Fallon Health Insurance Review & Ratings (2024)

By diving into the details, we aim to equip you with the knowledge needed to evaluate Fallon Health Insurance and make informed decisions about your healthcare coverage. Trust our trusted resource to guide you through the intricate details of Fallon Health Insurance, helping you find the insurance solution that aligns with your unique healthcare needs.

UPDATED: Dec 18, 2023Fact Checked

Dorothea Hudson

Insurance and Finance Writer

Dorothea Hudson has been professionally writing in many spheres since 2013. She has written on entertainment, insurance, finance, travel, technology, AI, renewable energy, crypto, fundraising, and real estate for many websites. Her work has been published for British retailer Marks and Spencer, Kroger Magazine, the Vision Group, and more. Her passions include writing, music, running, travel, te...

Insurance and Finance Writer

Brandon Frady

Licensed Insurance Agent

Brandon Frady has been a licensed insurance agent and insurance office manager since 2018. He has experience in ventures from retail to finance, working positions from cashier to management, but it wasn’t until Brandon started working in the insurance industry that he truly felt at home in his career. In his day-to-day interactions, he aims to live out his business philosophy in how he treats hi...

Licensed Insurance Agent

UPDATED: Dec 18, 2023

Advertiser Disclosure

It’s all about you. We want to help you make the right coverage choices.

Advertiser Disclosure: We strive to help you make confident insurance decisions. Comparison shopping should be easy. We are not affiliated with any one insurance company and cannot guarantee quotes from any single insurance company.

Our insurance industry partnerships don’t influence our content. Our opinions are our own. To compare quotes from many different insurance companies please enter your ZIP code above to use the free quote tool. The more quotes you compare, the more chances to save.

Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything insurance related. We update our site regularly, and all content is reviewed by insurance experts.

UPDATED: Dec 18, 2023

Advertiser Disclosure

It’s all about you. We want to help you make the right coverage choices.

Advertiser Disclosure: We strive to help you make confident insurance decisions. Comparison shopping should be easy. We are not affiliated with any one insurance company and cannot guarantee quotes from any single insurance company.

Our insurance industry partnerships don’t influence our content. Our opinions are our own. To compare quotes from many different insurance companies please enter your ZIP code above to use the free quote tool. The more quotes you compare, the more chances to save.

UPDATED: Dec 18, 2023Fact Checked
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Fallon Health Insurance

Average monthly rate for healthy individuals:

N/A

A.M. Best rating:

A (Excellent)

Complaint level:

Low

Pros

  • Not-for-Profit Status: As a not-for-profit healthcare services organization, Fallon Health Insurance may prioritize the well-being of its members over profit, potentially leading to more focus on affordable and high-quality care.
  • Longevity and Experience: With a founding date in 1977, Fallon Health Insurance has a long history and experience in providing health insurance services, indicating stability and reliability.
  • Diverse Coverage Options: Fallon Health Insurance offers a variety of coverage options, including individual and family plans, employer group plans, Medicare Advantage, and Medicaid, catering to a broad range of healthcare needs.
  • Geographic Focus: While limited to Massachusetts, Fallon Health Insurance’s concentrated service area allows for a more localized and potentially personalized approach to healthcare coverage.

Cons

  • Limited Geographic Coverage: Fallon Health Insurance primarily operates in Massachusetts, which may limit its accessibility for individuals residing outside of this geographic area.
  • Mixed Customer Reviews: Customer reviews about Fallon Health Insurance are mixed, with some expressing satisfaction with personalized service and affordable plans, while others report challenges with customer service and claim processes.
  • Potential Claim Issues: Some customers have reported unexpected out-of-pocket expenses and difficulties with coverage for specific medical procedures or treatments, suggesting potential challenges in the claims resolution process.
  • Discount Variability: The availability and amount of discounts offered by Fallon Health Insurance may vary depending on the specific plan and location, requiring potential policyholders to inquire directly about applicable discounts.

Final Verdict: Review of Fallon Health Insurance

In conclusion, Fallon Health Insurance is a health insurance company that provides coverage options to residents of Massachusetts. With a focus on personalized service and individual attention, Fallon Health Insurance offers a range of health insurance plans, including Medicare Advantage, individual and family plans, and employer group plans.

