Fallon Health expands access to its low-cost health insurance plan for individuals and families

Largest service area expansion in program history will support expected uptick in eligible members.

Worcester, Mass., November 9, 2023 ― Fallon Health today announced its affordable health plan, for individuals and families who obtain their coverage through the Massachusetts Health Connector, is expanding to serve even more people. During Open Enrollment, occurring now through January 23, 2024, Fallon Health’s Community Care product will be a new option for thousands of additional Health Connector customers who live in Berkshire and Suffolk counties. Fallon Health will continue to offer Community Care in its existing service area in parts of Norfolk and all of Worcester, and Middlesex Counties. Changes take effect January 1.

As the program’s footprint increases by approximately 35%, the largest in its nearly 10-year history, Fallon Health is adding nearly a dozen new provider organizations to its already robust network. Located in Eastern, Western, and Central Massachusetts, key additions include:

  • In Suffolk County, these include Harbor Health Services, Harvard Street Neighborhood Health Center, Whittier Street Health Center, South Cove Community Health Center, Beth Israel Deaconess Physician Organization, Boston Medical Center Integrated Care Services, and Mount Auburn Hospital Specialists.
  • In Berkshire County, these include BayCare Health Partners and Berkshire Faculty Practice.
  • And in Worcester County, these include Heywood Physician Hospital Organization and Charles River Medical Associates.
  • Seven hospitals in Suffolk, Berkshire, and Worcester County will also be added, including Baystate Medical Center, Berkshire Medical Center, Beth Israel Deaconess Medical Center, Boston Medical Center, Heywood Healthcare, Mount Auburn Hospital and New England Baptist Hospital.

“For nearly a decade, our Community Care program has proudly served thousands of individuals across the Commonwealth providing them with quality care and coverage at an affordable price. Today, we are pleased to extend that opportunity to even more individuals and families,” said Jennifer Lavigne, Sr. Director of Community Care. “We are also prepared to meet the needs of those who become newly eligible for a Health Connector Plan during an expected period of growth for the Commonwealth’s health insurance Marketplace.” 

There is an expected uptick in prospective members who are—or may become— newly eligible for a Health Connector plan. Approximately 50,000 people may become eligible based on new income eligibility guidelines. The Massachusetts Health Connector has also been enrolling former MassHealth members who are newly eligible for a Health Connector plan. Approximately 23% of those who lost coverage have made the switch, according to the most recent State data provided on the Medicaid Redetermination process, which still has several months to go.

For more information on Community Care, please contact the Massachusetts Health Connector at 1-888-813-9220, or call Fallon Health at 1-877-502-1200.

 

Melissa Randall
Director, Corporate Communications
Fallon Health
508-368-9345
melissa.randall@fallonhealth.org

About Fallon Health
Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care they need and deserve. Founded in 1977, Fallon Health delivers equitable, high-quality coordinated care and is continually rated among the nation’s top health plans for member experience, service, and clinical quality. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly).

 

About the Massachusetts Health Connector 
 The Massachusetts Health Connector is the Commonwealth’s health insurance Marketplace, and currently serves 275,000 individuals and small-employer members with health and dental insurance. Massachusetts residents who do not have health insurance from an employer or other entity can use the Marketplace to enroll in coverage. Through the ConnectorCare program, income-qualifying residents can access coverage that includes low-cost premiums and co-pays, and no deductibles.