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Medicare Advantage · HMO
Fallon Health
Plan year 2027

Fallon Medicare Plus Blue H9001-031-015 (HMO)

Monthly premium
$217
+ your Part B premium
Max out-of-pocket
$3,400
in-network annual cap
Primary care
$10
per visit copay
Specialist
$15–$30
per visit

Your costs at a glanceIn-network, for the 2027 plan year

Medical deductible
$0
Rx deductible
$0
Inpatient hospital
$300
per stay
no limit on covered hospital days
Inpatient mental health
$300
per stay
Outpatient surgery
$200
Emergency room
$140
Urgent care
$10

What's included, and what it's actually worth3 benefits included. Tap any card for the detail

Hearing

$695–$1,795copay per hearing aid
Details$695–$1,795 copay per hearing aid
This is a supplemental benefit with plan-specific limits. See plan documents for details.

Vision

$150/yr eyewear allowance
Eyewear allowance$150/yr eyewear allowance
This is a supplemental benefit with plan-specific limits. See plan documents for details.
See more details about this plan
Doctor Visits: PCP$10 copay
In-network$10 copay per visit
Doctor Visits: Specialist$15–$30
In-network$15–$30 per visit
Inpatient Hospital$300 per stay
In-network$300 per stay
Benefit limitNone — additional covered days are unlimited
Outpatient Surgery$200 copay
In-network$200 copay per procedure
Mental Health$300 per stay
Inpatient psychiatric$300 per stay
Fitness$0 fitness benefit

Your coverageCheck your coverageFrom the doctors and prescriptions you added

Our take

Where this plan shines

This plan’s out-of-pocket maximum ($3,400) is among the lowest available.
No separate drug deductible.
No separate medical deductible.

Things to know before you enroll

Network restriction — you’ll need to use in-network providers except in emergencies.
Limited coverage while traveling outside the plan’s service area.
Questions? Talk to a licensed agent at1-866-764-3312 (TTY: 711)

Plan documents

Plan questions

Common questions about Fallon Medicare Plus Blue (HMO)

What does Fallon Medicare Plus Blue (HMO) cover?

Fallon Medicare Plus Blue (HMO) is a Medicare Advantage plan that the current plan record identifies as including Part D prescription drug coverage. The plan record also identifies Part D prescription drug coverage. Published supplemental benefits include vision ($150/yr eyewear allowance), hearing ($695–$1,795 copay per hearing aid), and fitness ($0 fitness benefit). Review the plan documents for covered services, limits, and rules. Coverage can change each plan year.

Learn about Medicare Advantage

How much does Fallon Medicare Plus Blue (HMO) cost in 2027?

The published 2027 monthly plan premium for Fallon Medicare Plus Blue (HMO) is $217. Any Medicare premiums you owe are separate from the listed plan premium. The listed medical deductible is $0. The listed Part D deductible is $0. The in-network medical out-of-pocket maximum is $3,400; it does not include Part D drug spending. Published visit costs include primary care $10 and specialist visits $15–$30. These figures are plan data, not a personal yearly-cost estimate.

Understand Medicare drug-cost limits

Can I use my current doctors with Fallon Medicare Plus Blue (HMO)?

CMS lists Fallon Medicare Plus Blue (HMO) as a HMO plan. A network label alone does not confirm that a specific doctor participates. Use the doctor lookup tool, then confirm with the doctor's office and the plan before receiving care. Provider networks and member costs can change. Emergency care and travel coverage can follow different network rules.

Check your doctors

Does Fallon Medicare Plus Blue (HMO) cover my prescriptions?

The current plan record for Fallon Medicare Plus Blue (HMO) does not include tier-level formulary costs. The listed Part D deductible is $0. A tier listing does not confirm that a specific prescription is covered. Check each medication against the plan's current formulary, restrictions, pharmacy network, and costs before enrolling.

Check your prescriptions

What dental, vision, and hearing benefits does Fallon Medicare Plus Blue (HMO) include?

The current plan record for Fallon Medicare Plus Blue (HMO) lists vision ($150/yr eyewear allowance) and hearing ($695–$1,795 copay per hearing aid). The current data does not list dental as offered benefits. Benefit allowances, frequency, eligibility, and participating providers can have additional limits, so review the Summary of Benefits or Evidence of Coverage for the complete rules.

When can I enroll in Fallon Medicare Plus Blue (HMO)?

Fallon Medicare Plus Blue (HMO) is a 2027 Medicare Advantage plan. The Annual Enrollment Period runs from October 15 through December 7, with changes taking effect January 1. The Medicare Advantage Open Enrollment Period runs from January 1 through March 31 for people already enrolled in Medicare Advantage. A qualifying circumstance may create a Special Enrollment Period outside those dates. Confirm the enrollment window and effective date that apply to you before changing coverage.

Review Medicare enrollment periods

More plan options

Browse the full 2027 Medicare Advantage with drug coverage directory. This plan is offered in Massachusetts. Plan availability can vary by county.

Helpful next steps

Fallon Medicare Plus Blue H9001-031 (HMO) — 2027 Costs & Benefits