Retiree solutions and Medicare group plans

Employers who provide health insurance coverage for their retirees need three things:

  1. Health plans with doctors located where retirees live.
  2. Coverage that gives their retirees assurance that they will be well-cared for in their golden years.
  3. Affordable options that won’t impede the bottom line.

Group coverage 

As of 4/1/2021, we will no longer be selling Fallon Medicare PlusTM Freedom for new business, and the plan will be discontinued on 1/1/2022.

  • Fallon Medicare Plus Premier HMO

Fallon Medicare Plus Premier HMO 

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.

We offer two providers networks with our Medicare Advantage HMO plans: 
Fallon Medicare Plus Central Premier and Fallon Medicare Plus Premier.

Fallon Medicare Plus Central Premier is available only to residents of Worcester County. Members receive care and services from a tailored selection of providers based in the central part of the state.

Fallon Medicare Plus Premier is available to all eligible plan members. This network includes all of our contracted providers throughout the state—from Boston to the Berkshires.

Both plans include rich benefits like:

  • Benefit Bank—a card that can be used to pay for dental care, fitness memberships, eyewear and/or hearing aids.
  • Free on-demand workouts, livestream fitness classes and gym membership through SilverSneakers® (in addition to the Benefit Bank)
  • Free 13-consecutive week WW (formerly Weight Watchers®) membership
  • Prescription drug coverage with no coverage gap
  • Hearing aid benefit (in addition to the Benefit Bank)
  • Preventive and comprehensive dental care (in addition to the Benefit Bank)
  • $150 toward eyewear, every year (in addition to the Benefit Bank)

 

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 Central Premier, retirees must be a resident of Worcester County.

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
The Fallon Medicare Plus Premier HMO network is statewide.

Plan documents

Online tools

 

For more information

For more information, please contact the Medicare Sales Team at:
1-866-231-3669 (TRS 711)
MedicareSalesBrokers@fallonhealth.org

* Benefits may vary by plan and employer group.

SilverSneakers® is a registered trademark of Tivity Health, Inc.

Understanding Medicare

A helpful guide about Medicare, including what it is, what the options are and how to sign up.