What Is A Medicare Private-Fee-For-Service Plan? Should You Join A Medicare PFFS Plan?

What is a Medicare Private Fee-for Service plan? This video answers that question, discusses how a PFFS plan works and why you may or may not want to enroll in one.

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A Medicare Private Fee-for Service plan (PFFS) is a Medicare Advantage Plan. As with any Medicare Advantage Plan, when you join a Medicare Private Fee-for-Service plan you are subject to the enrollment periods, must have Medicare Parts A and B, live in the plans service area and not have end-stage renal disease.

Plans may or may not include Part D coverage and will often include ancillary benefits like dental and vision.

Unlike a Medicare HMO or Medicare PPO, you are not required to use a provider network when you are enrolled in a Medicare Private Fee-for-Service plan. You can choose any provider that will accept the plan's terms and conditions.

But this freedom to choose any provider comes with a cost. Providers can choose to accept Medicare PFFS plans on a visit-by-visit basis. You may not be able to keep the same provider throughout the year.

You need to be aware of this when deciding whether or not you will enroll in a Medicare Private Fee-for-Service plan.


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