Braven Health is a new insurance company created through a partnership with Horizon BCBSNJ and Hackensack Meridian Health (HMH). Braven Health, an affiliate of Horizon BCBSNJ, will offer Medicare Advantage plans in certain New Jersey counties effective January 1, 2021.
Braven Health will offer affordable Medicare Advantage health plans with access to the Horizon Hospital Network and the Horizon Managed Care Network. If you are a participating provider for Horizon BCBSNJ Medicare Advantage plans, Braven Health will be added as a new plan offering that you will service.
Participation in Braven Health plans are based on providers’ current participation with existing Horizon Medicare Advantage plans. Braven Medicare Choice (PPO) and Braven Medicare Freedom (PPO) plans will use the broad Horizon Managed Care Network and the broad Horizon Hospital Network. Braven Medicare Plus (HMO) will use the same subset of the Horizon Managed Care Network and the Horizon Hospital Network used by Horizon BCBSNJ Medicare Blue Advantage (HMO) plans.
Our online Doctor & Hospital Finder indicates network participation status in Braven Health plans.
|Braven Health plan||Uses the|
|Braven Medicare Plus (HMO)||A subset of the Horizon Managed Care Network and Horizon Hospital Network|
|Braven Medicare Choice (PPO)||The broad Horizon Managed Care Network and Horizon Hospital Network|
|Braven Medicare Freedom (PPO)||The broad Horizon Managed Care Network and Horizon Hospital Network|
Physicians, other health care professionals and hospitals participating in the Horizon Managed Care Network and the Horizon Hospital Network cannot choose to opt out of participation with Braven Health plans. The only option to not participate in Braven Health plans and other Horizon Medicare Advantage plans would be for a physician, health care professional or hospital to terminate participation in the Horizon Managed Care Network or the Horizon Hospital Network completely.
Braven Health will offer the following Medicare Advantage plans for January 1, 2021.
- Braven Medicare Plus (HMO)
- Braven Medicare Choice (PPO)
- Braven Medicare Freedom (PPO)
These new plans will be offered to Medicare beneficiaries who reside in the following New Jersey counties: Bergen, Essex, Hudson, Middlesex, Monmouth, Ocean, Passaic and Union.
Braven Health will also offer Medicare Advantage products to employer groups for their retirees when the headquarters of the employer group is within one of the eight New Jersey counties listed above.
Members enrolled in Braven Health plans are not limited to using only HMH or RWJBarnabas Health-affiliated providers and hospitals.
Coverage for out-of-network services depends on the plan design.
Braven Health and Horizon BCBSNJ will have different Medicare Advantage plan offerings.
- Braven Health is offering brand new Medicare Advantage plans for 2021 in eight New Jersey counties.
- Horizon BCBSNJ is offering Medicare Advantage plans in all 21 New Jersey counties.
Review more information about Braven Health Medicare Advantage Plans.
Overall Braven Health will not create significant administrative changes for participating providers.
- Braven Health will follow Horizon BCBSNJ’s policies and procedures, including its medical policies.
- Horizon BCBSNJ will provide back-office operations, including network management, claims, customer service and provider services required to operate a Medicare Advantage plan.
- Braven Health will have its own Payer ID (84367). All trading partners and direct submitters will need to register for Braven Health EDI prior to January 1, 2021.
One difference for providers is that Braven Health, as a new insurance company, will have its own Payer ID (84367), separate from Horizon BCBSNJ.
- Trading partners are currently enrolling and testing EDI capabilities with us for January 1, 2021.
- Direct submitters should register with Braven Health EDI capabilities.
For more information visit the Braven Health EDI page.
Heathier New Jersey Insurance Company d/b/a Braven Health (“Braven Health”) has a Medicare contract to offer HMO and PPO Medicare Advantage and Medicare Advantage with Prescription Drug plans, including group-Medicare Advantage and Medicare Advantage with Prescription Drug plans. Enrollment in Braven Health’s products depends on contract renewal. Products are provided by Healthier New Jersey Insurance Company d/b/a Braven Health. Communications are issued by Horizon Healthcare Services, Inc. d/b/a Horizon BCBSNJ in its capacity as administrator of programs and provider relations for all of its companies. Both are independent licensees of the Blue Cross and Blue Shield Association. The Blue Cross® and Blue Shield® names and symbols are registered marks of the Blue Cross and Blue Shield Association. The Horizon® name and symbols are registered marks of Horizon Blue Cross Blue Shield of New Jersey. Braven Health℠ is a service mark of Healthier New Jersey Insurance Company d/b/a Braven Health.