Benefits and services

Fallon Health Weinberg-HMO SNP covers the benefits you would get with Medicare Parts A & B and the Part D prescription drug benefit, plus more. We also cover the services that you need to help keep you healthy and independent.

With Fallon Health Weinberg-HMO SNP, you'll be covered for:

  • Emergency and urgent care
  • Outpatient health services
  • Inpatient hospital care
  • Primary care and specialist care
  • Behavioral health services
  • Skilled nursing facility, inpatient rehabilitative care
  • Outpatient surgery
  • Prescriptions and pharmacy benefits
  • Preventive care and screenings
    This includes, but is not limited to, HIV screening tests, bone mass measurements, colorectal screenings, mammography screenings, prostate cancer screening exams, and cardiovascular screening blood tests.
  • Home health care
  • Any additional services recommended by your primary care doctor or your Care Team that are medically necessary

For detailed information on the services above, see your 2017 Evidence of Coverage (H2470_W_2017_1 Accepted 09122016, pdf).

We also coordinate your services covered by New York State Medicaid, which include but are not limited to:

  • Health-related services
    This includes transportation, homemaker/chore services, personal care attendant services, respite care, dementia and social day care, environmental accessibility adaptations, personal emergency response systems, and companion services.
  • Dental care, including but not limited to routine care, diagnostics, and treatment

Evidence of Coverage
The Evidence of Coverage is a booklet you get when you join Fallon Health Weinberg-HMO SNP. It explains what benefits you have and how to use your benefits. It will also tell you what is covered, how to make a complaint and how to disagree or appeal any decision that is made about your health care. It also tells you about your Part D prescription drug coverage.

Healthy extras

  • NEW FOR 2017 - Prepaid Savings Card
    The Save Now Card allows you to buy certain over-the-counter items for free 
  • NEW FOR 2017 - Web/phone-based technologies for non-emergency conditions
    24 hour/7 day-a-week access to a doctor by phone, internet or mobile app 

  • SilverSneakers® Fitness program
    Fallon Health Weinberg-HMO SNP members have the benefit of the SilverSneakers Fitness program, a health and fitness program that gives you a basic membership to select fitness facilities—including an orientation of the facility(ies) and equipment—at no additional cost.

    Participating fitness facilities are located throughout Erie and Niagara Counties and across the nation, and offer fitness classes for all levels. You'll also have access to exercise equipment and, where available, swimming pools and steam and sauna rooms. It's a great way to stay fit and meet new friends!

  • Nurse Connect
    Free phone and online access to registered nurses 24 hours a day, seven days a week. Reach a nurse at 1-855-809-2592 (TTY: 1-800-790-3069).

  • Quit to Win
    Additional smoking and tobacco cessation offered by certified tobacco treatment counselors from our cessation program. Learn more by calling 1-888-807-2908 (1-800-868-5200, TTY 711).

  • Vision extras
    Members receive up to $100 supplementary benefit toward eyewear.

 

 

Fallon Health Weinberg is an HMO plan with a Medicare contract and a coordination of benefits agreement with the New York State Department of Health. Enrollment in Fallon Health Weinberg depends on contract renewal. Fallon Health Weinberg-HMO SNP is available to anyone age 21 and older who has Medicare Parts A & B, full Medicaid benefits and lives in the service area. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits  may change on January 1 of each year. You must continue to pay your Medicare Part B premium (unless your part B premium is paid for you by Medicaid or another third party).

SilverSneakers® is a registered trademark of Healthways, Inc.

To view the PDF files above, you may need to download a free copy of Adobe® Acrobat Reader software on your computer. (This link takes you away from the Fallon Health Weinberg website.)

H2470_W_2017_7 Approved 10182016
The information on this page was last updated on 10/1/2017.

Find a doctor

Looking for a doctor? Need to see if your current doctor is in our network?

Search online

Download the Provider and Pharmacy Directory (H2470_W_2017_26_r1_NM, pdf)

Contact us

Information before enrolling:
1-855-561-7248 (TTY 711)
8 a.m.–8 p.m., Monday–Friday
(Oct. 1–Feb. 14, seven days a week)

Customer Service:
1-855-561-7247 (TTY 711)
8 a.m.–8 p.m., Monday–Friday
(Oct. 1–Feb. 14, seven days a week)

Member information

2017 Summary of Benefits (H2470_W_2017_6_r1 Accepted 10152016) ►

2017 Evidence of Coverage (H2470_W_2017_1 Accepted 09122016, pdf) ►

About the Medication Therapy Management Program

Covered medications

Find a doctor

Find a doctor

Are you looking for a doctor, hospital, pharmacy, or other community service providers?

Find a doctor online ► or
Download the whole Fallon Health Weinberg-HMO SNP Provider and Pharmacy Directory (H2470_W_2017_26_r1_NM, pdf)