Q:

What coverage is available through Fallon Senior Plan?

A:

Quick Answer

Fallon Senior Plan provides coverage for physician visits, outpatient and inpatient visits, emergency room services and prescription drugs for senior citizens. It also provides Medicare Part D coverage. There are several plans with different levels of coverage depending on the member's location and budget.

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Full Answer

Fallon Senior Plan provides medical coverage through its network of physicians, doctors, hospitals and other providers. Each member selects a primary care physician who manages his care and obtains referrals to various specialists.

Members of the Fallon Senior Plan may have to co-pay in for some of the plan's services. For physician office visits, members make co-payments of $10 per visit, as of 2015. The co-payments for outpatient substance abuse and mental health care are also $10.

The plan covers 100 percent of inpatient hospital care and there are no co-payments. There are also no co-payments for preventive services and inpatient and outpatient surgery. For emergency room visits, members only pay $50, but the plan waives this amount if the hospital admits the member.

Fallon Senior Plan also covers prescription drugs and Medicare Part D. Members make co-payments of between $10 and $65 for a 30-day retail supply of prescription medication, and between $25 and $165 for a mail-order 90-day supply.

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