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Health & Fitness

Fallon/Reliant Customers: Tufts Is Not Your Only Choice

As almost anyone that has walked into a Fallon-Clinic/Reliant-Atrius office in the last six months knows, Fallon/Reliant Medicare patients who are using the Fallon Community Health Plan (FCHP) Part C Medicare Advantage plan this year will have to

  • Change insurance plans as of their next renewal date (see Note) 
  • or
  • Stop doing business with Fallon-Clinic/Reliant-Atrius doctors

Unfortunately, speaking as one of those people, I find the communications from Fallon-Clinic/Reliant-Atrius (and from FCHP) on this change to be confusing. And I am certified by the Centers for Medicare and Medicaid Services to volunteer to help people with Medicare issues, so if I find it confusing I can only imagine how someone that only thinks about their Medicare coverage for a few hours a year feels.

One issue I see is that there is a strong indication in all the letters and other mailings from Fallon-Clinic/Reliant-Atrius that your only choice if you want to keep going to a Fallon/Reliant doctor or facility is to switch to Tufts Health Plan Medicare Preferred. That appears to be true if you want to stay on a public Part C Medicare health plan.  But -- based on the various related web sites -- there does does not seem to be any reason that you can't change to a private Medigap supplement plan. Five or six such plans are available from insurance companies in Worcester County including from FCHP and Tufts. Per everything I see on the Fallon/Reliant web site, you can choose an FCHP (or any other) Medigap plan and still keep your Fallon/Reliant doctor(s).

There are advantages to public Part C vs. private Medigap and there are disadvantages.  I can't be more specific about the differences until the insurance companies release 2014 prices and evidence-of-coverage documents around September 15. Stand by!

Note: Most Medicare beneficiaries purchase their FCHP insurance individually and their key date is January 1, 2014 with decisions having to be made between October 15 and December 7, 2013.  However for those Medicare beneficiaries who purchase their FCHP insurance through a former employer, the effective and/or decision date may be sooner. Do not ignore any correspondence from a former employer.
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