UPDATES FROM FALLON HEALTH - April 2022

Staying up to date on the plans and coverage options available from insurance companies is likely a top priority for you, so that you can provide your clients with the information they want and need, when they need it. 

That’s why we want to keep you informed about what Fallon Health offers. Fallon Health’s Medicare products have several great benefits—more than many other plans do. In this edition of the Broker Bulletin, we’re featuring several of these benefits that help our members stay healthy and well. We’re also providing more details about Fallon Health’s Program of All-Inclusive Care for the Elderly, Summit ElderCare^®.

In everything we do, high quality and excellence is a priority. We listen to our members, and partner with them to understand what they want and need. This is just one of the things that sets Fallon Health apart. We are committed to providing our members with the best products and services possible. 

And remember, Fallon is here for you, too! There’s so much to learn about our products and services. Please reach out to the Fallon Medicare Broker team with any questions you may have.

Best,

Deb Daviau

VP of Medicare and Executive Director of NaviCare

After a stay in a hospital or a skilled nursing facility (SNF), there’s no place like home. However, getting back to a normal routine after a discharge can be challenging—particularly when it comes to meal preparations. 

Fallon Medicare Plus members are eligible for a plan benefit that can help. After an inpatient hospital or SNF stay, they have access to home delivery of 14 meals (two meals per day for seven days). The meals are prepared and delivered by Mom’s Meals and are available to Fallon Medicare Plus members at no cost.

How it works: Fallon’s case management team contacts members after they are discharged from an inpatient hospital or SNF admission and will arrange for members to receive meals. Members can select from several dietary options based on medical conditions. The meals are nutritionally balanced and prepared with quality ingredients.

When your clients join NaviCare, they get more benefits than they would with MassHealth Standard and/or Medicare. For example, two of the benefits they receive are:

Save Now card

With the preloaded Save Now card, NaviCare members get $150 to spend each calendar quarter (up to $600 a year) to buy items to help them stay healthy. Members can choose from hundreds of items, such as toothbrushes, cold/allergy medicine, pain relievers and probiotics. Purchases can be made at stores like CVS Pharmacy, Family Dollar and Walmart—or online with free home delivery.

Healthy Food card

NaviCare members can earn up to $100 per year on the Healthy Food card to buy fruits, veggies and more! They’ll be awarded $50 for completing an activity—up to two per year—such as getting an annual physical or flu shot. Those earned dollars can be spent at places like CVS Pharmacy, Dollar General, FarmboxRx, Family Dollar, Rite Aid, Walgreens and Walmart. 

Working out is one of the best things you can do for yourself. Our NaviCare and Fallon Medicare Plus (FMP) plans make this easy with the SilverSneakers program. Free to eligible members―it’s already in their plan*—the SilverSneakers fitness program includes access to online classes and instructional videos, an at-home fitness kit and/or a free gym membership. 

*SilverSneakers is not included in Fallon Medicare Plus Orange or Central Orange plans.

Learn more about this benefit:

Fallon Health’s Program of All-Inclusive Care for the Elderly (PACE), Summit ElderCare—the largest PACE in New England—offers and delivers complete, coordinated, individualized care for older adults who want to live at home instead of a nursing home. Participants can receive these services at one of our PACE centers or in their own homes. 

Who does Fallon Health’s PACE serve? Individuals who:

• Are age 55+ 
• Live in our service area 
• Require nursing home level of care but able to live safely in the community with PACE support

Who are Summit ElderCare’s current participants?

• Average age: 78
• 27% men, 73% women
• Diverse population, various languages spoken: English, Spanish, Khmer and more
• Often have multiple medical conditions: diabetes, dementia, coronary artery disease

Satisfaction scores* for Summit ElderCare

• 96% overall satisfaction
• 97% would recommend to a friend or relative
• 100% positive difference in participant’s quality of life

* Responses from a 2021 survey of more than 300 program participants and caregivers, who scored an 8, 9, or 10 out of a possible 10.

If you haven’t already, please check out the new broker pages on our website. You can find information there about becoming a broker with Fallon and tools you can use if you are already a broker with us. 

If you aren’t ready to become a Medicare broker with us, we also have a broker referral program that you can take advantage of. Fallon offers competitive compensation to agents and brokers who provide us with member referrals for several of our plans within our Government Programs products portfolio. For more information, please call our Medicare support team Monday–Friday, 8:30 a.m.–5 p.m., at 1-844-848-4931 (TRS 711), or email us at MedicareSalesBrokers@fallonhealth.org.

Our easy-to-reach Broker Relations team is available to you at every stage of the sales process. We provide you with personalized support over the phone.