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What is Medicare-Question
What is a PFFS plan?

Answer to What is Medicare question
A private fee-for-service plan (PFFS) is a type of Medicare Advantage plan. 

These plans in urban areas must establish a network of providers.  PFFS plans in rural areas do not have to set up networks

Even though there may be a network available, those who elect a PFFS plan do not have to use those services. They can see any Medicare-approved provider who has agreed to accept the plan’s terms and conditions of payment. However, these services can cost more than in-network care. A PFFS plan cannot require prior authorization of services.

Those with this coverage do not need to choose a primary care doctor. 

A PFFS plan include prescription drug coverage. If the plan does not offer this coverage, the beneficiary can purchase a stand-alone Part D drug plan. 


Last updated: 06-24-2015