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Benefit Reimbursements

Braven Health members can get reimbursements for things like eyewear, fitness memberships, hearing aids, acupuncture and more. In some cases, you may also be eligible for reimbursement for some of your prescription drugs.

Here’s how it works for the following benefits:

  • Eyewear Benefit
  • Hearing Aid Benefit
  • Fitness Benefit
  • Flex Benefit

Submit a reimbursement form with an itemized receipt and a copy of your member ID card to:

Braven Health
PO Box 1609
Newark, NJ 07101-1609
  • You may submit one or more requests for reimbursement up to the $200 limit for each benefit — eyewear, fitness, and flex. You can get reimbursed for up to $1,250 for hearing aids.
  • These reimbursements and any amounts paid out-of-pocket do not count toward your maximum out-of-pocket amount.
  • Braven Health members can receive up to $200 every two years for eyeglasses or contact lenses not associated with cataract surgery.

  • Braven Health PPO members can get reimbursed for the purchase or repair of hearing aids up to $1,250 every year :

    • $750 for purchase of hearing aid for one ear
    • $500 for purchase of hearing aid for second ear

  • Braven Health members can receive up to $200 each calendar year towards memberships at a health club, yoga studio and/or virtual fitness program you use at home, including Peloton®  memberships and the iFit fitness app, found on most NordicTrack®  and PROFORM®  machines. You cannot get reimbursed for activation fees, personal training sessions or other health club fees associated with membership.

  • Braven Health members can receive up to $200 in total each calendar year for one or more of the following benefits that are not covered by Medicare:

    • Acupuncture - must be provided by a licensed or certified practitioner in the state of New Jersey. A valid receipt must contain practitioner information.
    • Weight management program - limited to Weight Watchers plans that offer weekly structured weight loss management lessons, coaching and monitoring. The plan may not offer meals as part of the benefit.
    • Nutritional/dietary benefit - must be provided by a licensed or certified practitioner in the state of New Jersey (i.e., physician, nurse, registered dietician or nutritionist). A valid receipt must contain practitioner information.
    • Activity tracker - a wearable device that records a person’s physical activity and other data relating to their fitness or health, such as the number of calories burned and heart rate.
    • Therapeutic massage - must be furnished by a state licensed massage therapist. A prescription must be attached with a submission written by a physician or a medical professional with a diagnosis that is not primarily for comfort or relaxation. In order to be covered it must treat or make better the impact of injuries (e.g., pain, stiffness, loss of range of motion).
    • Bathroom safety devices - Includes raised toilet seats, bathroom rails, toilet rails, shower stools/benches/chairs, transfer benches, hand held showers, non-slip tread strips and installation fees. An in-home assessment by a health professional is not eligible for reimbursement.

  • If for some reason you paid the full cost of a covered prescription, you can ask us to reimburse you for the difference between your copay or coinsurance and the total cost of the medication. Instances where this may happen include but are not limited to:

    • The covered drug/product you needed is not usually stocked at a network retail (local) or home delivery pharmacy service.
    • You become sick or you run out of your medication when traveling outside of Braven Health's service area.
    • You couldn't choose a network pharmacy because you received the covered drug while in an Emergency Room, medical clinic or other outpatient facility.

    Submit a reimbursement form with an itemized receipt and a copy of your member ID card to the address below:

    Medicare Claims
    PO Box 20970
    Lehigh Valley, PA 18002-0970

    pdf image Medicare Rx Claim Form

    pdf image Medicare Rx Claim Form - Spanish

    Please note: Prescription drug claims are managed by Prime Therapeutics, Braven Health's pharmacy benefits manager.