Monthly plan premiums for people who get extra help from Medicare to help pay for their prescription drug costs

If you get extra help from Medicare to help pay for your Medicare prescription drug plan costs, your monthly plan premium will be lower than what it would be if you did not get extra help from Medicare. The amount of extra help you get will determine your total monthly plan premium as a member of our plan.

View a PDF version of these charts Opens in a new window
(pdf)

Residents of Worcester County and portions of Franklin County

Your level of extra helpFallon Senior Plan Super Saver Rx HMO*Fallon Senior Plan Saver Enhanced Rx HMO-POS*Fallon Senior Plan Standard Enhanced Rx HMO*Fallon Senior Plan Plus Enhanced Rx HMO*
100%

$0

$58.90

$161.80

$214.40

75%

$0

$64.70

$168.90

$222.60

50%

$0

$70.50

$175.90

$230.70

25%

$0

$76.20

$183.00

$238.90

Residents of Bristol, Middlesex, Norfolk and Plymouth Counties

Your level of extra helpFallon Senior Plan Super Saver Rx HMO*Fallon Senior Plan Saver Enhanced Rx HMO*Fallon Senior Plan Plus Enhanced Rx HMO*
100%

$0

$25.20

$127.00

75%

$0

$31.20

$134.30

50%

$0

$37.10

$141.50

25%

$0

$43.10

$148.80

Residents of Essex and Suffolk Counties

Your level of extra helpFallon Senior Plan Super Saver Rx HMO*Fallon Senior Plan Saver Enhanced Rx HMO*Fallon Senior Plan Plus Enhanced Rx HMO*
100%

$0

$30.20

$135.00

75%

$0

$36.20

$142.30

50%

$0

$42.10

$149.50

25%

$0

$48.10

$156.80

Residents of Hampden and Hampshire County

Your level of extra helpFallon Senior Plan Super Saver Rx HMO*Fallon Senior Plan Saver Enhanced Rx HMO*Fallon Senior Plan Plus Enhanced Rx HMO-POS*
100%

$0

$10.20

$93.80

75%

$0

$16.20

$100.40

50%

$0

$22.10

$106.90

25%

$0

$28.10

$113.50

Residents of Barnstable County

Your level of extra helpFallon Senior Plan Super Saver Rx HMO*Fallon Senior Plan Saver Enhanced Rx HMO*Fallon Senior Plan Plus Enhanced Rx HMO*
100%

$0

$60.20

$170.00

75%

$0

$66.20

$177.30

50%

$0

$72.10

$184.50

25%

$0

$78.10

$191.80

*This does not include any Medicare Part B premium you may have to pay.

The above premiums include coverage for both medical services and prescription drug coverage.

If you aren’t getting extra help, you can see if you qualify by calling:

  • 1-800-Medicare; TTY/TDD users call 1-877-486-2048 (24 hours a day/7 days a week),
  • Your State Medicaid Office, or
  • The Social Security Administration at 1-800-772-1213. TTY/TDD users should call 1-800-325-0778 between 7 a.m. and 7 p.m., Monday through Friday.

You can also call the numbers above to check your extra help status or level.

Massachusetts has a State Pharmaceutical Assistance Program called Prescription Advantage. (This link takes you away from the Fallon Senior Plan website.) This program may also provide assistance in helping you pay for your prescription drug costs. To find out if you qualify for Prescription Advantage, call 1-800-AGE-INFO (1-800-243-4636), TTY: 1-877-610-0241.

For information about the Centers for Medicare & Medicaid Services (CMS) Best Available Evidence (BAE) policy, visit the CMS website. (This link takes you away from the Fallon Senior Plan website.)

Fallon Health is an HMO/HMO-POS plan with a Medicare contract. Enrollment in Fallon Health depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits and premiums may change on January 1 of each year. You must continue to pay your Medicare Part B premium. To view the PDF files above, you may need to download a free copy of Adobe®Acrobat Reader software on your computer. (This link takes you away from the Fallon Senior Plan website.)

H9001_F_2017_21 Approved 10172016
The information on this page was last updated on 10/1/2016.

Call us toll-free at 1-888-340-5504 (TRS 711), 8 a.m.–8 p.m., Monday–Friday. (Oct. 1–Feb. 14, seven days a week.)

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