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Learn All About Our Medicare Options.

Meet the New Jersey’s health care leaders that are bringing a whole new approach to Medicare

Introducing Braven Health

Unable to attend a live session? Launch the video above to view a recorded presentation. In this video, you will:

Meet the New Jersey’s health care leaders that are bringing a whole new approach to Medicare
Learn all about our Medicare options
Take a deep dive into the medical and drug benefits available
Review our extensive network of hospitals, doctors and other health care professionals
Learn how you can personalize your experience with extra savings

Transcript

Slide 1:

Welcome! We are very excited to share information with you about our 2021 Braven Health Medicare Advantage Plans!

Slide 2:

During this presentation, we will discuss exactly what is Braven Health? We will review your Health Care Options as a Medicare beneficiary. We will take a deeper dive into our 2021 Braven Health Medicare Advantage Plans. And I will share with you some extra savings and advantages available with our Braven Health Medicare Advantage plans.

Slide 3:

So what is Braven Health?

Slide 4:

Braven Health is a NJ Medicare plan built in partnership by two of NJ’s top health care leaders:

Horizon Blue Cross Blue Shield of New Jersey, which brings nearly 90 years of experience working to clear a path for members to get the care they need; and Hackensack Meridian Health, New Jersey’s largest, most comprehensive health system, which is included in our fast growing network. Now it’s very important to understand that as a Braven Health member you are in no way limited to using only Hackensack Meridian Health providers; on the contrary, our partnership with Hackensack Meridian Health simply means that you will have the opportunity to see not only Horizon BCBSNJ providers, but Hackensack Meridian Health providers included in our network as well — which allows you the broadest possible network access.

Slide 5:

Our Medicare Advantage plans are your gateway to the Braven Health experience, including:

A focus on your total health, with doctors, specialists, nurses and your insurer all on the same team
Three plan options, including some plans featuring $0 premium
Low out of pocket costs
An extensive network
Flexible out of network benefit options
Up to $400 in Wellness Extras
Up to $360 in yearly OTC Credits (and I’ll tell you exactly what those are)
Plus, even more benefits and extras

Slide 6:

Before we get into the specifics of our Braven Health Medicare Advantage plans, let’s take a moment to discuss the options available to you for your health care as a Medicare Beneficiary.

Slide 7:

Before you enroll into any plan it’s good to understand the Parts of Medicare. Now you may already be a Medicare beneficiary with a pretty good understanding of how it all works. Or perhaps Medicare is newer to you. Either way, a quick review is always a good idea. There are basically 4 parts to Medicare: Part A, which is your hospital coverage; Part B, which is your Medical coverage; Part D which covers your prescription drugs; and Part C, which is Medicare Advantage.

Slide 8:

So Medicare Part C, or Medicare Advantage, actually combines your Part A Hospital coverage, your Part B Medical coverage, and your Part D Prescription Drug coverage conveniently into one plan called a Medicare Advantage Prescription Drug plan.

Slide 9:

Now you may have had prescription drug coverage under an employer plan for example, which probably worked a little differently than Medicare Part D Prescription Drug coverage works. So let’s take a moment to look at exactly how the prescription drug portion of your Medicare Advantage plan works.

There are different drug stages for your Part D prescription drug coverage. Each stage determines the cost of your medications.

Stage 1 is your Deductible Stage. If your plan has a deductible, you would pay the full discounted cost of your medication up to the deductible amount.

Once your deductible has been satisfied, you would move into the Initial Coverage stage. During this stage, you will pay a small amount toward the cost of your medications in the form of copays or coinsurance until you reach the initial coverage limit.

You would then enter what is called the Coverage Gap, also known as the donut hole. During this stage, your out-of-pocket costs may be higher for certain medications.

Once your out of pocket limit is reached, you will move into the Catastrophic Coverage stage. At this point your plan will pay most of the cost of your medications.

Slide 10:

Now that we have a better understanding of how Medicare Advantage combines your Hospital, Medical and Prescription Drug coverage, and how the prescription portion of your Medicare Advantage plan works, let’s take a closer look at our 2021 Braven Health Medicare Advantage plans.

Slide 11:

There are three Medicare Advantage plan options for 2021:

Braven Medicare Choice (PPO)
Braven Medicare Freedom (PPO); and
Braven Medicare Plus (HMO)

Our PPO plans include in-network access to the Blue Medicare Advantage PPO network outside of NJ in 43 states — as well as flexible out-of-network benefits either within or outside of NJ.

