Benefits and coverage overview
Fallon Community Health Plan gives you choices in quality health care.
Your health insurance plan is made up of one of three different doctor networks and one of several different plan types. Combined, you’re getting a customized plan that best meets your health needs and budget.
Members can log in to My FCHP for more detailed information on their specific plan.
How we work
Doctor networks
When a set of doctors, or providers, contract with a health plan to provide their members with care, it’s called a “network.”
Most health insurance companies have one provider network, and they either have your doctor or they don’t. FCHP has a number of physicians and providers, hand-picked for quality, location and cost-savings.
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FCHP Direct Care - our limited provider network that provides access to providers and community-based hospitals in Massachusetts.
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FCHP Select Care - an expansive HMO network of providers and community-based hospitals throughout Massachusetts and Southern New Hampshire at a competitive price.
- FCHP Steward Community Care - a limited network that includes all of the Steward Health Care system community doctors and hospitals.
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FCHP Tiered Choice - a tiered network in which providers are tiered based on how they manage total costs. Your costs for care depend on which tier your provider is in.
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Fallon Preferred Care - a PPO network that allows members to see any provider they wish, no PCP or referrals required.
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FCHP MassHealth
Plan designs
With all of our plan designs, you get a standard set of benefits that are meant to keep you healthy and to take care of you when you need it. The main differences between each plan are the copayments and deductibles (if the plan has them).
More specific details about plans are available from your benefits administrator or by logging in to My FCHP.
Benefits and coverage
Most of our plans include:*
Members can log in to My FCHP for more detailed information on their specific plan.
FCHP Direct Care is a plan with a limited provider network. This plan provides access to a network that is smaller than FCHP Select Care. In this plan, members have access to network benefits only from the providers in FCHP Direct Care. Please visit our Find a Doctor tool or consult the FCHP Direct Care provider directory to determine which providers are included in FCHP Direct Care. A paper copy can be requested by calling our Customer Service Department at 1-800-868-5200.
FCHP Steward Community Care provides access to a network that is smaller than FCHP Select Care. In this plan, members have access to network benefits only from the providers in FCHP Steward Community Care. Please visit our Find a Doctor tool or consult the FCHP Steward Community Care provider directory to determine which providers are included in FCHP Steward Community Care. A paper copy can be requested by calling our Customer Service Department at 1-800-868-5200.
FCHP Tiered Choice provides access to a network that is smaller than the FCHP Select Care provider network, and includes the tiered provider network called FCHP Tiered Choice. In this plan, members have access to network benefits only from the providers in FCHP Tiered Choice, and may pay different levels of copayments, coinsurance and/or deductibles depending on the tier of the provider delivering a covered service or supply. This plan may make changes to a provider’s benefit tier annually on January 1. Please visit our Find a Doctor tool or consult the FCHP Tiered Choice provider directory to determine which providers are included in FCHP Tiered Choice. A paper copy can be requested by calling our Customer Service Department at 1-800-868-5200.
* Benefits and coverage may vary by product, plan design and employer. For specific details regarding your FCHP plan, benefits and features, please check with your employer or contact a member of our customer service team at 1-800-868-5200 (TTY users please call TRS Relay 711), Monday through Friday, 8 a.m. to 6 p.m. Eastern time. MassHealth members can call FCHP Customer Service at: 1-800-341-4848 (TTY users please call TRS Relay 711), Monday through Friday, 8 a.m. to 6 p.m.