Medicare PFFS stands for Private-Fee-for-Service. It is a Medicare Advantage option available in select areas.
What is a Medicare PFFS plan?
A Medicare PFFS plan is similar to an HMO or PPO plan, you will pay the plan’s premium as well as co-pays and coinsurance as you receive medical services. However, the biggest difference about a PFFS plan is that you are not limited to a network of providers.
With a PFFS plan, you will present your plan ID card to the healthcare provider before receiving services. The healthcare provider will then either agree or disagree with the plan’s terms and conditions. If they agree, they will then bill the plan.
Common Features of a PFFS plan
You can present your PFFS plan ID card to any provider in the U.S. that accepts Medicare. PFFS plans are popular among Medicare beneficiaries who travel often, for this reason.
When choosing a PFFS plan, you can choose one with a built-in drug plan, or you can choose a “medical only” PFFS plan and enroll in a separate Part D drug plan.
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