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A Medicare Advantage Private Fee-for-Service plan, or PFFS, may be more flexible than some Medicare Advantage plans, both for you and for the plan itself.
When you’re enrolled in any kind of Medicare Advantage plan — including a Private Fee-for-Service plan– you’re still enrolled in the Medicare program. Medicare Advantage plans must include all Original Medicare (Part A and Part B) benefits except hospice care, which is still covered under Part A. Available from private, Medicare-approved insurance companies, Medicare Advantage plans often include extra benefits, such as prescription drug coverage.
If you enroll in a Medicare Advantage PFFS plan, generally you can go to any Medicare-approved doctor or hospital that accepts the plan’s payment terms and agrees to treat you. Not all health-care providers accept Medicare Advantage PFFS plans, but if your PFFS plan has its own network, you can see any of the health care providers affiliated with that particular network. In addition, some Medicare Advantage PFFS plans may let you go out-of-network for certain services, but usually for a higher cost.
Here are some common questions and answers about PFFS plans:
|Are prescription drugs covered?||Sometimes. If your Medicare Advantage PFFS plan doesn’t offer prescription drug coverage, you can enroll in a Medicare Part D Prescription Drug Plan to get coverage.|
|Do I need to choose a primary care doctor?||No.|
|Do I have to get a referral to see a specialist?||No.|
eHealth's Medicare website is operated by eHealthInsurance Services, Inc., a licensed health insurance agency doing business as eHealth. The purpose of this site is the solicitation of insurance. Contact may be made by an insurance agent/producer or insurance company. eHealth and Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. We offer plans from a number of insurance companies.