Fallon Health Accelerates Access to Health Care Services for Members Impacted by Coronavirus

Worcester, Mass., March 13, 2020 ― Fallon Health today announced it is taking several meaningful steps to make it easier for members to be tested for—and receive care related to— the Novel Coronavirus (COVID-19). 

Effective immediately, Fallon is implementing the following:

  • Relaxing administrative procedures, such as out-of-network and prior authorization requirements, for medically necessary care as dictated by the Massachusetts Division of Insurance in accordance with Department of Public Health (DPH) and Centers for Disease Control and Prevention (CDC).
  • Coverage of medically necessary coronavirus testing and counseling for members who meet DPH and CDC guidelines. Fallon members (including members of commercial, Medicare and Medicaid plans) will have no cost-sharing for medically necessary COVID-19 testing and counseling.
  • Waiving of copayments for medically appropriate coronavirus treatment in accordance with the CDC and DPH guidelines.
  • A dedicated hotline (1-877-835-8440, TRS 711) to connect members with representatives who can address questions about the coronavirus, discuss available benefits and provide phone numbers for additional help.

Richard Burke, President and CEO of Fallon Health, said the organization is monitoring the evolving situation and its impact to make appropriate policy adjustments that are in the best interests of members.

“The safety and well-being of our members is a top priority for Fallon Health. We are pleased to accelerate access to health care services for those who may be impacted by coronavirus,” he said.

Fallon is also encouraging the use of telehealth services—access to doctors and nurses by phone or video.

“Telehealth is a trusted alternative to in-person doctor visits and provides a 24/7 solution for patients who are concerned about illnesses, including the flu and/or coronavirus. These phone or video consults ensure access to care while reducing the opportunities for disease transmission,” said Carolyn Langer, M.D., Chief Medical Officer for Fallon Health. “Fallon members who have the telehealth benefit—such as Teladoc or Nurse Connect—can also use those channels to receive medical services or advice.”

Coverage of and access to telehealth services vary by plan. To check coverage, members may log into the Documents Portal to view benefit documents. Members with this benefit will be able to utilize services related to COVID-19 with no cost-sharing at www.teladoc.com/fallon.

Melissa Randall
Corporate Communications Manager, Fallon Health

About Fallon Health
Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products.