COVID-19 updates
Since the pandemic hit our communities last year, we’ve all been trying to protect ourselves and each other from the dangers the virus has presented. It’s been a constantly changing, fluid environment, full of stress and uncertainty. At Fallon Health, we’ve adapted our policies and business practices to meet the challenges of this difficult time. Applying best practices for planning, preparedness and recovery, we’ve protected our workforce and our business continuity—and ensured your clients’ employees receive the necessary and appropriate care throughout the pandemic.

Today, the landscape is beginning to look different. With FDA-approval of three effective and safe vaccines—from Pfizer, Moderna and Johnson & Johnson—we can begin to see better days on the horizon.

Good news on vaccinations
Fallon will be covering vaccination for all members with no cost sharing. Currently, Massachusetts is in Phase 2 of its vaccination plan, with individuals ages 65 and over, as well as individuals with two qualifying comorbidities, eligible for vaccinations. Educators, child care workers and school staff are eligible as of March 11.

Your clients’ employees in Massachusetts can visit the state’s website to determine eligibility and then to locate vaccination sites and make an appointment. Those who can’t access the online system can get scheduling assistance by calling the Massachusetts COVID-19 vaccine hotline at 2-1-1, Monday–Thursday, 8:30 a.m.–8 p.m., and Friday–Sunday, 8:30 a.m.–5 p.m. Workers outside Massachusetts should access their state’s public health department for vaccine availability in their area.

Coverage for testing
New legislation signed into law in Massachusetts this year mandates that commercial health plans cover:

  • COVID-19-related emergency, inpatient and cognitive rehabilitation services, without cost-sharing, including professional diagnostic and laboratory services (in-network and out-of-network).

  • Medically necessary COVID-19 testing for asymptomatic individuals (as defined by the Executive Office of Health and Human Services) who work in health care, restaurant, retail or hospitality jobs, and must interact with the public as part of their official duties. For the test to be deemed medically necessary, an asymptomatic individual working in those industries must also have been identified as a close contact or have had a known or suspected exposure to the virus with the last 14 days.

Testing is widely available in Massachusetts and easily located on the state’s Find a COVID-19 Test website.

Keeping up with routine care
While waiting their turn for COVID-19 vaccinations, your clients’ employees should stay in touch with their PCP. It’s important to get timely medical advice for new health concerns, as well as routine care and screenings. Please remind them that Fallon is a resource they can access just by calling the number on the back of their member ID cards.

Many providers are offering telehealth services for their patients. Fallon is waiving member cost-sharing for COVID-related medically necessary telehealth services. For non-COVID-related telehealth visits, member cost-sharing is the amount reflected in plan documents.
WBJ webcast series
Find out how New England's second-largest city continues to expand
Worcester Emerging 2021, an in-depth, three-part webcast series, will explore what’s behind the city’s ongoing momentum, including current and future growth opportunities. Fallon is proud to be a platinum sponsor of the series, which is being co-produced by the Worcester Business Journal and the State House News Service, which covers state government activities year-round.

We invite you to join any or all of these free events. The city’s business, political, and cultural leaders will share their insights on the economic challenges and significant opportunities in Worcester today.

  • Worcester 2021 and Beyond: A Conversation with City Leaders, 9–10 a.m. on March 9

  • Civic and Cultural Life, noon–1 p.m. on March 16

  • Investing in Worcester, 9–10 a.m. on March 23

Despite the pandemic, several billion dollars of work in construction, development and revitalization is underway in Worcester. As an affordable city with vibrant arts, dining and cultural scenes, Worcester is also a center for higher education, health care and biotech. “The Worcester Renaissance” that took root pre-pandemic will be getting back into gear in 2021 as New England’s second-largest city continues to expand.

Visit the WBJ website to sign up for all three free webinars or to find more information.
New member portal features improved tools, better access
Fallon members now have access to new, easy-to-use, self-service tools in our updated, secure member portal, MyFallon. Using the enhanced MyFallon member portal, your clients’ employees can:

  • See copayments and/or coinsurance for common services

  • Track deductibles and out-of-pocket maximums

  • Check authorization status

  • Log in to many of Fallon Health's online tools with a single username and password

The new MyFallon also improves on tools that were already available to members:

  • Claims lookup

  • View benefit documents, claims statements and letters

  • Temporary ID card/order ID card

  • Change PCP

  • Change address

  • A secure online form for contacting Fallon
“The new portal connects members with resources that help them get the most from their health insurance," said Emily West, Senior Vice President and Chief Operating Officer at Fallon. “By making information readily available, MyFallon helps influence healthy behavior and empowers members to play a bigger role in managing their individual wellness goals."

Members can register or log in to the new portal by visiting myfallon.org
Health and wellness
Information you can use and share
You can find health and wellness information for your clients and their employees on our website. A library of health and wellness flyers and kits is also available.
In case you missed it …
Visit our website for previous COVID-19-related messages for brokers. We’ve posted PDF versions of the messages for you there.