About Fallon and Summit ElderCare

About Fallon Health

Founded in 1977, Fallon Health provides health care services designed to meet the unique and changing needs of all we serve. Fallon is both an insurer and provider of care. 

Our products

Our product portfolio includes a variety of group and non-group health plan options (HMO, POS, PPO, Medicaid and Medicare Advantage plans) featuring flexible and innovative benefit designs. We administer fully-insured and self-insured funding arrangements with customized services for employers. In addition, Fallon offers a Senior Care Options product, called NaviCareSM HMO, for those age 65 and over in Worcester County who are enrolled in MassHealth Standard.

Our provider network

Our uniquely developed provider networks offer high-quality, cost-effective, coordinated care and give our members access to doctors and hospitals throughout Massachusetts. We also offer a broad spectrum of services and programs to ensure our members, at every stage of life, remain as healthy and productive as possible.

A provider of care

Fallon is a provider of care through its Summit ElderCare® program, an advanced and completely integrated program that offers seniors and their caregivers an alternative to nursing home placement.

Commitment to quality and service

Our continued commitment to deliver high-quality health care and exceptional customer service has earned us consistent rankings as one of the nation’s highest-rated health plans according to the National Committee for Quality Assurance (NCQA)*.

About Summit ElderCare

Summit ElderCare, founded by Fallon Health in 1995, is an innovative approach to providing care to the frail and the elderly while allowing them to remain at home. The Program of All-inclusive Care for the Elderly (PACE) model is centered around the belief that it is better for the well-being of seniors with chronic care needs and their families to be served in the community whenever possible. The Summit ElderCare program is based on this model, started in the 1970s by a small community in San Francisco looking for a better way to care for their elders. Years later, their grassroots efforts were recognized by the Centers for Medicare & Medicaid Services. Summit ElderCare is the only program of its kind in Central Massachusetts.

Summit ElderCare preserves and supports the elderly adult’s family as an integral part of its mission. The collaborative expertise of many different professionals working together as members of the interdisciplinary team along with the family members is a key feature of the PACE program. Each of Summit ElderCare’s personal care providers specialize in geriatric care.

* NCQA is a private, non-profit organization dedicated to improving health care quality.