Braven Health Medicare Advantage: How These New Jersey PPO Plans Work in 2026

What Braven Health is — and who runs it

Braven Health is a Medicare Advantage (Part C) insurer that operates only in New Jersey. It was created as a joint venture of three established New Jersey organizations: Horizon Blue Cross Blue Shield of New Jersey, Hackensack Meridian Health, and RWJBarnabas Health. Plans first launched for the 2022 plan year in eight counties and later expanded statewide.

Because it is built on Horizon's networks, Braven members generally get in-network access to the Horizon Managed Care Network and Horizon Hospital Network. It is a private company, not a part of the federal Medicare program. Medicare Advantage plans are sold by private insurers that contract with the Centers for Medicare & Medicaid Services (CMS), and this guide is independent and not affiliated with any government agency or with Braven Health.

• Type of coverage: Medicare Advantage (Part C), an alternative to Original Medicare
• Owners: Horizon BCBSNJ, Hackensack Meridian Health, and RWJBarnabas Health
• Where it operates: New Jersey only — but available in all 21 counties for 2026

What the 2026 plans look like

For 2026, Braven Health markets PPO (preferred provider organization) plans. A PPO lets you see out-of-network providers, though you typically pay more than you would in network. Plan lineups, premiums, and benefits change every year and differ by county, so confirm the details for your own ZIP code before enrolling.

Braven advertises features such as $0 monthly premiums on some plans, $0 in-network primary-care visits, dental, vision and hearing coverage, and a spending card for certain extra benefits. These are plan-specific marketing claims, not guarantees that apply to every Braven plan or every member — read the plan's Summary of Benefits and Evidence of Coverage for the exact figures, and note that a $0 premium plan can still carry copays, coinsurance, and an out-of-pocket maximum.

• All 2026 Braven plans shown are PPOs, with some offered at a $0 plan premium in certain counties
• Extra benefits (dental, vision, hearing, a benefits card) vary by plan — none are universal
• Each plan sets its own copays, network rules, and annual in-network out-of-pocket maximum

The Medicare costs you keep paying

A common misunderstanding is that a $0-premium Medicare Advantage plan means $0 in total cost. It does not. To be in any Medicare Advantage plan you must stay enrolled in Medicare Part A and Part B and keep paying your Part B premium, which is $202.90 per month in 2026, with a $283 annual Part B deductible (CMS figures).

Most people pay no premium for Part A because they have 40 or more quarters of Medicare-covered work; otherwise Part A costs $311 per month with 30–39 quarters or $565 per month with fewer than 30. Higher earners also pay more through IRMAA: in 2026, income-related surcharges begin above a modified adjusted gross income of $109,000 (single) or $218,000 (joint) based on 2024 income, pushing the total Part B amount to between $284.10 and $689.90 per month, plus a Part D surcharge of $14.50 to $91.00 per month.

• 2026 Part B: $202.90/month premium, $283 annual deductible (CMS)
• Part A premium: free at 40+ quarters; $311/mo at 30–39 quarters; $565/mo under 30 quarters (CMS)
• IRMAA in 2026 starts above MAGI $109k single / $218k joint (2024 income)

Braven Advantage vs. Original Medicare plus Medigap

Choosing a Braven Advantage plan is really a choice between two coverage structures. With Original Medicare you can use almost any provider nationwide that accepts Medicare, and you pay Part A and Part B cost-sharing — for example, a $1,736 hospital deductible per benefit period, $434/day for hospital days 61–90, and 20% coinsurance for most Part B services after the deductible (CMS). Original Medicare has no annual out-of-pocket cap on its own, which is why many people add a Medigap policy and a separate Part D drug plan.

A Medicare Advantage plan like Braven's bundles hospital, medical, and usually drug coverage into one plan with a yearly out-of-pocket maximum, but limits you to the plan's network and rules (referrals, prior authorization, and service area). Neither approach is universally better — it depends on your providers, your travel, your prescriptions, and your budget. If you take drugs, also remember the 2026 Part D out-of-pocket cap is $2,100 per year.

When and how to enroll

You can join, switch, or drop a Medicare Advantage plan only during set windows: your seven-month Initial Enrollment Period around your 65th birthday, the Annual Enrollment Period from October 15 to December 7, the Medicare Advantage Open Enrollment Period from January 1 to March 31, or a Special Enrollment Period triggered by qualifying life events such as moving out of the plan's service area.

Before enrolling in any Braven plan, verify that your doctors and hospitals are in network for that specific plan and county, check whether your prescriptions are on the plan's formulary, and read the official Summary of Benefits. Enroll directly through the plan or through Medicare's Plan Finder rather than relying on summaries like this one, and avoid any late-enrollment gaps — the Part B late penalty is a permanent 10% surcharge for each full 12-month period you could have had Part B but didn't.