Standard Platinum: Community Care Connector Platinum

Fallon Community Health Plan · 2027 plan year

Platinum
Ind. deductible
$0
Family deductible
$0
Ind. OOP max
$3,500
Family OOP max
$7,000

Compare with other Platinum plans in MA

Side by side: deductibles, out-of-pocket limits and copays.

Other cost-sharing reduction variants for this plan:

More Fallon Community Health Plan plans in MA

Monthly premiums by age

Rating Area 2

AgeIndividual
Under 15$494
21$778
30$847
40$917
50$1,146
60$1,556
64 and over$1,556

Live premium estimate

$

Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$25.00

Specialist

BenefitIn-network
Specialist Visit$45.00

Hospital

BenefitIn-network
Emergency Room Services$200.00
Inpatient Hospital Services (e.g., Hospital Stay)$500.00 Copay per Stay
Outpatient Surgery Physician/Surgical ServicesNo charge
Urgent Care Centers or Facilities$45.00

Pharmacy

BenefitIn-network
Non-Preferred Brand Drugs$60.00
Generic Drugs$20.00
Preferred Brand Drugs$40.00
Specialty Drugs$60.00

Mental Health

BenefitIn-network
Mental/Behavioral Health Outpatient Services$25.00
Mental/Behavioral Health Inpatient Services$500.00 Copay per Stay

Other

BenefitIn-network
Nutritional Counseling$25.00
Orthodontia - Child50.00%
Abortion for Which Public Funding is ProhibitedNo charge
Accidental Dental$25.00
Allergy Testing$45.00
Bariatric Surgery$500.00
Basic Dental Care - Child25.00%
ChemotherapyNo charge
Chiropractic Care$25.00
Delivery and All Inpatient Services for Maternity Care$500.00
Dental Check-Up for ChildrenNo charge
Diabetes Education$25.00
DialysisNo charge
Durable Medical Equipment20.00%
Emergency Transportation/AmbulanceNo charge
Eye Glasses for ChildrenNo charge
Habilitation Services$45.00
Hearing Aids20.00%
Home Health Care ServicesNo charge
Hospice ServicesNo charge
Imaging (CT/PET Scans, MRIs)$200.00
Infertility Treatment$250.00
Infusion TherapyNo charge
Inpatient Physician and Surgical ServicesNo charge
Laboratory Outpatient and Professional Services$25.00
Major Dental Care - Child50.00%
Other Practitioner Office Visit (Nurse, Physician Assistant)$25.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)$250.00
Outpatient Rehabilitation Services$45.00
Prenatal and Postnatal CareNo charge
Prosthetic Devices20.00%
RadiationNo charge
Reconstructive Surgery$500.00
Rehabilitative Occupational and Rehabilitative Physical Therapy$45.00
Rehabilitative Speech Therapy$45.00
Routine Eye Exam (Adult)No charge
Routine Eye Exam for ChildrenNo charge
Routine Foot Care$25.00
Skilled Nursing Facility$500.00 Copay per Stay
Substance Abuse Disorder Inpatient Services$500.00 Copay per Stay
Substance Abuse Disorder Outpatient Services$25.00
Transplant$500.00
Treatment for Temporomandibular Joint Disorders$45.00
Weight Loss ProgramsNo charge
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging$25.00

Service area

This plan covers 93 geographic areas. 93 of them are covered only in part, meaning specific ZIP codes rather than the whole county. The filing does not list which, so confirm with the insurer or on HealthCare.gov before enrolling.

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