A Medicare PFFS Plan is a type of Medicare Advantage Plan (Part C) offered by a private insurance company. PFFS plans aren’t the same as Original Medicare or Medigap. The plan determines how much it will pay doctors, other health care providers, and hospitals, and how much you must pay when you get care. The PFFS plan:
Need hourly care?
Your local team of Client Care Managers are on call 24/7 to answer your questions and work with you to design a customized plan of care that is right for you.
Private Fee-for-Service (PFFS) Plans
If you join a PFFS Plan that has a contracted network of providers, you can also see any of the network providers who have agreed to always treat plan members. If you go to a doctor, other health care provider, facility, or supplier that doesn’t belong to the plan’s network for non-emergency or non-urgent care services, your plan may not cover your services, or your costs could be higher.
Are prescription drugs covered? Prescription drugs may be covered in PFFS Plans. If your PFFS Plan doesn’t offer drug coverage, you can join a separate Medicare Drug Plan (Part D) to get coverage.
Do you need to choose a primary care doctor?
You don’t need to choose a primary care doctor in PFFS Plans.
