UPDATES FROM FALLON HEALTH - May 2022

Can you believe how fast this year is going? It seems like just yesterday the days started getting longer. Now the sun is out until after 7 p.m., and June is nearly upon us. 

Since the last five months sped by so quickly, the next five likely will also. Which means the start of AEP, the Annual Enrollment Period, will be upon us before we know it! Here at Fallon, we’re working to develop comprehensive plans with competitive benefits that serve the needs of our existing and prospective members. As the summer progresses, keep an eye out in for information on 2023 product training, which will start in late August.

Until then, I hope you have some wonderful plans for the summer.

Best,

Deb Daviau

VP of Medicare and Executive Director of NaviCare

Fallon Health offers $100 referral fees to brokers who provide member referrals for several of our plans, including:

• Fallon Medicare Plus™ Medicare Advantage (individual and group plans)
• Fallon Medicare Plus™ Supplement
• NaviCare^® SCO or HMO SNP
• Fallon’s Program of All-Inclusive Care for the Elderly (PACE), Summit ElderCare^®

Fallon’s Medicare support team has information about how to make referrals and about the criteria for each product line. Learn more by contacting them by phone, Monday–Friday, 8:30 a.m.–5 p.m., at 1-844-848-4931 (TRS 711), or by email at MedicareSalesBrokers@fallonhealth.org. 

Fallon Health has received state and CMS approval to expand access to its PACE— Summit ElderCare—in 10 counties across Massachusetts. This means thousands of older adults who live in areas where Fallon’s Massachusetts PACE wasn’t previously available will now have access to this innovative program.

Fallon is the largest PACE provider in New England. It offers and delivers complete, coordinated, individualized care for older adults who want to live at home instead of a nursing home. Participants may receive these services at home or at one of our Summit ElderCare PACE centers in Leominster, Lowell, Springfield, Webster and Worcester.

You asked, we listened. While Fallon Health has an expansive group of providers and hospitals across Massachusetts for our products, we heard loud and clear that we would benefit from a network expansion in certain geographic areas. We’re pleased to share with you the latest network additions:

• Sturdy Hospital, as well as their primary care physicians (PCPs) and specialists, are now part of the Fallon Medicare Plus, NaviCare and Summit ElderCare networks
• Signature Healthcare PCPs and specialists, which were already part of the NaviCare network, are now part of the Fallon Medicare Plus network
• Brockton Hospital, which was already part of the NaviCare network, is now part of the Fallon Medicare Plus network
• Duffy Health providers are now part of the Fallon Medicare Plus and NaviCare networks

Have more suggestions of providers or hospitals to add? Keep them coming! 

Want to see what providers are in our networks? Searching for your clients’ doctors, dentists or local hospitals is easy using our “Find a doctor” tool at fallonhealth.org/findphysician.

Search by provider name or explore a specific plan’s network to see what providers are included. You can also search specifically for PCPs or by specialty. The results you receive will indicate if providers are accepting new patients, as well as what Fallon plans they belong to.

Important note for your clients: If they become Fallon members, they will need to choose a PCP from our network. They can search for a PCP through the “Find a Doctor” tool or by using our Provider Directory.

If you haven’t already, please check out the 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. 

For more information, please contact our Medicare support team at MedicareSalesBrokers@fallonhealth.org.

Our easy-to-reach Broker Relations team is available to you at every stage of the sales process. We can provide you with personalized support over the phone Monday–Friday, 8:30 a.m.–5 p.m.