If you are shopping for Medicare Advantage plans, you may be curious about the different plan-types that are on the market. Private-fee-for-service plans are typically offered by private insurance providers, and the U.S. government makes this option available to Medicare Advantage buyers as well. If you are interested in what private-fee-for-service plans have to offer, here is what you need to know about how they work.
What Is A Private Fee-For-Service Insurance Plan?
A private fee-for-service (PFFS) plan determines how much it will guarantee doctors and other health care providers. The amount they are willing to pay is listed in the policy contract or negotiated on a case-by-case basis by the policy administrators. The costs for each service will vary depending on the health care provider you see and the PFFS plan you hold and the county and state you live in will determine which plans you have access to.
Benefits of PFFS Medicare Advantage Plans
PFFS plans do not require you to select a primary care physician, therefore you will not need a referral from a physician to see a specialist. Some PFFS plans are also less burdened with network restrictions. This is unlike many other Medicare Advantage plans, which require you to remain in-network for most treatments. Many PFFS plans even allow policyholders to seek services from any Medicare-approved health care provider.
How Does PFFS Pay For Treatment
If you have a PFFS plan, the payment terms they negotiate may change over time. Furthermore, if a health care provider chooses to accept those terms once, they are not required to do so in the future. Whether they are willing to accept the costs set by your PFFS plan is up to them and therefore they have the right to deny your plan’s cost terms even if they have administered you the treatment in the past.
How To Choose A PFFS Plan
If you are shopping for a PFFS plan, you should make sure you understand exactly what benefits you need before you start. For example, not all PFFS plans include prescription drug coverage. If you are sure you will need prescription drug coverage, weigh your options. Sometimes Part D medicare prescription drug coverage may offer you supplemental coverage that your Advantage plan doesn’t.
When choosing your plan you should also think about where you will be able to receive treatment. Ask your plan provider if their policy’s terms are commonly accepted in the area and whether you will have trouble finding health care providers that accept your preferred policy. If you are having trouble understanding which PFFS policy is best for you, speak to an insurance agent.
Finding A PFFS Plan
If you are shopping for a Medicare Advantage plan, you should consider the benefits of a PFFS policy. For assistance, speak to a representative from Cornerstone Senior Advisors. Contact us now for a free quote.