As previously mentioned, all of our Medicare Advantage plans provide access to an extensive network of high-quality doctors, specialists, and hospitals near you that includes — but does not limit you to — the entire Hackensack Meridian Health system as well.

Slide 12:

Our choice of Medicare Advantage plans include:

$0 dollar premium, $0 dollar medical deductible and $0 dollar prescription deductible on certain plans
$0 in-network doctor visit copays
$0 Telehealth copay for online doctor and therapist visits with Braven Health’s care online program
Comprehensive dental coverage
Built-in vision and hearing benefits
Up to $360/year in OTC card credits for over the counter health items
Up to $200/year in reimbursements for any gym and/or yoga studio membership
Up to $200/year in reimbursements for a weight loss program, activity tracker and more, and
Worldwide emergency and urgent care

Slide 13:

Now there are certain eligibility requirements to qualify for a Braven Health Medicare Advantage plan. You must have Medicare Part A and Part B. And you must reside in the service area for the Braven Health Medicare Advantage Plan you wish to enroll in.

Slide 14:

So let’s begin by discussing our Braven Medicare Choice PPO and Braven Medicare Freedom PPO plans. The service area for both of these plans includes the following counties:

Bergen
Essex
Hudson
Middlesex
Monmouth
Ocean
Union, and
Passaic

Now keep in mind that the service area only references the county you must live in in order to be eligible for your selected Braven Health plan, in this case the Braven Medicare Choice or Braven Medicare Freedom PPO. However the doctors and/or health care professionals that you will have access to are not limited only to the county you live in. You will have in-network access to providers and hospitals across the entire state of NJ, and outside of NJ as well. And you will also have the option of out of network coverage at a higher cost share.

Slide 15:

Now that you know where the plans are actually offered, let’s explore our network in greater detail.

In NJ, our large PPO network includes:

Up to 51,000 in network doctors and health care professionals
82 In-network hospitals and out-patient facilities
Extended in network access in 43 participating states

So what does this mean? Let’s say you travel on vacation to Florida, which happens to be one of the 43 states that participates in our national Medicare Advantage PPO network. If you were to see a provider who participates in Florida’s Medicare Advantage PPO network, your claims would be paid in-network, the same as if you had seen a participating provider in NJ. So our Medicare Advantage PPO Visitor Traveler Program essentially gives you in-network access to over 613,000 providers and 4,100 hospitals outside of NJ, in addition to our extensive network in NJ.

Slide 16:

Now, let’s take a closer look at our Braven Medicare Choice (PPO). This plan includes:

$0 Medical Deductible
$0 Monthly Premium
$0 copay for doctor office visits and online doctor or therapist visits (also known as Telehealth) through Braven Health’s care online program
This plan requires no referrals
It includes routine vision, dental and hearing benefits
Prescription copays starting at $0
Out-of-state network access as we discussed
Up to $400 back in Wellness Extras
Up to $280 in over-the-counter (or OTC) card credits and I will give you all of those details, and
Comprehensive Dental Coverage — all included

Slide 17:

Now here are the Medical benefit details for our Braven Medicare Choice (PPO) plan.

You will notice 2 columns indicating in network cost share and out of network cost share. Note that for most benefits, if there is an out of network cost share, it is a flat co-pay.

So you’ll see $0 dollar monthly premium; $0 medical deductible; which means that you go right into benefits; your PCP in network visit is $0, your specialist visit is $20 in network, out of network, $10 for your PCP, $30 for your specialist. Your annual physical exam, your Telehealth, your routine vision, hearing and dental are all $0 in network. Vision and hearing $30 out of network. Emergency copay $90 whether in or out of network. Your inpatient maximum out of pocket per admission is $1600. And your overall plan maximum out of pocket is $6700 in network, $10,000 out of network.

Slide 18:

Now here are the prescription details for our Braven Medicare Choice (PPO) plan. Remember you will need to satisfy your deductible first before benefits will begin. For this plan, the prescription deductible is $150 and is only applicable for Tiers 3, 4 and 5, which are the preferred brand, non-preferred drug and specialty tiers. So if your prescription falls under Tiers 1 or 2, preferred generic or generic, you would pay no deductible and go right into your initial coverage benefits. Note that for a Tier 1 preferred generic drug the cost sharing would be $0 whether you fill your prescription at a pharmacy or via mail order. Also note that Tiers go from the least to most expensive medications, with Tier 5 specialty being the most expensive. So you will see that the cost sharing, in turn, increases as the Tiers go up.

