Switching your company’s health insurance to Fallon Health?

We're here to make sure you have a "Smooth Switch."

SmoothSwitchWelcome to Fallon Health! We want to make your transition to Fallon as smooth as possible. If you have questions about your company’s transition, or would like more information, simply call your account manager. And, as always, members can call Fallon Health Customer Service at 1-800-868-5200 (TRS 711), Monday, Tuesday, Thursday and Friday from 8 a.m. to 6 p.m. and Wednesday from 10 a.m. to 6 p.m.

What you need to know about providers

If they haven't already indicated their primary care provider (PCP) on their enrollment form, HMO plan members need to select a PCP for each family member on their plan. To find a PCP, or see if a provider is in their network, members can check our online Find a Doctor tool. Once they've selected a PCP, they can call Customer Service so that we can enter their PCPs into our system. Or, they can log into myFallon, our secure member portal, and use the “Change PCP” tool. .

Members of our PPO are not required to choose a PCP. However, we still recommend that these members have a doctor whom they see regularly to help coordinate their care. Also, though PPO members may choose to see any provider without a referral, if they choose providers outside of the network, they may have higher out-of-pocket costs.

For more information about providers, including specialists and ob/gyns, see the "Welcome to Fallon Health" booklet for employers (pdf).

What you need to know about ongoing treatment

Members who are actively undergoing treatment for a medical condition may have many questions for you about the change in their coverage.We have developed flyers that review what new Fallon members need to know and do to help keep their health care on track.

Information on switching to Fallon Health when:

For more information about continuing care, you can also see the "Welcome to Fallon Health" booklet for employers (pdf).

How to help your employees with their transition to Fallon Health

  • Tell employees to notify Fallon if they or their dependents are currently receiving treatment.
  • Remind members to tell their providers that their insurance has changed.
  • Have employees download the free Fallon Health Member ID Card app for their iPhone or Android.
  • Encourage everyone to learn about and understand their new health coverage.
  • Remind members to pick a PCP and indicate their choice on their enrollment form.
  • Inform members that they can find doctors online using our Find a Doctor tool.
  • Tell employees that they can see their claims, view their specific benefit info, change their PCP, print a temporary ID card and more on our secure member portal, myFallon.
  • Tell members receiving ongoing treatment to contact us to coordinate their transition.
  • Become familiar with Fallon’s transition processes for members in treatment, and have handouts at the ready for employees.
  • Remind members of Fallon’s health and wellness resources—especially the It Fits! fitness reimbursement feature.

Other helpful information about Fallon Health

Contact us

If you have questions about your company’s transition, or would like more information, simply call your account manager. And, as always, members can call Fallon Health Customer Service at 1-800-868-5200 (TRS 711), Monday, Tuesday, Thursday and Friday from 8 a.m. to 6 p.m. and Wednesday from 10 a.m. to 6 p.m.