Call us 1-800-868-5200 (TRS 711)
Mon., Tue., Thu., Fri.: 8 a.m. to 6 p.m. Wed: 10 a.m. to 6 p.m.

for:

Fallon Medicare Plus™ Supplement (Medigap) options

IMPORTANT INFORMATION ABOUT CORONAVIRUS

With Fallon Medicare Supplement (Medigap) plans, you have the freedom to see who you want to see when you want to see them. There are no network restrictions and little to no out-of-pocket expenses. You can see any provider that accepts Medicare, and the services are covered. No PCP. No referrals. No copayments.

2021
2020

2021 plan details

	Fallon Medicare Plus Supplement Core	Fallon Medicare Plus Supplement 1A	Fallon Medicare Plus Supplement 1*
Monthly plan premium (You could qualify for a 15% discount. See the Outline of Coverage for details.)	$138	$199	$229
Benefit	Fallon Medicare Plus Supplement Core Copayment	Fallon Medicare Plus Supplement 1A Copayment	Fallon Medicare Plus Supplement 1* Copayment
Hospitalization	$0 after you meet your $1,484 Part A deductible	$0	$0
Home health care	$0	$0	$0
Doctor office visits	$0 after you meet your $203 Part B deductible	$0 after you meet your $203 Part B deductible	$0
Specialist office visits	$0 after you meet your $203 Part B deductible	$0 after you meet your $203 Part B deductible	$0
Emergency room visits	$0 after you meet your $203 Part B deductible	$0 after you meet your $203 Part B deductible	$0
Same-day surgery	$0 after you meet your $203 Part B deductible	$0 after you meet your $203 Part B deductible	$0
Diagnostic tests (X-rays, MRI, CT, PET and nuclear studies)	$0 after you meet your $203 Part B deductible	$0 after you meet your $203 Part B deductible	$0
Physical and speech therapy	$0 after you meet your $203 Part B deductible	$0 after you meet your $203 Part B deductible	$0
Eyewear discount program Includes one routine eye exam every year at a plan provider and up to $150 allowance toward first pair of eyeglasses or contact lenses per calendar year.	$0	$0	$0
Part B outpatient drugs	$0 after you meet your $203 Part B deductible	$0 after you meet your $203 Part B deductible	$0
SilverSneakers^® Fitness program Includes access to online classes and instructional videos, an at-home fitness kit and/or a free gym membership	$0	$0	$0
Nurse Connect Free telephone access to registered nurses 24 hours a day, seven days a week, 365 days a year.	$0	$0	$0
Quit to Win program Smoking cessation program offers one-on-one telephone coaching, group and text support with individualized stop-smoking plans.	$0	$0	$0
Naturally Well Discounts on acupuncture, chiropractic care and massage therapy.	$0	$0	$0
ID card app for smartphones View ID card, email or fax an image of ID card to doctor, hospital or pharmacy and more. Smartphone app is for both iPhones and Androids.	$0	$0	$0
Foreign travel Emergency services while traveling outside the U.S.	Not covered	$0	$0
Part D drugs	You must enroll in Medicare Part D to be covered.

Helpful documents

Member Handbook (pdf)
Outline of coverage (pdf)
Enrollment form (pdf)
Mail this form to:
Fallon Health
Attn: Medicare Sales
10 Chestnut St.
Worcester, MA 01608-9971
A Guide to Health Insurance for People with Medicare

* You must have turned 65 before Jan. 1, 2020 to apply for Fallon Medicare Plus Supplement 1.