Slide 19:

Next, let’s take a closer look at our Braven Medicare Freedom (PPO). Now this plan includes:

$0 Medical Deductible
$0 In-network Doctor Visits
A $35 Premium
$0 copay for online doctor and therapist visits through your Telehealth benefit
No referrals required
Routine vision, dental and hearing benefits
Up to $400 back in Wellness Extras
Up to $360 in over-the-counter (OTC) card credits
And that Comprehensive Dental Coverage which again I’m going to tell you all about

Slide 20:

Now here are the medical benefit details for our Braven Medicare Freedom (PPO) plan.

Again you will notice 2 columns indicating in network cost share, and out of network cost share. Note that for many benefits, if there is an out of network cost share, it will usually be 30% coinsurance.

$35 monthly premium, no medical deductible which again brings you right into your benefits. $0 for your PCP visit in network; $20 for your specialist visit; out of network 30%. Your annual physical, your routine vision and hearing, your dental as well as your telehealth, $0 in network; your vision and hearing 30% out. Your maximum out of pocket for your hospital stay is $1500 per admission in network, 30% coinsurance out of network. Maximum out of pocket for the plan, $6500 in network, $9500 out of network. And of course your emergency care copay is $90 whether in or out of network, and that is worldwide.

Slide 21:

Now here are the prescription details for our Braven Medicare Freedom (PPO) plan. For this plan, the deductible is $100 and again is only applicable for Tiers 3, 4 and 5, which are the preferred brand, non-preferred drug and specialty tiers. So once again if your prescription falls under Tiers 1 or 2, preferred generic or generic, you would pay no deductible and go right into your initial coverage benefits. Note that for a Tier 1 preferred generic drug the cost sharing is also $0 whether you fill your prescription at a pharmacy or via mail order. And again you will see that cost sharing increases as the Tiers go up.

Slide 22:

Finally, let’s take a closer look at our Braven Medicare Plus (HMO). The service area for this plan includes the following counties:

Bergen
Essex
Hudson
Middlesex
Monmouth
Ocean
Union

Note that Passaic County is not included for Braven Medicare Plus (HMO). Also recall as I explained earlier that the service area only references the county you must live in in order to be eligible for your selected Braven Health plan, in this case, the Braven Medicare Plus HMO. Now while you must use physicians, health care professionals and facilities that participate in the Braven Medicare Plus HMO plan, these providers are not limited only to the county you live in. With this plan you will have access to in-network providers and hospitals across the entire state of NJ.

Slide 23:

Our Braven Medicare Plus (HMO) plan includes:

$0 Monthly Premium
$0 Medical Deductible
$0 Prescription Deductible
$0 Copay for Primary Care Doctor visits and online doctor and therapist visits through your Telehealth benefit
No referrals are required
This plan includes routine vision, dental and hearing benefits
Prescription copays starting at $0
Up to $280 in over-the-counter (OTC) card credits
Up to $400 back in Wellness Extras, and
Comprehensive Dental Coverage

Slide 24:

Here are the medical benefit details for our Braven Medicare Plus (HMO) plan. Notice there is only one column, indicating in network benefits only, with plenty of benefits at $0 cost share.

Monthly premium $0; no medical deductible, bringing you right into benefits; your PCP visit is $0, specialist visit is $20, your physical, your Telehealth, your vision, dental, hearing all $0. Worldwide emergency $90; your inpatient maximum out of pocket is $1625 per admission. Flat $195 for ambulatory surgical center; your maximum out of pocket for this plan is $6500.

Slide 25:

Here are the prescription details for our Braven Health Medicare Plus (HMO) plan. Note that for this plan there is no prescription deductible, which means that you would go right into your initial coverage benefits no matter what tier your medications fall into. Note again $0 cost sharing for preferred generic drugs whether filling your prescription at the pharmacy or via mail order. And similar to our PPO plans, the higher the tier, the higher the cost of the medication, which means the higher your cost share.

