Fallon Health

Almost 10 years on the MA HealthConnector for small businesses and Fallon Health is by far the worst insurance (and yet the 2nd most expensive) insurance plan I have had to date. Wouldn't even cover a mammogram. I put off all kinds of appointments for fear of never knowing what kind of bill I was going to end up with.

Worst insurance company I’ve ever had the displeasure of dealing with. If I could give negative star reviews I would. They will deny EVERY claim and hide behind fine print. I have been denied for everything my doctor has deemed medically necessary. Even if they concede it was necessary they hide behind getting “prior authorization” in order to not pay. Be prepared to behave a law degree in order to get through their BS Update: I had someone reach out to me immediately after this review and they worked to resolve the issue. I’m thankful for the resolution, I suspect however without this review they would not have reached out and they still require more referrals and prior approvals than any other company I’ve used.

I had to call Fallon Health Care for a billing problem today I was having with a local hospital. I spoke with a Representative named Debbie and I just had to let you know how wonderful she was. She was extremely helpful and knowledgeable and really took her time to explain everything I wanted to know. She didn’t try to rush me off the phone or put mon hold. She was engaged with everything I was saying. When the call was over I felt I had just spoken to someone who really cared about my situation and all my questions were resolved satisfactorily. She is an outstanding representation of your company.

I am writing to formally express my deep dissatisfaction with my experience as a Fallon Health member. I believe you should be aware of the following significant issues, which have made my time with Fallon extremely frustrating and disappointing: 1. Poor Network Coverage: The network of providers was shockingly limited, making it difficult to find in-network doctors or specialists without unreasonable wait times or long travel distances. 2. Unreliable Digital Tools: Fallon’s digital platforms — including the member portal and app — were clunky, outdated, and unreliable. It was difficult to look up coverage, manage prescriptions, or even view claims. 3. Invasive and Confusing Third-Party Partnership: The partnership with FusionAdvantage resulted in repeated harassing phone calls from a t

Just don't do it. They are the worst. There website says all these doctors accept your plan. You will call 20 and all 20 will say they don't accept it. It's like they are stealing from you. They take your payment every month and make sure you can't see a doctor. I know we all dislike insurance companies but I've never had an issue like I have with Fallon Health. Save your self money and aggravation and find a real provider.