Seniors Using Hackensack-Affiliated Medicare Plan Must Find New Health Insurance

A New Jersey-based health insurance company for seniors is leaving the health care market in six weeks, forcing 42,000 residents to find a new Medicare plan, the company confirmed.

Braven Health — run by Horizon Blue Cross, Hackensack Meridian Health and RWJBarnabas Health — will stop offering Medicare Advantage plans in New Jersey on Jan. 1, a spokesperson told Patch.

That means that 42,000 seniors around New Jersey may have to find new providers and possibly pay more out of pocket for health insurance after Dec. 31.

Braven Health, founded in 2020, is unique because of its partnership involving two New Jersey hospital systems — Hackensack and RWJ Barnabas. It's a Medicare Advantage plan, sometimes known as Medicare Part C, a private alternative to original government Medicare that's still government-approved.

Seniors using the plan, which has been available in all 21 counties, were able to get in-network rates for various providers, just like with other Medicare plans.

Now, they will have to switch to a new network for next year, with different rates and providers.

Thomas Wilson, a spokesman for Braven Health, told Patch, "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."

Becker's Hospital Review, an industry news source, reported that Braven is one of at least eight plans across the country that are dropping their Medicare Advantage plans because of higher costs and other factors.

Miguel Bello, an insurance agent with Absolute Insurance Management for seniors — with offices in Bergen County and Toms River — said he is just starting to get calls from Braven customers who need to help picking a new plan in the next few weeks.

"Today I actually met two people who have Braven who need to be moved at the end of the year, and we are very close to the 15th, and they have not received their letter of termination," Bello told Patch earlier this week. "Maybe some customers don't even know. Some may not have opened the mail, and think it's [junk mail]."

He added, "Unfortunately, this business has changed pretty drastically in the last couple of years."

He said that some clients have found Clover Health to be a similar alternative. While he does get commissions from the insurance companies, he said he helps his clients with various questions and finding a less expensive plan even if they already have insurance.

Braven Health has a phone number to help customers who need to weigh several plans. They must consider the monthly costs, copays for visits, and their healthcare needs (see contact information at the end of this story).

Braven sent a letter to consumers this month 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."

Wilson, the Braven spokesman, told Patch, "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."

Other Medicare Advantage plans are available, he said, 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, experts say.

An industry newsletter reported this month, "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."

Finding a new plan involves weighing several factors, like whether their doctors are in network, and costs and copays.

"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," experts reported,

Braven Can Still Help

Braven health debuted in New Jersey in 2020. In 2021, Luisa Charbonneau, the chief executive officer, said, “We launched Braven Health 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."

Wilson, the Braven spokesman, said the company is available to help transition seniors to a new policy.

"We want every Braven Health member to feel supported as they explore coverage options for 2027," he said. "During the Annual Enrollment Period, we’ll provide targeted communications and personalized outreach to help members understand their choices and navigate the transition. Members can contact Customer Service at any time to speak with an agent who can help them review their coverage options."

To contact Braven or find out more, head here.