What Coverage Is Available Through Fallon Senior Plan?

What Coverage Is Available Through Fallon Senior Plan?

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.

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.