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 options

At Fallon Health, we offer complete solutions for your retirees. Fallon Senior Plan™ Premier HMO is our Medicare Advantage Plan that offers a statewide network of providers. Members have access to doctors and hospitals everywhere from the South Coast to the North Shore and from western Massachusetts to Boston. For those looking for even more flexibility, we offer Fallon Companion Care—with no deductibles or referrals, plus access to providers across the U.S.

Plan choices

  • Fallon Senior Plan Premier HMO
  • Fallon Companion Care

Fallon Senior Plan Premier HMO

Overview

For retirees who live in Massachusetts and select neighboring cities and towns, we offer Fallon Senior Plan Premier HMO. The Fallon Senior Plan Premier HMO network is statewide and includes some of the best local providers, including:

  • UMass Memorial Health Care
  • Lahey Hospital and Medical Center
  • MetroWest Medical Centers
  • Lowell General Hospital
  • Mercy Medical Center
  • South Shore Hospital

See the entire hospital and medical group list

Network hospitals

Addison Gilbert Hospital, Gloucester
Anna Jaques Hospital, Newburyport
Athol Memorial Hospital, Athol
Berkshire Medical Center, Pittsfield
Beth Israel Deaconess Hospital-Milton
Beth Israel Deaconess Hospital-Needham
Beth Israel Deaconess Hospital-Plymouth
Beth Israel Deaconess Medical Center, Boston
Beverly Hospital, Beverly
Boston Medicare Center, Boston
Cape Cod Hospital, Hyannis
Carney Hospital, Boston
Clinton Hospital, Clinton
Fairview Hospital, Great Barrington
Falmouth Hospital, Falmouth
Good Samaritan Medical Center, Brockton
Harrington HealthCare at Hubbard, Webster
Harrington Memorial Hospital, Southbridge
HealthAlliance Hospital, Fitchburg
HealthAlliance Hospital, Leominster
Heywood Hospital, Gardner
Holy Family Hospital at Merrimack Valley, Haverhill
Holy Family Hospital at Methuen, Methuen
Holyoke Medical Center, Holyoke
Lahey Hospital and Medical Center, Burlington
Lawrence General Hospital, Lawrence
Lowell General Hospital—Main Campus, Lowell
Lowell General Hospital—Saints Campus, Lowell
Marlborough Hospital, Marlborough
Massachusetts Eye & Ear Infirmary, Boston
Mercy Medical Center, Springfield
MetroWest Medical Center, Framingham
MetroWest Medical Center, Natick
Milford Regional Medical Center, Milford
Morton Hospital, Taunton
Mount Auburn Hospital, Cambridge
Nashoba Valley Medical Center, Ayer
New England Baptist Hospital, Boston
Newton-Wellesley Hospital, Newton
Noble Hospital, Westfield
North Shore Medical Center—Salem Hospital, Salem
North Shore Medical Center—Union Hospital, Lynn
Norwood Hospital, Norwood
Saint Anne’s Hospital, Fall River
Saint Elizabeth’s Medical Center, Boston
Saint Vincent Hospital, Worcester
South Shore Hospital, Weymouth, MA
UMass Memorial Medical Center— Memorial Campus, Worcester
UMass Memorial Medical Center—University Campus, Worcester
Winchester Hospital, Winchester

Medical groups

Berkshire Health North
Beth Israel Deaconess Physician Organization
Cape Cod Health Network
Carney Independent Physicians Association
Central Massachusetts Independent Physician Association (CMIPA)
Compass Medical Associates
Good Samaritan Independent Physicians Association
Greater New Bedford Community Health Center
Harrington Physician Hospital Organization
Hawthorn Medical Associates
Heywood Physician Hospital Organization
Hilltown Community Health Centers
Jordan Physician Associates, Inc.
Lahey Clinic
Lawrence General Independent Physicians Association
Lowell General Physician Hospital Organization
Mercy Care Alliance
Merrimack Valley Independent Physicians Association
Merrimack Valley Physicians
Merrimack Valley Regional Medical Group
MetroWest Health Care Alliance
Modern Care Medical Group, LLC
Nashoba Valley Independent Physician Association
Norwood Independent Physicians Association
Pentucket Medical Associates
Plymouth Bay Medical Associates
Prima CARE, P.C.
RiverBend Medical Group
Saint Anne’s Independent Physicians Association
Saint Elizabeth’s Health Professionals
Southcoast Physicians Group
South Shore Physicians Hospital Organization
Steward Health Care System
UMass Memorial Medical Group
Valley Health Partners

A Medicare Advantage plan, Fallon Senior Plan Premier HMO provides more benefits and extras than Original Medicare alone, including:

  • $0 annual wellness exams, plus additional health screenings at no cost!
  • Part D prescription drug coverage with no deductible and no coverage gap
  • 24/7 access to doctors by phone, video or mobile app
  • Free basic gym membership through the SilverSneakers® Fitness program
  • $150 toward the purchase of eyewear every year
  • Preventive dental care, including dental checkups (two every year), plus coverage for fillings, root canals, and more*
  • Hearing aid benefit

Eligibility

To be eligible for Fallon Senior Plan 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 Senior Plan Premier HMO, retirees must live in the service area. The Fallon Senior Plan Premier HMO service area includes the Massachusetts counties of Barnstable, Berkshire, Bristol, Essex, Franklin, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk and Worcester, as well as some cities and towns that neighbor Massachusetts (shown in green, yellow, brown and blue on the map).

See a larger version of this map
Yhe Fallon Senior Plan Premier HMO network is statewide.

Fallon Companion Care

Overview

Fallon Companion Care is our coast-to-coast health care coverage solution for Medicare-eligible retirees, whether they live in Wellfleet or West Palm Beach.

Like Fallon Senior Plan Premier HMO, Fallon Companion Care offers more than Original Medicare alone. And, since Fallon Companion Care doesn’t have a provider network, retirees can choose any provider who accepts Medicare and is most convenient for them.

Fallon Companion Care acts as a secondary payer for Medicare-approved services, and covers costs not paid by Medicare for services such as:

  • Doctor office visits
  • Tests and screenings, including X-rays and labs
  • Hospital admissions
  • Durable medical equipment, including wheelchairs and oxygen
  • Emergency care inside and outside the U.S.

Fallon Companion care plan options include those with and without prescription drug coverage.

Fallon Companion Care also includes the It Fits! benefit—a $200 annual fitness reimbursement that members can use for anything from gym memberships at the gym of their choice to yoga classes to ski lift tickets.

Eligibility

To be eligible for Fallon Companion Care, 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.

Service area

Fallon Companion Care is available to retirees who live in the United States.

The Fallon Companion Care network is nationwide.

For more information

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