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Medicare Advantage · HMO
Fallon Health
Plan year 2027

Fallon Medicare Plus Green H9001-030-015 (HMO)

Monthly premium
$105
+ your Part B premium
Max out-of-pocket
$6,000
in-network annual cap
Primary care
$10
per visit copay
Specialist
$20–$50
per visit

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

Medical deductible
$0
Rx deductible
$300
Inpatient hospital
Days 1-5: $300/day, Days 6-90: $0/day
no limit on covered hospital days
Inpatient mental health
Days 1-5: $300/day, Days 6-90: $0/day
Outpatient surgery
$325
Emergency room
$130
Urgent care
$25

What's included, and what it's actually worth4 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.

OTC allowance

$175/yr OTC allowance
Prepaid card$175/yr OTC allowance

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$20–$50
In-network$20–$50 per visit
Inpatient Hospital$300/day, days 1–5
In-networkDays 1-5: $300/day, Days 6-90: $0/day
Benefit limitNone — additional covered days are unlimited
Outpatient Surgery$325 copay
In-network$325 copay per procedure
Mental HealthDays 1-5: $300/day, Days 6-90: $0/day
Inpatient psychiatricDays 1-5: $300/day, Days 6-90: $0/day
Fitness$0 fitness benefit

Your coverageCheck your coverageFrom the doctors and prescriptions you added

Our take

Where this plan shines

No separate medical deductible.

Things to know before you enroll

This plan’s out-of-pocket maximum is above the national median.
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 Green (HMO)

What does Fallon Medicare Plus Green (HMO) cover?

Fallon Medicare Plus Green (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), over-the-counter (OTC) ($175/yr OTC allowance), 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 Green (HMO) cost in 2027?

The published 2027 monthly plan premium for Fallon Medicare Plus Green (HMO) is $105. Any Medicare premiums you owe are separate from the listed plan premium. The listed medical deductible is $0. The listed Part D deductible is $300. The in-network medical out-of-pocket maximum is $6,000; it does not include Part D drug spending. Published visit costs include primary care $10 and specialist visits $20–$50. 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 Green (HMO)?

CMS lists Fallon Medicare Plus Green (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 Green (HMO) cover my prescriptions?

The current plan record for Fallon Medicare Plus Green (HMO) does not include tier-level formulary costs. The listed Part D deductible is $300. 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 Green (HMO) include?

The current plan record for Fallon Medicare Plus Green (HMO) lists vision ($150/yr eyewear allowance) and hearing ($695–$1,795 copay per hearing aid). It also lists over-the-counter (OTC) ($175/yr OTC allowance). 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 Green (HMO)?

Fallon Medicare Plus Green (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 Green H9001-030 (HMO) — 2027 Costs & Benefits