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GIC Medicare Health Plan Options
Fallon Senior Plan
Eligibility
Plan Contact Information
Plan Service Area
Plan Overview
Fallon Senior Plan is a Medicare Advantage HMO plan that requires members to selec a Primary Care Physician (PCP) to manage their care. With an HMO, you receive care through the plan’s network of doctors, hospitals, and other providers. There are no out-of-network benefits, with the exception of emergency care. Fallon Senior Plan is a Medicare plan under contract with the federal government that includes Medicare Part D prescription drug benefits. Contact the plan to see if your provider is in the network. This Medicare plan’s benefits and rates are subject to change January 1, 2009.
Benefits Effective January 1, 2008
Physician Office Visit and Preventive Care
100% after $10 per visit
Outpatient Mental Health and Substance Abuse Care
100% after $10 per visit
Inpatient Hospital Care
100%
Inpatient and Outpatient Surgery
100%
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Emergency Room
100% after $50 co-pay per visit (waived if admitted)
Prescription Drug Co-payments
Retail up to 30-day supply: Mail Order up to 90-day supply:
Tier 1: $10 Tier 1: $20
Tier 2: $20 Tier 2: $40
Tier 3: $40 Tier 3: $80
Eligibility
Retirees, Retired Municipal Teachers (RMTs), Elderly Governmental Retirees (EGRs), survivors, and their eligible dependents with Medicare Part A and Part B are eligible. Members must live in the plan’s service area.
Service Area
Fallon Senior Plan is available in the following Massachusetts county:
Worcester
Fallon Senior Plan is partially available in the following Massachusetts counties: Franklin, Hampden, Hampshire, Middlesex, Norfolk
The plan may not be available in every city and town in these counties. Call the plan for details.
Monthly Rates as of July 1, 2008
Plan Contact Information
Contact the Plan for additional information on participating providers and benefits.
Fallon Senior Plan
1.866.344.4442
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