nursing facilities, and over-the-counter items. However, the plan does not cover several services, including cardiac rehabilitation, acupuncture, and certain types of nursing and personal care.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a $295 copay for days 1-7 and no copay for days 8-90 for Inpatient Hospital-Acute, and a $295 copay for days 1-7 and no copay for days 8-60 for Inpatient Hospital Psychiatric. Additional days for Inpatient Hospital-Acute have no copay, while Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered. Additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered, including all outpatient hospital services with a $295 copay, observation services with a $295 copay, ambulatory surgical center services with a $225 copay, and outpatient substance abuse services with a $40 copay for both individual and group sessions. Outpatient blood services are also covered, including services not usually covered by Medicare plans, with a waived deductible for three pints.
Partial Hospitalization See details
Partial Hospitalization is covered by the Braven Medicare Salute (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 by the Braven Medicare Salute (PPO) plan, with prior authorization required for all ambulance services. Ground and Air Ambulance Services have a copay of $275.00, and Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Braven Medicare Salute (PPO) plan. Emergency Services have a $110 copay, and Urgently Needed Services have a $55 copay, both with no coinsurance. Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $110 copay, and Worldwide Emergency Transportation has a $275 copay, all with no coinsurance, and are subject to a maximum plan benefit of $100,000.
Primary Care See details
The Braven Medicare Salute (PPO) plan covers primary care physician services, chiropractic services with a $15 copay, occupational therapy services with a $10-$35 copay, physician specialist services with a $40 copay, mental health specialty services with a $40 copay for individual and group sessions, psychiatric services with a $40 copay for individual and group sessions, physical therapy and speech-language pathology services with a $10-$35 copay, and opioid treatment program services with a $40 copay. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
The Braven Medicare Salute (PPO) plan covers preventive services, including Medicare-covered services, annual physical exams, and additional preventive services. Some additional 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 $40 copay, and prescription hearing aids (all types) with a copay between $299 and $1199. Routine hearing exams and fitting/evaluation for hearing aids are covered, but prescription hearing aids - inner ear, outer ear, and over the ear are not covered, nor are OTC hearing aids.
Vision Services See details
The Braven Medicare Salute (PPO) plan covers vision services, including routine eye exams with a copay of $0-$40. Eyewear is covered, including contact lenses (one pair per year, up to $200), eyeglasses (lenses and frames, one pair per year), eyeglass lenses (one pair per year), eyeglass frames (one frame per year, up to $200), and upgrades.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with a $45 copay, and other dental services such as oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, restorative services with 0-50% coinsurance, and orthodontics with a $2,500 annual maximum benefit, but does not cover maxillofacial prosthetics, implant services, or orthodontics. Adjunctive general services, prosthodontics (removable and fixed), and oral and maxillofacial surgery are covered with 50% coinsurance.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Braven Medicare Salute (PPO) plan. Medicare Part B Insulin Drugs have a copay between $0 and $35, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Braven Medicare Salute (PPO) plan. You will pay a 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment coverage includes Durable Medical Equipment (DME) with an 18% coinsurance and no copay, Prosthetic Devices with a 20% coinsurance and no copay, Medical Supplies with a 20% coinsurance and no copay, and Diabetic Supplies with between 0% and 20% coinsurance and no copay. 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 by the Braven Medicare Salute (PPO) plan. Diagnostic Procedures/Tests have a copay between $0 and $55, while Lab Services are not covered. Diagnostic Radiological Services have a copay up to $180, Therapeutic Radiological Services have 20% coinsurance, and Outpatient X-Ray Services have a $40 copay.
Home Health Services See details
Home Health Services are covered by the Braven Medicare Salute (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 Salute (PPO) plan. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Braven Medicare Salute (PPO) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $188.
Other Services See details
The Braven Medicare Salute (PPO) plan does not cover acupuncture, 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, or Self-Directed Personal Assistance Services. The plan covers over-the-counter items, with a maximum benefit of $70.00 every three months. The plan also covers a meal benefit for a chronic illness.
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