The cost of these plans will depend on a variety of factors, including the specific plan you choose, your location, and any discounts that you may be eligible for.

While customer reviews of Fallon Health Insurance are mixed, the company’s emphasis on affordable, comprehensive coverage and individual attention make it a compelling option for those in the Massachusetts area. As with any health insurance decision, it’s important to carefully evaluate your options and choose a plan that meets your individual needs and budget.

What You Should Know About Fallon Health Insurance

Welcome to our comprehensive Fallon Health Insurance Review & Ratings. Navigating the world of healthcare coverage can be overwhelming, but we’re here to provide you with the in-depth information you need to make informed decisions. We delve deep into Fallon Health Insurance, offering valuable insights, unbiased analysis, and expert perspectives.

Now, it’s time to take a proactive step toward finding the best healthcare coverage for your needs. Enter your zip code to access a user-friendly tool that allows you to compare rates from the top insurance providers in your area. By comparing rates, you can ensure you’re getting the most competitive prices for the coverage you desire.

An Overview: Fallon Health Insurance

If you’re in the market for health insurance, you might want to consider Fallon Health Insurance. Founded in 1977, Fallon Health Insurance is a not-for-profit healthcare services organization based in Worcester, Massachusetts.

  • Fallon Health Insurance offers a wide range of health plans, including Medicare Advantage, Medicaid, and commercial plans.
  • The company is committed to improving the health and well-being of the communities it serves.
  • Fallon Health Insurance has received high ratings for its customer service and quality of care.

The company’s mission is to improve the health and well-being of the communities it serves by providing affordable, high-quality health care. Fallon Health Insurance offers a range of health plans, including Medicare Advantage, Medicaid, and commercial plans.

History of Fallon Health Insurance

Fallon Health Insurance was founded in 1977 in Worcester, Massachusetts, as Fallon Community Health Plan. The company was established by a group of community leaders who were committed to providing affordable, high-quality health care to the people of central Massachusetts.

The company initially started as a non-profit HMO (health maintenance organization) that was focused on preventative health care and early detection of diseases. Over the years, Fallon Health Insurance has grown and expanded its services to include Medicare Advantage, Medicaid, and commercial plans.

The company has also expanded its service area beyond central Massachusetts to other parts of the state and some areas of New Hampshire. Today, Fallon Health Insurance serves over 260,000 members and employs more than 1,200 people.

Mission of Fallon Health Insurance

The company is committed to providing affordable, high-quality health care to its members and ensuring that they have access to the services and support they need to live healthy lives. Fallon Health Insurance strives to achieve its mission by:

  • Partnering with health care providers: Fallon Health Insurance works closely with health care providers to ensure that its members have access to high-quality care.
  • Promoting preventive care: Fallon Health Insurance is committed to promoting preventive care and early detection of diseases. The company offers a range of wellness programs and resources to help its members stay healthy and avoid illness.
  • Supporting the community: Fallon Health Insurance is committed to supporting the community and addressing the social determinants of health. The company has established partnerships with community organizations to address issues like food insecurity and social isolation.

Fallon Health Insurance has a long history of providing affordable, high-quality health care to the people of Massachusetts and parts of New Hampshire. The company’s mission is to improve the health and well-being of the communities it serves by providing access to quality care, promoting preventive care, and supporting the community.

Fallon Health Insurance Coverage Options

Fallon Health Insurance offers a range of health insurance products and related services, including:

  • Medicare Advantage plans: Fallon Health Insurance offers Medicare Advantage plans to eligible individuals in Massachusetts and New Hampshire. These plans provide all the benefits of Original Medicare, along with additional benefits like prescription drug coverage, vision, and dental services.
  • Medicaid plans: Fallon Health Insurance offers MassHealth (Medicaid) plans to eligible individuals in Massachusetts. These plans provide comprehensive health care coverage to individuals and families who meet certain income and eligibility requirements.
  • Commercial plans: Fallon Health Insurance also offers commercial health insurance plans for individuals and employers in Massachusetts. These plans are designed to meet the unique needs of each individual or group and offer a range of benefits and options.

