Medicare Advantage PFFS

Carolina Insurance partners is your local medicare insurance broker

What Is Medicare PFFS?

A Medicare PFFS plan is a private fee for service plan. This means that you will pay the premiums associated with the plan, as well as co-pays and coinsurance for medical services. The main difference between this plan and the HMO and PPO plans is that you aren’t limited to a certain network of healthcare providers.

Instead, you must present your PFFS plan ID card to your provider before accepting medical care. That provider must then agree to accept the plan’s terms and conditions and bill the plan. For this reason, PFFS plans are popular with people who travel frequently. However, keep in mind that providers who are not contracted with the plan are not required to provide service except in an emergency.

What You Need to Know Before You Enroll

You can present your PFFS ID card to any Medicare-participating provider in the United States and ask if they’ll treat you.

You can choose a PFFS plan with a built-in drug plan or opt for a separate drug plan.

Have more questions about PFFS plans and whether one would be a good fit for you? Reach out to our agents today to start a discussion and learn more.

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