2020 plan details

	Fallon Medicare Plus Supplement Core	Fallon Medicare Plus Supplement 1A	Fallon Medicare Plus Supplement 1*
Monthly plan premium (You could qualify for a 15% discount. See the Outline of Coverage for details.)	$126	$215	$229
Benefit	Fallon Medicare Plus Supplement Core Copayment	Fallon Medicare Plus Supplement 1A Copayment	Fallon Medicare Plus Supplement 1* Copayment
Hospitalization	$0 after you meet your $1,408 Part A deductible	$0	$0
Home health care	$0	$0	$0
Doctor office visits	$0 after you meet your $198 Part B deductible	$0 after you meet your $198 Part B deductible	$0
Specialist office visits	$0 after you meet your $198 Part B deductible	$0 after you meet your $198 Part B deductible	$0
Emergency room visits	$0 after you meet your $198 Part B deductible	$0 after you meet your $198 Part B deductible	$0
Same-day surgery	$0 after you meet your $198 Part B deductible	$0 after you meet your $198 Part B deductible	$0
Diagnostic tests (X-rays, MRI, CT, PET and nuclear studies)	$0 after you meet your $198 Part B deductible	$0 after you meet your $198 Part B deductible	$0
Physical and speech therapy	$0 after you meet your $198 Part B deductible	$0 after you meet your $198 Part B deductible	$0
SilverSneakers^® Fitness program Includes a free basic membership at participating fitness facilities throughout the U.S.	$0	$0	$0
Nurse Connect Free telephone access to registered nurses 24 hours a day, seven days a week, 365 days a year.	$0	$0	$0
Quit to Win program Smoking cessation program offers one-on-one telephone coaching and text support with individualized stop-smoking plans.	$0	$0	$0
Naturally Well Discounts on acupuncture, chiropractic care and massage therapy.	$0	$0	$0
Eyewear discount program Includes one routine eye exam every year at a plan provider and up to $150 allowance toward first pair of eyeglasses or contact lenses per calendar year.	$0	$0	$0
Foreign travel Emergency services while traveling outside the U.S.	Not covered	$0	$0
Non-Part B drugs	Not covered	Not covered	Not covered

*You must have turned 65 before Dec. 31, 2019 to apply for Fallon Medicare Plus Supplement 1.

Helpful documents

Member Handbook (pdf)
Outline of coverage (pdf)
Enrollment form (pdf)
Mail this form to:
Fallon Health
Attn: Medicare Sales
10 Chestnut St.
Worcester, MA 01608-9971
A Guide to Health Insurance for People with Medicare and Bulletin

Healthy extras

With Fallon Medicare Plus Medicare Supplement plans, you have access to extras at no additional cost, like:

SilverSneakers^® Fitness program—includes access to online classes and instructional videos, an at-home fitness kit and/or a free gym membership.
Nurse Connect 24-hour nurse call line
Free telephone access to registered nurses 24 hours a day, seven days a week, 365 days a year.
Vision care
One routine eye exam every year at a plan provider. Up to $150 allowance toward first pair of eyeglasses (prescription lenses and frames) or contact lenses every calendar year.
Naturally Well discounts on alternative and complementary health care
Discounts on acupuncture, chiropractic care and massage therapy.
Healthwise Knowledgebase health encyclopedia
The Healthwise Knowledgebase is an online health encyclopedia which features information on diseases, conditions, medications and other health topics.
Fitness center discounts
In addition to SilverSneakers, members can receive reduced rates on memberships to several health club facilities in Massachusetts.
Smoking cessation program
Our tobacco treatment program, Quit to Win, offers one-on-one telephone coaching and text support with individualized stop-smoking plans.

Contact us

1-866-330-6380 (TRS 711)
8 a.m.–5 p.m., Monday–Friday

Or fill out the form below to have someone from Fallon Health get in touch with you:

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SilverSneakers^® is a registered trademark of Tivity Health, Inc. Fallon Health & Life Assurance Company, Inc., is a wholly owned subsidiary of Fallon Community Health Plan.

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You must have turned 65 before
Jan. 1, 2020 to apply for Fallon Medicare Plus Supplement 1.

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One Chestnut Place, 10 Chestnut Street, Worcester, MA 01608
1-800-868-5200 (TRS 711), Mon., Tue., Thu., Fri.: 8 a.m. to 6 p.m. Wed: 10 a.m. to 6 p.m.

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