|
Fallon Medicare Plus Supplement Core |
Fallon Medicare Plus Supplement 1A |
Fallon Medicare Plus
Supplement 1* |
Monthly plan premium
(You could qualify for a 15% discount. See the Outline of Coverage for details.) |
$165 |
$199 |
$275 |
Benefit |
Fallon Medicare Plus Supplement Core
Copayment |
Fallon Medicare Plus Supplement 1A
Copayment |
Fallon Medicare Plus
Supplement 1*
Copayment |
Hospitalization |
$0 after you meet your $1,632 Part A deductible |
$0 |
$0 |
Home health care |
$0 |
$0 |
$0 |
Doctor office visits |
$0 after you meet your $240 Part B deductible |
$0 after you meet your $240 Part B deductible |
$0 |
Specialist office visits |
$0 after you meet your $240 Part B deductible |
$0 after you meet your $240 Part B deductible |
$0 |
Emergency room visits |
$0 after you meet your $240 Part B deductible |
$0 after you meet your $240 Part B deductible |
$0 |
Same-day surgery |
$0 after you meet your $240 Part B deductible |
$0 after you meet your $240 Part B deductible |
$0 |
Diagnostic tests
(X-rays, MRI, CT, PET and nuclear studies) |
$0 after you meet your $240 Part B deductible |
$0 after you meet your $240 Part B deductible |
$0 |
Physical and speech therapy |
$0 after you meet your $240 Part B deductible |
$0 after you meet your $240 Part B deductible |
$0 |
SilverSneakers®—includes access to online classes and instructional videos, a free gym membership, and more. |
$0 |
$0 |
$0 |
Care Connect—24/7 phone access to registered nurses who will recommend where you should receive care or will connect you to your doctor. |
$0 |
$0 |
$0 |
Quit to Win program—our smoking cessation program offers one-on-one telephone coaching, group and text support with individualized
stop-smoking plans. |
$0 |
$0 |
$0 |
Naturally Well—discounts on acupuncture, chiropractic care, and massage therapy. |
$0 |
$0 |
$0 |
Eyewear discount program— includes one routine eye exam every year at a plan provider and $150 toward first pair of eyeglasses or contact lenses per calendar year. |
$0 |
$0 |
$0 |
Foreign travel—emergency services while traveling outside the U.S. |
Not covered |
$0 |
$0 |
Part D drugs |
You must enroll in Medicare Part D to be covered.
|
You must enroll in Medicare Part D to be covered.
|
You must enroll in Medicare Part D to be covered. |