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.

Plan choices

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, no referrals and access to a nationwide network of providers.

  • Fallon Senior Plan Premier HMO
  • Fallon Companion Care

Fallon Senior Plan Premier HMO

Overview

For those 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 Clinic
  • MetroWest Medical Centers
  • Lowell General Hospital
  • Mercy Medical Center

See the entire hospital and medical group list

Network hospitals

Addison Gilbert Hospital, Gloucester
Anna Jaques Hospital, Newburyport
Beth Israel Deaconess Hospital-Milton
Beth Israel Deaconess Hospital-Needham
Beth Israel Deaconess Hospital-Plymouth
Beth Israel Deaconess Medical Center, Boston
Beverly Hospital, Beverly
Cape Cod Hospital, Hyannis
Carney Hospital, Boston
Clinton Hospital, Clinton
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, Methuen
Holyoke Medical Center, Holyoke
Lahey Clinic, Burlington
Lawrence General Hospital, Lawrence
Lowell General Hospital—Main campus, Lowell
Lowell General Hospital—Saints campus, Lowell
Marlborough Hospital, Marlborough
Massachusetts Eye and Ear Infirmary, Boston
Mercy Medical Center, Springfield
Merrimack Valley Hospital, Haverhill
MetroWest Medical Center, Framingham
MetroWest Medical Center, Natick
Milford Regional Medical Center, Milford
Morton Hospital and Medical Center, 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
Quincy Medical Center, Quincy
Saint Anne’s Hospital, Fall River
Saint Elizabeth’s Medical Center, Boston
Saint Vincent Hospital, Worcester
UMass Memorial Medical Center— Memorial Campus, Worcester
UMass Memorial Medical Center—University Campus, Worcester
Winchester Hospital, Winchester
Wing Memorial Hospital, Palmer

Medical groups

Accountable Care Associates (and Affiliates)
Beth Israel Deaconess Physician Organization
Beth Israel Deaconess HealthCare-Plymouth
Cape Cod Health Network
Carney Independent Physicians Association
Central Massachusetts Independent Physician Association (CMIPA)
Good Samaritan Independent Physicians Association
Harrington Physician Hospital Organization
Heywood Physician Hospital Organization
Hilltown Community Health Centers
Lahey Clinic
Lawrence General Independent Physicians Association
Lowell General Physician Hospital Organization
Merrimack Valley Independent Physicians Association
Merrimack Valley Regional Medical Group
Merrimack Valley Physicians
MetroWest Health Care Alliance
Modern Care Medical Group, LLC
Nashoba Valley Independent Physician Association
Norwood Independent Physicians Association
Pentucket Medical Associates
RiverBend Medical Group
Saint Anne’s Independent Physicians Association
Saint Elizabeth’s Health Professionals
Steward Health Care System
Tri-County Medical Associates
Whittier Independent Practice Association
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:

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 all of Barnstable, Bristol, Essex, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk and Worcester counties. It also includes parts of Franklin County (Erving, New Salem, Orange, Warwick, Wendell and Wendell Depot) as well as some cities and towns that neighbor Massachusetts (shown in green, yellow 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 your 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:

  • Tests and screenings, including X-rays and labs
  • Outpatient prescription drugs
  • Inpatient hospital care
  • Durable medical equipment, including wheelchairs and oxygen
  • Emergency care inside and outside the U.S.

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.

Eligiblity

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 your retirees, wherever they live.

The Fallon Companion Care network is nationwide.

For more information

For more information, please contact the Medicare Sales Team at:
1-888-377-1980 (TRS 711)
joingroupseniorplan@fchp.org

* Benefits may vary by plan and employer group.