Shop for a plan

With Fallon Medicare Plus Medicare Advantage plan options, you get more than Original Medicare alone—you receive extra benefits to help keep you healthy. You'll have access to a network of quality providers and you’ll pay $0 for services like:

$0

Medical deductible
Annual physical exam
Annual wellness visit
Preventive screenings
Meals delivered to your home after a discharge from an observation stay or inpatient admission at a hospital or nursing home facility
Telehealth visits (PCP and behavioral health)
Diagnostic tests, X-rays, and lab work

Plan options and benefits

Choose a plan—Orange, Green, or Blue—that works for your needs and budget

Benefits and copayments Orange Green Blue
Annual supplemental physical exam $0 $0 $0
Primary care provider (PCP) office visits $0 $5 $10

Telehealth: PCP and Behavioral health

$0 $0 $0

Specialty office visits, in person or via telehealth (except as noted above)

$40 $40 $20

Preventive dental (cleanings, exams, and X-rays)

$0 $0 $0

Routine eye exam

$0 $0 $20

Ambulance

$295 $225
($900 out-of-pocket
maximum per year)
$125
($500 out-of-pocket maximum per year)

Inpatient hospital care–acute

$370 per day
(days 1-5)
$0 per day
(days 6-90)
$300 per day
(days 1-5)
$0 per day
(days 6-90)
$200 per admission ($400 out-of-pocket maximum per year)

Diagnostic services
(Tests, procedures, X-rays, labs)

$0 $0 $0

Hi-tech imaging
(CT, PET, and MRI scans and nuclear studies)

$300 $250
($1,000 out-of-pocket maximum per year)
$150
($600 out-of-pocket maximum per year)

Outpatient surgery

$350 $275 $120

Worldwide ER visits

$90 $90 $120

Urgent care Inside/Outside the U.S. and its territories

$10/$90 $5/$90 $10/$120

Part D prescription drug coverage

Included Included Included
Benefit Bank $1,000 $500 $250
Over-the-counter benefit $275
per calendar year
$255
per calendar year
Not included
Dental—preventive and
comprehensive
Included Included Included
SilverSneakers®—free gym
membership, online classes,
and more
Not included Included Included

Compare and get a quote

shop for a planWe have a variety of plans with different premiums and levels of coverage. You choose the plan that best meets your needs and your budget.

Shop for Medicare Advantage plans

Enroll

Enroll in a planIf you already know which plan is right for you, you can enroll using our quick and easy online tool.


Enroll online

Or:

Learn more during our presentations

learn more at a meetingJoin us for a presentation to learn about Fallon Health's options for people with Medicare. Can’t make the presentation? No problem. You can also click the button below to view a pre-recorded presentation at any time or to email us to schedule a one-on-one meeting.

Register for a presentation or view a pre-recorded presentation

 

Call us toll-free at 1-888-340-5504 (TRS 711), 8 a.m.–8 p.m., seven days a week.
(Apr.–Sept., we are available 8 a.m.–8 p.m., Mon.–Fri.)

Fallon Health is an HMO plan with a Medicare contract. Enrollment in Fallon Health depends on contract renewal.

H9001_240092_M | The information on this page was last updated on 10/1/2023.

Are you eligible?

To join our plans you: 

  • Must be enrolled in Medicare Part A and Part B 
  • Must continue to pay your Medicare Part B premium if it’s not paid for by Medicaid or another third party 
  • Must live in the Fallon Medicare Plus service area. Our service area includes the entire State of Massachusetts except for Dukes and Nantucket counties. (If you get health insurance through an employer group, your service area may be different.)