Plan design options
One size does not fit all. Especially when it comes to your health care. Which is why Fallon Community Health Plan gives you several HMO options to choose from—all designed to meet your particular health care needs and your budget.
No copayments for routine physical exams!
FCHP Direct Care and FCHP Select Care members make no copayments for office visits with their primary care physician or gynecologist for routine physical exams*. Also, well-child visits for dependent children (to age 19) are covered in full.
Fallon Community Health Plan is proud to be the only health plan in Massachusetts to offer this benefit to our members. Because we’re committed to making sure our members receive the right care at the right time, this unique benefit makes preventive care easier and more affordable.
With wellness visits covered in full, there’s no reason to put off your yearly physical exam or your family’s well-child visits!
FCHP follows the Massachusetts Health Quality Partners (MHQP) recommended guidelines for pediatric and adult wellness visits.**
* Benefit based on your plan’s anniversary date. FCHP defines a PCP as a provider of internal medicine, a provider of family practice, or a pediatrician.
** MHQP refers to these as health maintenance visits.
FCHP Direct Care
With FCHP Direct Care, Fallon Community Health Plan offers you a unique option that no other HMO has: a high-quality health plan built exclusively around Acton Medical Associates, Charles River Medical Associates, Fallon Clinic, Lawrence General physicians, Lowell General physicians, Northeast Physician Hospital Organization and Southboro Medical Group, giving you access to more than a thousand physicians in our service area.
FCHP Select Care
The FCHP Select Care network includes physician practices, community hospitals and medical facilities across our service area, giving you a greater choice of health care providers.
To give you even more choices, both FCHP Direct Care and FCHP Select Care are available in Premium Saver, Premium Saver Value, and Premium Saver 500/1000 options. With Premium Saver and Premium Saver Value, the upfront premiums are lower while copayments are slightly higher when accessing services. With Premium Saver 500/1000, our high-deductible plans, preventive services continue to be covered in full after a small copayment. For certain other services, a $500 or $1,000 deductible applies before coverage begins. See our guide to preventive and diagnostic services for Premium Saver 500/1000 (pdf 67 KB) plans.
FCHP Care Choice
And if you’d like additional premium savings with the benefits of tax-advantaged health savings accounts, FCHP now offers qualified high-deductible plan options through our Care Choice plans. With FCHP Direct Care Choice and FCHP Select Care Choice, most preventive services are covered in full. For specific information on those services, see our preventive and diagnostic services for Care Choice plans.
FCHP HMO options, at-a-glance
For more detailed information about your benefits, download the Summary of Benefits for each of these plan design
For plans with an anniversary date of April 1, 2007, or later
Guides to preventive and diagnostic services (which services are subject to deductibles)
Wondering if your doctor is in our network? Let our physician finder help!
Additional plan design options are available; benefits may vary by employer. For more information about FCHP’s plan design options, contact a member of our customer service team at:
800-868-5200 (TDD/TTY: 877-608-7677)
Monday through Friday
8 a.m. to 6 p.m.
contactcustomerservice@fchp.org