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.
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 $250 that can be used for dental care, prescription eyewear, fitness/gym memberships, and prescription hearing aids. Use the card to pay a portion, or the full cost, of an item.
- Hearing aids
Pay between $695 and $2,645 when you make purchases through Amplifon. Copays vary by hearing aid type and technology. You can use your Benefit Bank toward these copayments or on prescription hearing aids purchased from other providers.
- Eyewear
$150 toward eyewear, every year. You can also use your Benefit Bank toward additional—or out-of-network—eyewear costs.
- Dental
You pay $0 for preventive dental like cleanings, exams, and X-rays. Comprehensive dental care, like root canals, fillings, and crowns are also covered at network dentists—with a copay. Your Benefit Bank can be used to pay for copays and out-of-network dental services.
- 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.
- Teladoc®
24/7 access to treatment from board-certified doctors, by phone, mobile app, or video—with a $0 copay.
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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 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
2026 plan documents (coming soon)
Online tools
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