Private Fee-for-Service (PFFS) Plans
Private Fee-for-Service plans cover Medicare benefits like doctor and hospital services, much like Medicare HMOs and PPOs. Unlike Medicare HMOs and PPOs, PFFS plans do not have a formal network of doctors and hospitals. Still, not all doctors and hospitals are willing to treat members of a PFFS plan. If considering enrolling in a PFFS plan, make sure your doctor and hospital are willing to accept the private fee-for-service plan's payments for services before you enroll. Also, be sure you understand a plan's benefits and cost sharing requirements before you enroll because Private Fee-for-Service plans decide how much enrollees pay for Medicare-covered services and may charge higher cost sharing for certain health care services than the original Medicare program. While PFFS plans are not required to offer the Medicare drug benefit, most do. If you enroll in a Private Fee-for-Service plans without drug coverage, you can also enroll in a Medicare stand-alone prescription drug plan for your drug coverage.
A Medicare Advantage Private Fee-for-Service plan works differently than a Medicare supplement plan. Your provider is not required to agree to accept the plan's terms and conditions of payment, and thus may choose not to treat you, with the exception of emergencies. If your provider does not agree to accept the terms and conditions of payment, they may choose not to provide health care services to you, except in emergencies. If this happens, you will need to find another provider that will accept the terms and conditions of payment. Providers can find the plan's terms and conditions of payment on the plan's website.
Private Fee-for-Service plans cover Medicare benefits like doctor and hospital services, much like Medicare HMOs and PPOs. Unlike Medicare HMOs and PPOs, PFFS plans do not have a formal network of doctors and hospitals. Still, not all doctors and hospitals are willing to treat members of a PFFS plan. If considering enrolling in a PFFS plan, make sure your doctor and hospital are willing to accept the private fee-for-service plan's payments for services before you enroll. Also, be sure you understand a plan's benefits and cost sharing requirements before you enroll because Private Fee-for-Service plans decide how much enrollees pay for Medicare-covered services and may charge higher cost sharing for certain health care services than the original Medicare program. While PFFS plans are not required to offer the Medicare drug benefit, most do. If you enroll in a Private Fee-for-Service plans without drug coverage, you can also enroll in a Medicare stand-alone prescription drug plan for your drug coverage.
A Medicare Advantage Private Fee-for-Service plan works differently than a Medicare supplement plan. Your provider is not required to agree to accept the plan's terms and conditions of payment, and thus may choose not to treat you, with the exception of emergencies. If your provider does not agree to accept the terms and conditions of payment, they may choose not to provide health care services to you, except in emergencies. If this happens, you will need to find another provider that will accept the terms and conditions of payment. Providers can find the plan's terms and conditions of payment on the plan's website.
