Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026

Fallon Medicare Plus Green, 2027

H9001Contract030Plan

HMO · 10 counties in Massachusetts

Run by Fallon Community Health Plan (contract H9001), sold as Fallon Health, owned by Fallon Community Health Plan, Inc.

Renews in fewer counties

2026 star rating, contract H9001: 4 of 5

Fallon Medicare Plus Green (H9001-030) costs $72 to $105 a month in 2027, up $5 from 2026, with an in-network out-of-pocket limit of $6,000 ($5,200 in 2026). It leaves 2 counties it served in 2026, where 202 of its members lived; they choose another plan for 2027 (the counties are listed below).

What changes from 2026 to 2027?

The changed lines are marked and come first. In-network amounts; members keep paying the Part B premium unless the plan reduces it. Where the plan files different amounts for parts of its area, the premium and limit show their range (your county's are in the table below). The plan files its benefits in parts for different counties, so lines marked ◆ show the most generous part of its area and some counties get less: the plan's Evidence of Coverage gives your county's amounts.
What you pay or get	2026	2027	Change
Monthly premium	$67 to $100	$72 to $105	up $5
In-network out-of-pocket limit	$5,200	$6,000	up $800
Emergency room (best in its area)	$110 copay	$130 copay	up $20
Ground ambulance, in network (best in its area)	$225 copay	$300 copay	up $75
Counties served	12	10	down 2
Drug tier 4, non-preferred drug	34% of the cost	25% of the cost	down 9 points
16 lines do not change
Drug deductible	$300	$300	no change
Part B premium reduction, monthly (best in its area)	none	none	no change
Primary care visit (best in its area)	$10 copay	$10 copay	no change
Specialist visit (best in its area)	$20 copay	$20 copay	no change
Medical deductible, in network (best in its area)	none	none	no change
Hospital stay, in network (best in its area)	$300 a day for days 1–5, then $0 a day for days 6–90	$300 a day for days 1–5, then $0 a day for days 6–90	no change
Skilled nursing facility, in network (best in its area)	$0 a day for days 1–20, then $150 a day for days 21–44, then $0 a day for days 45–100	$0 a day for days 1–20, then $150 a day for days 21–44, then $0 a day for days 45–100	no change
Comprehensive dental, yearly limit (best in its area)	not offered	not offered	no change
Eyewear, yearly limit (best in its area)	$150 a year	$150 a year	no change
Hearing aids, yearly limit for both ears (best in its area)	not offered	not offered	no change
Over-the-counter items, yearly (best in its area)	$175 a year	$175 a year	no change
Drug tier 1, preferred generic	$0	$0	no change
Drug tier 2, generic	$7	$7	no change
Drug tier 3, preferred brand	$47	$47	no change
Drug tier 5, specialty tier	29% of the cost	29% of the cost	no change
Drug tier 6, select care drugs	$0	$0	no change

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS plan benefit package files, 2027 and 2026; CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026). Plan details can change during the year; confirm on Medicare Plan Finder.

What will prescriptions cost?

Your share for a 30-day supply at a retail pharmacy, as filed with CMS; tiers whose share changes are marked
Tier	What the tier holds	2026	2027
Tier 1	Preferred Generic	$0	$0
Tier 2	Generic	$7	$7
Tier 3	Preferred Brand	$47	$47
Tier 4	Non-Preferred Drug	34% of the cost	25% of the cost
Tier 5	Specialty Tier	29% of the cost	29% of the cost
Tier 6	Select Care Drugs	$0	$0

Source: CMS plan benefit package files, 2027 and 2026. Insulin is capped at $35 a month by law. A drug's tier is set by the plan's formulary.

How does it compare with plans sold where it is?

In the counties it serves, 57 plans open to everyone are sold for 2027, this one included. Against the others, 25 plans have a lower out-of-pocket limit, 1 the same, 30 a higher one. On the premium, 35 plans have a lower premium, 21 a higher one.

Out-of-pocket limits of the 57 plans open to everyone

$0 to under $2,0000 plans

$2,000 to under $4,0008 plans

$4,000 to under $6,00017 plans

$6,000 to under $8,000 (this plan)27 plans

$8,000 to $10,0005 plans

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).

Where is it sold, and what does it cost there?

It stops serving 2 counties it served in 2026 (listed in the next section).

10 counties, grouped by what the plan costs there
Monthly premium	Out-of-pocket limit	Where
$72	$6,000	Franklin (MA), Hampden (MA), Hampshire (MA)
$83	$6,000	Bristol (MA), Essex (MA), Middlesex (MA), Norfolk (MA), Plymouth (MA), Suffolk (MA)
$105	$6,000	Worcester (MA)

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).

What if you live in a county it leaves?

Its 2026 members in the 2 counties listed below cannot stay in it for 2027; each county page lists the 2027 plans sold there.

Your coverage: This plan ends for you on December 31, 2026, because it is no longer sold where you live.
October 15 to December 7, 2026: Open enrollment: join another Medicare Advantage plan, or Original Medicare with a drug plan. Coverage starts January 1, 2027.
December 8, 2026 to the end of February 2027: A special enrollment period because the plan is leaving: you can still join a plan, but coverage starts the first day of the month after you join, so choose by December 31 to have no gap.
If you do nothing: You are enrolled in Original Medicare when the plan ends, without a drug plan unless you join one (with Extra Help or full Medicaid, Medicare enrolls you in one).
Without a drug plan: Going 63 days or more in a row without drug coverage can mean a late enrollment penalty if you join a drug plan later; joining by the end of February keeps a January and February gap under 63 days, waiting longer does not.
If you choose Original Medicare: You have a guaranteed right to buy Medigap Plan A, B, C, D, F, G, K or L sold in your state by any insurance company; if you were new to Medicare on or after January 1, 2020, Plans D and G take the place of C and F. Apply from 60 days before to 63 days after the plan ends; the policy starts once your Medicare Advantage coverage ends. Other Medigap plans are not covered by this right.

The 2 counties it leaves, most members first
County	Members, Sept. 2026
Berkshire, MA	117
Barnstable, MA	85

Source: CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11); Medicare.gov, “Special enrollment periods” and “When can I buy Medigap?” (read Oct. 7, 2026).

Who runs this plan?

Plan ID: H9001-030
Legal name of the contract: Fallon Community Health Plan
Sold as: Fallon Health
Parent company: Fallon Community Health Plan, Inc.
Plan type: HMO
2026 star rating of the contract: 4 of 5 overall; health plan 4 of 5, drug plan 4 of 5
Members, September 2026: 2,330
Plan website, as filed with CMS: fallonhealth.org/medicare

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS 2026 Star Ratings (October 2025); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11). CMS publishes the 2027 Star Ratings in October 2026.

What else should you check?

Other 2027 plans in Worcester, MAWhere most of its members live; premiums and limits side by side
Every Fallon Health plan for 2027Its contracts, counties and plans that end
The other 3 plans of contract H9001Same company, same contract
Is your prescription covered?Coverage share and tier for 2,259 drugs

Data, not advice. These are the plan's filed amounts, not a quote for you; confirm on Medicare Plan Finder or call the plan before you enroll.