Coverage for abortion and abortion-related services

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In 2022, the State of Massachusetts passed new laws that requires health plans, such as Fallon Health’s Community Care plans, to cover abortion and abortion-related care at no cost for members.

For all Community Care plans except the Low Silver HSA plan (qualified high-deductible health plan), we will cover abortion and abortion-related care with $0 out of pocket costs for members. For Low Silver HSA plan members, abortion and abortion-related care will be covered in full after you meet your deductible.

Definition of abortion and abortion-related services

Covered abortion services includes surgical and medication abortion (including Mifepristone and Misoprostol). When provided along with a covered surgical or medication-based abortion, we will also cover the following abortion-related care at no cost to members: 

  • Pre-operative and pre-abortion evaluation and examination
  • Pre-operative counseling
  • Laboratory services, including pregnancy testing, blood type, and RH factor
  • Rh (D) immune globulin (human)
  • Anesthesia (general or local)
  • Post-operative and post-abortion care
  • Follow-up
  • Advice on contraception or referral to family planning services and
  • Ultrasounds

For specific details about your Fallon Health plan and benefits, log into MyFallon and click “My Documents” or call a member of our customer service team at 1-800-868-5200 (TTY 711), Monday, Tuesday, Thursday, and Friday from 8 a.m. to 6 p.m. and Wednesday from 10 a.m. to 6 p.m.