North Jersey Seniors On One Medicare Plan May Have To Find New Insurance And Doctors

NORTH JERSEY — Braven Health — a partnership between Horizon Blue Cross, Hackensack Meridian Health and RWJBarnabas Health — will stop offering Medicare Advantage plans in New Jersey on Jan. 1, a spokesperson confirmed Friday.

This means seniors may have to find new providers and possibly pay more out of pocket for health insurance in 2027.

Braven Health, unique because of a partnership involving two major hospital systems, allows in-network rates for various providers, and has been available in all 21 counties.

Becker's Hospital Review, an industry news source, reported last week that Braven, as well as at least seven other plans serving various states, are "exiting the Medicare Advantage Market for 2027."

Braven recently sent a letter to consumers saying, "As we prepare for this transition, we are committed to helping our members understand their Medicare coverage options and make informed decisions about coverage for 2027." The transition information is here.

Costs Rising

An industry expert said last week that according to federal data, thousands of seniors on Medicare "could see their current plan eliminated by their insurer, be blindsided by the loss of a particular benefit or be forced to manage a significantly higher maximum out-of-pocket cost limit next year."

Thomas Wilson, a spokesman for Braven Health, told Patch on Friday, "Like many Medicare Advantage plans across the country, Braven Health faced market conditions that compromised our ability to continue providing members with the high quality coverage and service they deserve.

"Faced with the choice to offer a plan that does not reflect our core values or withdraw from the market, Braven Health made the difficult choice to not offer Medicare Advantage plans after Dec. 31, 2026."

He added, "Braven will continue to support the healthcare needs of our members through 2026 and will help them transition their coverage to an option that is right for them."

He said alternative Medicare Advantage plans are available, as well as the option to return to Original Medicare.

Changes For 2027

Several other national health insurance carriers are reducing their plan offerings for next year or shifting more costs to seniors.

Another industry newsletter reported Thursday, "People who have a Medicare Advantage plan — and wind up needing care and prescriptions next year — are in for a rude awakening. Medicare Advantage insurers are raising out-of-pocket costs for enrollees, drastically cutting money for dental work and other benefits, and eliminating plans that have broad networks of hospitals and doctors, according to federal data released this week and analyzed by STAT and several investment firms.

"That could result in more shock for older adults, like discovering their doctor is no longer accepted by their plan, if they don’t shop carefully during Medicare’s annual enrollment period for 2027 plans, which starts Oct. 15."

Medicare Advantage, sometimes known as Medicare Part C, is an alternative to original Medicare that offers private, government approved Medicare plans.

In 2021, Luisa Charbonneau, the chief executive officer of Braven Health, said, “We launched Braven Health last year to create a personalized health care experience to meet the unique health needs of our members ... We listened to Medicare-eligible consumers and developed enhanced, cost effective, flexible plans that are designed to put patients first. Braven Health’s seamless coordination is a new approach to Medicare, and we look forward to delivering enhanced benefits and high-quality, affordable care to our members.”

Find out more here.