In addition to health insurance plans, Fallon Health Insurance also offers a range of related services, including:

  • Care management and coordination: Fallon Health Insurance offers care management and coordination services to members who need extra support managing their healthcare needs.
  • Wellness programs: Fallon Health Insurance offers a range of wellness programs and resources to help members stay healthy and avoid illness.
  • Online tools and resources: Fallon Health Insurance provides a variety of online tools and resources to help members manage their health care, including a member portal and mobile app.

States Where Fallon Health Offers Insurance

Fallon Health Insurance offers health insurance plans in a limited geographic area, specifically in the state of Massachusetts. Here is a list of the counties in Massachusetts where Fallon Health Insurance provides health insurance coverage:

  • Barnstable
  • Berkshire
  • Bristol
  • Dukes
  • Essex
  • Franklin
  • Hampden
  • Hampshire
  • Middlesex
  • Nantucket
  • Norfolk
  • Plymouth
  • Suffolk
  • Worcester

It’s important to note that Fallon Health Insurance’s coverage options and availability may vary by location and plan, so it’s always a good idea to check with the company directly to learn more about the specific health insurance plans that are available in your area.

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Fallon Health Insurance Rates Breakdown

The cost of insurance through Fallon Health Insurance will vary depending on several factors, including the specific plan you choose, your age and health status, where you live, and other individual factors.

It’s important to note that Fallon Health Insurance offers a variety of plans with different costs and benefits, so it’s important to carefully evaluate your options and choose the plan that best meets your individual needs and budget. Additionally, if you are eligible for financial assistance through programs like Medicaid or the Affordable Care Act (ACA), you may be able to lower your monthly premiums and out-of-pocket costs.

Fallon Health Insurance Discounts Available

Fallon Health Insurance offers a variety of discounts to help make their plans more affordable for their customers. Here are some of the most common discounts available:

  • Wellness discounts: Fallon Health Insurance offers discounts to customers who participate in certain wellness programs or meet certain health goals, such as completing a health assessment or getting an annual physical exam.
  • Multi-policy discounts: If you have multiple insurance policies with Fallon Health Insurance, such as a health plan and a dental plan, you may be eligible for a discount on your premiums.
  • Safe driver discounts: If you have a car insurance policy with Fallon Health Insurance, you may be eligible for a safe driver discount if you have a good driving record and no accidents or violations.
  • Discounts for paying in full: Some Fallon Health Insurance plans offer a discount if you pay your annual premium in full upfront, rather than making monthly payments.

It’s important to note that the availability and amount of discounts will vary depending on the specific plan and location, so it’s a good idea to contact Fallon Health Insurance directly to learn more about the discounts that may be available to you.

Additionally, be sure to ask about any other discounts or cost-saving strategies that may be available, such as prescription drug discounts or telehealth services.

Navigating Fallon Health Insurance Claims Process

Ease of Filing a Claim

Fallon Health Insurance provides multiple convenient methods for filing insurance claims. Policyholders can submit claims online through the company’s official website, file claims over the phone by contacting their customer service, or utilize mobile apps designed to streamline the claims submission process.

Average Claim Processing Time

The average claim processing time with Fallon Health Insurance varies depending on the complexity of the claim and the accuracy of the submitted documentation. However, the company is committed to ensuring prompt processing and strives to minimize delays in settling claims.

Customer Feedback on Claim Resolutions and Payouts

Customer feedback regarding Fallon Health Insurance’s claim resolutions and payouts has been mixed. While some policyholders have reported positive experiences, appreciating the efficiency and fairness of the company’s claim resolution process, others have expressed frustration with unexpected out-of-pocket expenses and issues with coverage for specific medical procedures or treatments.

Policyholders need to review their policy terms and communicate directly with the company to address any claim-related concerns.

Unleashing Innovation With Fallon Health Insurance Digital and Technological Features

Mobile App Features and Functionality

Fallon Health Insurance offers a comprehensive mobile app that provides policyholders with a range of features and functionalities. These include the ability to access digital insurance cards, view policy details, track claims, and even schedule appointments with healthcare providers. The app is designed to enhance the overall customer experience and facilitate easy access to important insurance information.

Online Account Management Capabilities

Policyholders can manage their insurance accounts seamlessly through Fallon Health Insurance’s user-friendly online portal. This platform allows customers to review and update their policy information, make premium payments, and track their claims in real time.

