Learn about your plan options
Fallon Community Health Plan offers you two HMO plans: FCHP Direct Care and FCHP Select Care. The choice of two plans lets you find a level of benefits that best fits your health care needs.
What should I look for in a health plan?
Choosing a health plan can be a confusing process, but we’re here to make it easier. Here are a few questions you can ask that will help you make the right choice:
- How much will I pay for office visits, hospitalization, prescription drugs and vision care?
- Which doctors, hospitals and other medical providers are part of the plan?
- Does the plan cover mental health counseling, obstetrical-gynecological care or care for chronic conditions? What services are not covered?
- What are my options for chiropractic or alternative health care, such as acupuncture?
- Will I be able to receive care close to home or work?
- Does the plan offer discounts or reimbursements for fitness centers or healthy activities? What types of wellness programs would be available to me?
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Your plan options
FCHP Direct Care
FCHP Direct Care is one of two HMO plans we offer to Commonwealth of Massachusetts employees and retirees. With FCHP Direct Care, you’ll have access to care from Acton Medical Associates, Charles River Medical Associates, Fallon Clinic, Lahey Clinic, Lawrence General, Lowell General, Mount Auburn Cambridge IPA, Northeast PHO, Signature Healthcare Brockton Hospital, Signature Healthcare Bridgewater Goddard Park Medical Associates, and Southboro Medical Group among others. You’ll also enjoy a variety of health and wellness programs — from fitness reimbursements to discounts on acupuncture, chiropractic care, and massage therapy.
 Learn more about FCHP Direct Care
Find a doctor in the FCHP network
FCHP Select Care
FCHP Select Care is the second HMO plan available to Commonwealth of Massachusetts employees and retirees. This plan gives you a wider choice of health care providers, including all those in the FCHP Direct Care network plus physicians and facilities throughout western, central, and eastern Massachusetts.
Tier 1, 2 and 3 measurements of plan physician quality and cost-efficiency
Fallon Community Health Plan is committed to giving all our members access to a network of high-quality, cost-efficient plan physicians. The tiering works as follows:
***Tier 1 (excellent): Plan physicians practicing at an excellent level of quality and efficiency. You will pay the lowest copayment when you see a Tier 1 plan physician.
**Tier 2 (good): Plan physicians practicing at a good level of quality and efficiency. Also included in this tier’s copayment are providers that didn’t have sufficient data with which to rate them, and providers that belong to a specialty or subspecialty that is not being tiered by the health plan.
*Tier 3 (standard): Plan physicians practicing at a standard level of quality and efficiency. You will pay a higher copayment when you see a Tier 3 plan physician.
Also, please be aware that the tiering level of plan physicians will be re-evaluated on an annual basis. The re-evaluation may result in a change to a plan physician’s tiering level. You should check the annual provider directory or the "Find a doctor" tool for annual tiering level changes.
The plan physician quality and efficiency measures are only one factor you should consider when selecting a primary care physician or specialty physician. Tier 1 plan physicians may not be available in certain areas.
Learn more about FCHP Select Care
Find a doctor in the FCHP network
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What are some of the differences between the two plans?
While both plans offer the highest quality of care, they differ in their provider network and copayments (your out-of-pocket costs) for services. The table below compares some of these differences. For more detailed information on either FCHP Direct Care or FCHP Select Care, visit the links below.
Learn more about FCHP Direct Care
Learn more about FCHP Select Care
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