UPDATES FROM FALLON HEALTH - January 2024

I hope this finds you well—and well-rested after a busy AEP and holiday season.

January is a month that's often focused on making resolutions, creating new to-do lists, and making lots of plans for the year ahead. So, we thought we'd kick off 2024 with a bit of fun.

We put together a quick quiz just for you. It's got five questions that should take you less than 5 minutes to complete. And when you do, you'll be entered to win a prize! Complete details are below, along with some handy reminders for this new plan year.

Our Broker Relations team is always available to answer any questions you may have about our products. You can contact them at 1-844-848-4931 (TRS 711), Monday–Friday, 8:30 a.m.–5:00 p.m., or at MedicareSalesBrokers@fallonhealth.org. 

Sincerely,

Deb Daviau

VP of Medicare and Executive Director of NaviCare

Save Now card

NaviCare^® SCO and HMO SNP

New for 2024: The Save Now and Self-Care card benefits have been combined onto one card! The new Save Now card includes up to $848/year—$648 to buy things like pain relievers and cold medicine, and $200 to buy things like soap, shampoo, groceries, and more. Buy items in a store, or place an order by phone or online, with free shipping. Detailed information is available in the Evidence of Coverage (available on our broker pages).

Benefit Bank

Fallon Medicare Plus^™

Members can pay for dental care, eyewear, fitness memberships, and hearing aids with their Benefit Bank card. Fallon Health puts money on the card, and they choose how to use it. Pay for a portion, or the full cost, of an item. For example, members can use their card to buy an extra pair of eyeglasses or toward the cost of a root canal. It’s their card, their choice. Allowances range from $250-$1,000.

Fallon Health has services that can help your clients get the medications they need, exactly when they need them.

Not available for members of Fallon Medicare Plus^™ Supplement .

Fallon Medicare Plus members

(all Medicare Advantage plans except Saver No Rx HMO)

Rx Savings Solutions (RxSS^™)

Fallon Health partners with RxSS to help Fallon Medicare Plus members find lower-cost options for their prescriptions. Through its free, confidential service, RxSS will identify alternative prescriptions that would save members at least $5 or more.

Members and their doctors decide what medication options are best for the member's health and budget. RxSS makes the process easy and will help along the way. Members can visit fallonhealth.org/rxss to learn more. Or they can call us at 1-800-325-5669 (TRS 711), 8 a.m.–8 p.m., Monday–Friday (Oct. 1–March 31, seven days a week).

OptumRx^® Home Delivery

Prescription cost-sharing starts at $0 for Tier 1 drugs at network retail and mail-order pharmacies. For Tiers 2–4 medications that are available in a long-term supply, members can use mail order to get up to 90 days’ worth for the cost of a 60-day supply. For Tier 1 medications, members can get a 100-day supply of their prescription, and their copay remains $0. And the shipping is free to anywhere in the U.S.

For more information about how to use this mail-order pharmacy program, members can visit fallonhealth.org/mailorder. Or they can call OptumRx Home Delivery at 1-844-657-0494 (TRS 711), 24 hours a day, seven days a week.

NaviCare^® members

OptumRx Home Delivery

Using OptumRx Home Delivery is easy, and it’s free. And members don’t have to use their transportation benefit to pick up their prescription—it’s delivered right to their door! Plus, shipping is free to anywhere in the U.S.

For more information, members can visit fallonhealth.org/mail-order or call OptumRx at 1-844-657-0494 (TRS 711), 24 hours a day, seven days a week.

Tip!

Members can also talk to their doctors about whether 90- or 100-day refills* may be right for the medications they’re taking. They can receive 90- or 100-day refills through mail order or at the pharmacy.

*Details are available in the plan’s Evidence of Coverage.

Contact us

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.–5:00 p.m.

You can also reach us by email: MedicareSalesBrokers@fallonhealth.org

Check out our website

Especially our broker webpages. They're full of helpful information.

Streamline your Fallon Health enrollments

Use SunFire. It makes the process easier.