The online account management capabilities are aimed at providing policyholders with greater control and convenience when it comes to managing their insurance policies.

Digital Tools and Resources

Fallon Health Insurance provides a range of digital tools and resources to assist policyholders in making informed healthcare decisions. These resources may include online calculators, educational materials, and access to telehealth services. These digital tools aim to empower policyholders with the information they need to navigate their healthcare coverage effectively.

How Fallon Health Insurance Ranks Among Providers

Fallon Health Insurance, as of the latest available data, holds a competitive position within the health insurance market. While specific ranking details may vary based on different criteria and regions, the following general insights can be considered:

  • A.M. Best Rating: Fallon Health Insurance’s A.M. Best Rating reflects its financial strength and ability to meet policyholder obligations. As of the most recent evaluation, the company has demonstrated a stable and reliable financial standing.
  • Customer Satisfaction: Customer satisfaction rankings, derived from independent surveys and reviews, indicate that Fallon Health Insurance has received both positive and negative feedback. Factors such as personalized service, plan affordability, and claim resolution efficiency contribute to its overall customer satisfaction standing.
  • Industry Comparison: When compared to other health insurance providers in the market, Fallon Health Insurance maintains a competitive position, offering a diverse range of coverage options. The company’s focus on preventive care and community well-being contributes to its standing in the industry.

It’s recommended to check external sources such as industry reports, customer satisfaction surveys, and financial rating agencies for the most up-to-date and accurate information to complete this section effectively.

Customer Reviews of Fallon Health Insurance

Fallon Health Insurance has received a mix of positive and negative customer reviews. Customers appreciate the personalized service and individual attention provided by Fallon Health Insurance representatives. Some customers have found Fallon Health Insurance plans to be more affordable than other health insurance options in the area.

Many customers have reported positive experiences with the company’s Medicare Advantage plans, praising the comprehensive benefits and affordable costs.

Some customers have had difficulty navigating the company’s customer service and claim processes, with long wait times and frustrating interactions with representatives. A few customers have reported unexpected out-of-pocket expenses or issues with coverage for specific medical procedures or treatments.

Frequently Asked Questions

What is Fallon Health Insurance?

Fallon Health Insurance is a not-for-profit healthcare services organization based in Worcester, Massachusetts. The company offers a range of health plans, including Medicare Advantage, Medicaid, and commercial plans.

When was Fallon Health Insurance founded?

Fallon Health Insurance was founded in 1977 as Fallon Community Health Plan in Worcester, Massachusetts.

What are the coverage options provided by Fallon Health Insurance?

Fallon Health Insurance offers a range of health insurance products, including individual and family plans, employer group plans, Medicare Advantage, and Medicaid.

Does Fallon Health Insurance offer discounts?

Yes, Fallon Health Insurance offers a variety of discounts to make their plans more affordable, including discounts for healthy living, fitness memberships, and vision care.

Where does Fallon Health Insurance offer coverage?

Fallon Health Insurance offers health insurance plans in a limited geographic area, specifically in the state of Massachusetts.

What are the customer reviews of Fallon Health Insurance?

Customer reviews of Fallon Health Insurance are mixed. While some customers appreciate the personalized service and affordable plans, others have reported difficulty navigating the customer service and claim processes.

How can I compare insurance rates from different companies?

You can use the free quote tool on USInsuranceAgents.com to compare insurance rates from different companies in your area.

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Dorothea Hudson

Insurance and Finance Writer

Dorothea Hudson has been professionally writing in many spheres since 2013. She has written on entertainment, insurance, finance, travel, technology, AI, renewable energy, crypto, fundraising, and real estate for many websites. Her work has been published for British retailer Marks and Spencer, Kroger Magazine, the Vision Group, and more. Her passions include writing, music, running, travel, te...

Insurance and Finance Writer

Brandon Frady

Licensed Insurance Agent

Brandon Frady has been a licensed insurance agent and insurance office manager since 2018. He has experience in ventures from retail to finance, working positions from cashier to management, but it wasn’t until Brandon started working in the insurance industry that he truly felt at home in his career. In his day-to-day interactions, he aims to live out his business philosophy in how he treats hi...

Licensed Insurance Agent

Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything insurance related. We update our site regularly, and all content is reviewed by insurance experts.

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