Ready for virtual open enrollment

UPDATES FROM FALLON HEALTH

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With open enrollment season on its way, the Fallon Health team wants you to know that we’re hosting presentations and meetings virtually—so your employees have the opportunity to learn about our offerings even in these difficult times. We want to make the process as seamless as possible for you.

Here’s how our virtual open enrollment meetings and health fairs will work:

Your Fallon Account Manager will host employee presentations via live video or an on-demand recording.

The Account Manager can customize the presentation for your group and have a PDF of the presentation sent to you prior to the meeting.

Attendees will be able to submit real-time questions through the chat feature. The Account Manager will take questions during or immediately after the presentation.

A recording of the presentation will be sent to your broker and/or human resources department.

When Massachusetts guidelines allow—and your organization is ready—your Account Manager will conduct in-person meetings or presentations to smaller-sized groups.

In the meantime, please check out our Open enrollment made simple flyer for more information on virtual options. Your Account Manager is also available to provide details and help you plan for your next Fallon Health open enrollment event.

We look forward to seeing you on-screen soon!

Encouraging members to get necessary care—by telehealth or in person

The ongoing COVID-19 pandemic has led some people to put off medical care that’s necessary and sometimes even urgent. But it’s important to get needed care in a timely, safe way.

For non-emergency health concerns, the first step should be contacting the primary care provider. Many PCPs will offer a telehealth or in-person visit for routine or urgent care needs, depending on their current office policies and government health safety guidelines.

Fallon members can access telehealth services from all network providers that are offering them. While Fallon recommends that members contact their own health care provider first, members who have the Teladoc benefit can also use that service.

We are continuing to waive all member cost-sharing for medically necessary telehealth services, whether they’re COVID-19 related or not. Members who have the NurseConnect benefit can also use this channel to receive medical services or advice at no cost.

Options and criteria for COVID-19 testing

Fallon covers COVID-19 diagnostic testing, based on CDC and other regulatory guidance, for an individual in one of the following three categories:

A health care provider has identified the individual as having COVID-19 related symptoms.

A local Board of Health, the Massachusetts Department of Public Health, the Community Tracing Collaborative or a health care provider has determined that the individual has been in close contact with someone confirmed or clinically diagnosed with COVID-19.

An individual is admitted to a health care facility, such as a hospital or skilled nursing facility.

Testing solely to meet back-to-work/school COVID-19 testing requirements is not covered, unless it’s deemed medically necessary by a provider.

If your employees want to be tested, please let them know about the current strategic testing program in Massachusetts. The state’s Stop the Spread program is offering free COVID-19 testing in selected cities and towns through August 14. Asymptomatic individuals may be tested at these site, even if they don’t reside in the particular city or town.

Health and wellness

Information you can use and share

You can find health and wellness information for your employees on our website. A library of health and wellness flyers and kits is also available.