Medicare Private Fee for Services # 10144
Medicare Private Fee for Services # 10144

Private Fee-for-Service (PFFS) Plans

A Medicare Private Fee-for-Service Plan is a Medicare Advantage Plan offered by a private insurance company. In a Medicare Private Fee-for-Service Plan,  Medicare pays a set amount of money every month to the private insurance company to provide health care coverage to people with Medicare on a fee-for-service arrangement. Also, the insurance company, rather than the Medicare Program, decides how much you pay for the services you get.  * Publication 10144  * 

  • PFFS enrollees may receive covered services from any provider in the U.S. who is eligible to provide Medicare services and agrees to accept the plan’s terms and conditions of payment.
  • Some PFFS plans contract with network provider.  If the PFFS plan has a network, enrollees may pay more if they see out-of-network providers.
  • Except for emergencies, enrollees must inform providers before receiving services that they are PFFS plan members so the non-network providers can decide whether to accept the plan’s terms and conditions.
  • Non-network providers may, on a patient-by-patient, and visit-by-visit basis decide whether to treat the beneficiary.
  • Non-network providers that accept Original Medicare may choose not to accept PFFS plan enrollees.

I’m not aware of any in CA

Resources

Medicare.Gov

Publication 10144  Private Fee for Service

 

Check out ALL Medicare Plans - We won't be your broker, but do get a referral fee
Check out ALL Medicare Plans – We won’t be your broker, but do get a referral fee

 

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