Overview
Fallon Medicare Plus Premier HMO is our Medicare Advantage Plan for retirees that offers comprehensive coverage and more benefits than members would get with Original Medicare alone.
We offer two providers networks with our Medicare Advantage HMO plans:
Fallon Medicare Plus Central Premier and Fallon Medicare Plus Premier.
Fallon Medicare Plus Central Premier
Fallon Medicare Plus Central Premier is available to Worcester County residents only. It is a limited provider network, which means that members can only receive care from these select provider groups:
- Reliant Medical Group
- Heywood Hospital and providers
- St. Vincent Hospital
- Select Steward Health Care providers
- And other contracted providers
Fallon Medicare Plus Premier
Fallon Medicare Premier is our statewide network, available to members across our entire service area*, including those who live in Worcester County.
The Fallon Medicare Plus Premier network includes thousands of providers—from the Berkshires to Boston, from the South Shore to the North Shore.
Both plans include rich benefits like:
- Benefit Bank
The Benefit Bank card is preloaded with money that can be used for dental care, eyewear, fitness memberships, and hearing aids. Use the card to pay a portion, or the full cost, of an item. Allowances are either $250 or $500, depending on the chosen plan.
- Hearing aids
Copayments varying from $695 to $2,645 through Amplifon. You can use your Benefit Bank toward these copayments or on hearing aids purchased from other providers, if you choose.
- Eyewear
$150 toward eyewear, every year. Also, the Benefit Bank can be used toward additional eyewear costs.
- Dental
Coverage for preventive care like cleanings, routine exams, and X-rays as well as comprehensive services like root canals. Also, the Benefit Bank can be used to pay for dental services.
- SilverSneakers®
Includes a free gym membership and on-demand library of classes, workouts, and instructional videos. Plus, the Benefit Bank can be used to pay for fitness memberships.
- WW® membership
Free 13-consecutive-week WW membership (formerly Weight Watchers).
- Care Connect
24/7 access to registered nurses by phone, at a $0 copay. Nurses provide guidance on where
to go for care and/or they can connect you with your doctor.
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Eligibility
To be eligible for Fallon Medicare Plus Premier HMO, members must:
- Be eligible for a Medicare group plan through an employer or a union health and wellness organization
- Be enrolled in Medicare Part A and Part B
- Continue to pay their Medicare Part B premium or have it paid for by another source
- Reside within the approved service area.
Service area
To be eligible for Fallon Medicare Plus Central Premier, retirees must be a resident of Worcester County.
To be eligible for Fallon Medicare Plus Premier, retirees must live in one of the following Massachusetts counties: Barnstable, Berkshire, Bristol, Essex, Franklin, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk, or Worcester. Or, they may reside in specific cities or towns that border Massachusetts, as seen in the map below.
See a larger version of this map
2023 plan documents
Online tools
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