|
Fallon Medicare Plus Supplement Core |
Fallon Medicare Plus Supplement 1A |
Fallon Medicare Plus
Supplement 1*** |
Monthly plan premium
(You could qualify for a 15% discount. See the Outline of Coverage for details.) |
$178 |
$218.70 |
$298 |
| Benefit |
Fallon Medicare Plus Supplement Core
Copayment |
Fallon Medicare Plus Supplement 1A
Copayment |
Fallon Medicare Plus
Supplement 1***
Copayment |
| Hospitalization |
$0 after you meet your $1,632* Part A deductible |
$0 |
$0 |
| Home health care |
$0 |
$0 |
$0 |
| Doctor office visits |
$0 after you meet your $240** Part B deductible
|
$0 after you meet your $240** Part B deductible
|
$0 |
| Specialist office visits |
$0 after you meet your $240** Part B deductible
|
$0 after you meet your $240** Part B deductible
|
$0 |
| Emergency room visits |
$0 after you meet your $240** Part B deductible
|
$0 after you meet your $240** Part B deductible
|
$0 |
| Same-day surgery |
$0 after you meet your $240** Part B deductible
|
$0 after you meet your $240** Part B deductible
|
$0 |
Diagnostic tests
(X-rays, MRI, CT, PET and nuclear studies) |
$0 after you meet your $240** Part B deductible
|
$0 after you meet your $240** Part B deductible
|
$0 |
| Physical and speech therapy |
$0 after you meet your $240** Part B deductible
|
$0 after you meet your $240** Part B deductible
|
$0 |
Eyewear discount program
Includes one routine eye exam every year at a plan provider and up to $150 allowance toward first pair of eyeglasses or contact lenses per calendar year. |
$0 |
$0 |
$0 |
| Part B outpatient drugs |
$0 after you meet your $240** Part B deductible
|
$0 after you meet your $240** Part B deductible
|
$0 |
SilverSneakers® Fitness program
includes access to online classes and instructional videos, a free gym membership, and more |
$0 |
$0 |
$0 |
Care Connect
24/7 phone access to registered nurses who will recommend where you should receive care or will connect you to your doctor. |
$0 |
$0 |
$0 |
Quit to Win program
Our smoking cessation program
offers one-on-one telephone coaching, group, and text
support with individualized stop-smoking plans. |
$0 |
$0 |
$0 |
Naturally Well
Discounts on acupuncture, chiropractic care,and massage therapy. |
$0 |
$0 |
$0 |
MyFallon app for smartphones
See your ID card
and plan documents. The app is for both iPhones
and Androids. |
$0 |
$0 |
$0 |
Foreign travel
Emergency services while traveling outside the U.S. |
Not covered |
$0 |
$0 |
| Part D drugs |
You must enroll in Medicare Part D to be covered. |