Other important plan information

Medicare Plan ratings

The Medicare Program rates how well Medicare health and drug plans perform in different categories (for example, detection and prevention of illness, ratings from patients, patient safety, drug pricing and customer service). The information in this document is an overall plan rating of our plan's performance.

Fallon Health Weinberg - CY 2017 Medicare Plan Ratings (H2470_W_2017_43 Accepted 10182016, pdf)

Your rights and responsibilities as a member of the plan

You can find information about your rights and responsibilities in your 2017 Evidence of Coverage (H2470_W_2017_1 Accepted 09122016, pdf) in Chapter 8, "Your rights and responsibilities."

Potential for contract termination

All Medicare Advantage Plans agree to stay in the program for a full year at a time. Each year, plans decide whether to continue for another year. If Fallon Health Weinberg-HMO SNP leaves the program, you will not lose your Medicare or New York State Medicaid coverage (provided that you continue to meet the eligibility requirements for New York State Medicaid). If Fallon Health Weinberg-HMO SNP decided not to continue, you would be notified by letter at least 90 days before your coverage ended. The letter would explain your options.

Getting care during a disaster

If the Governor of your state, the U.S. Secretary of Health and Human Services, or the President of the United States declares a state of disaster or emergency in your geographic area, you are still entitled to care from your plan.

Generally, during a disaster, you can get care from out-of-network providers at in-network cost-sharing. If you cannot use a network pharmacy during a disaster, you may be able to fill your prescription drugs at an out-of-network pharmacy.

Ending your membership

Ending your membership in Fallon Senior Plan may be voluntary (your own choice) or involuntary (not your own choice).

You may end your coverage with Fallon Health Weinberg-HMO SNP at any time. To disenroll, call Fallon Health Weinberg at 1-855-561-7247 (TTY 711), Monday-Friday, 8 a.m.-8 p.m. (Oct. 1-Feb. 14, seven days a week).

Voluntary disenrollments are effective the last day of each month after the request for the disenrollment is received. You will remain enrolled in Fallon Health Weinberg-HMO SNP and be fully covered until the last day of the month.

If we end your membership in our plan, we must tell you our reasons in writing for ending your membership. We must also explain how you can make a complaint about our decision to end your membership.

You can find more information about ending your membership in your 2017 Evidence of Coverage (H2470_W_2017_1 Accepted 09122016, pdf) in Chapter 10, "Ending your membership in the plan."

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.

Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next.

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.

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

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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)

Find a doctor

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Download the whole Fallon Health Weinberg-HMO SNP Provider and Pharmacy Directory (H2470_W_2017_26_r1_NM, pdf)

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

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