Slide 26:

Now let’s elaborate a bit more on some of those great additional benefits that are included in our 3 Braven Health Medicare Advantage plans.

Slide 27:

The Annual Physical Exam is $0 copay in-network on all plans and includes:

A detailed medical/family history
A Head to toe assessment
One visit each year

Slide 28:

Our routine Dental benefit includes:

Three oral exams per year
Three cleanings per year
One fluoride treatment every six months
One full mouth X-ray every three years

And also note that on our PPO Products, out-of-network dental coverage is available at the same cost share as in-network, however you will receive the best value by utilizing a participating dental provider.You can find a list of all participating providers right on this Braven Health website by clicking the ‘Find A Doctor’ tab on the home page.

Slide 29:

Now you heard me mention Comprehensive dental coverage a few times when describing our plans. So exactly what is that? Well in addition to routine dental coverage, the comprehensive dental benefit includes 50% coverage up to an $800 maximum amount annually for services like restorative, endodontics, periodontics, and simple extractions. Again, you would get the most value by utilizing a participating dental provider for these services.

Slide 30:

The Annual Flex Benefit includes reimbursement of up to $200 annually for:

WW® (Weight Watchers)
Acupuncture
Nutritional therapy
An activity tracker like a Fitbit or Apple watch
Bathroom safety devices like bathtub rails
Therapeutic massage. Now for this one you would need a prescription or a letter of medical necessity from your doctor

And you could receive up to $200 toward any of these single items or a combination of any or all of these items.

Slide 31:

Our Hearing Benefits include:

$0 for routine hearing exam
$0 copay for hearing aid evaluation and fitting, and
Up to $1,250 annually toward hearing aids

For Braven Medicare Plus (HMO) the routine hearing exam & hearing aid services must be coordinated through HearUSA.

Slide 32:

Our Vision Benefits include:

$0 routine annual eye exams
$0 copay for eyeglasses or contact lenses after cataract surgery, and
Up to $200 every 2 years for eyewear (eyeglasses or contact lenses) not associated with cataract surgery

Slide 33:

Now are you ready to hear about even more extra savings and advantages to keep you healthy? I’m excited to tell you!

Slide 34:

So what is this OTC Benefit card all about? Our Braven Health plans feature the over the counter (also known as OTC) Benefit Card. Every three months, you will receive at least $70 in credits towards the purchase of various personal health items such as denture cream, first aid kits, walking canes and a lot more, from participating retailers like:

Walmart
CVS Pharmacy, and
Walgreens

Once you’re enrolled you can see a full list of participating retailers by visiting OTCnetwork.com

Slide 35:

You will also receive reimbursement of up to $200 a year towards any gym and/or yoga studio membership of your choosing.

Slide 36:

Now our meal plan offers you more ways to get the care you need right from home. So following an inpatient hospital discharge to your home, you may be eligible to receive up to 28 nutritious meals delivered right to your home over a 14 day period — that’s 2 meals a day — to help you recover from your illness. Meals must be coordinated by your care manager and they must be consistent with the established treatment plan for your illness.

Slide 37:

You’ve also heard me mention Telehealth a few times during this presentation. So this benefit gives you 24/7 access to online doctor and therapist visits using your phone, tablet or computer — all for a $0 copay with Braven Health’s care online program.

Slide 38:

In addition, our 24 Hour Nurse Line gives you access to caring, registered nurses who have an average of 15 years of clinical experience for immediate answers to your health questions anytime, from anywhere — 24 hours a day.

Slide 39:

Pillpack, an Amazon company, allows you to get your prescriptions, your over-the-counter medications and your vitamins packaged according to your doctor’s instruction, into individual packets by the times of day you take them. So no more fiddling around with pill boxes — it’s all done for you. There is no additional cost to sign up and shipping is free.

Slide 40:

AllianceRx Walgreens Prime allows you to get up to a 90-day supply delivered right to you, anywhere in the United States. Again, shipping is always free.

Slide 41:

Now, if you would like to learn more about whether a Braven Health Medicare Advantage plan is right for you, please call us at 1-833-713-1313. Our licensed representatives are available Monday thru Friday from 8a.m. to 6p.m. and would be more than happy to speak with you and answer any questions you might have.

Slide 42:

Thank you so much for watching our presentation. We look forward to speaking with you soon!

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H0885_H4675_Web2021RN Last Updated 07/01/2021