A Medicare PFFS (Private Fee-for-Service) plan is a type of Medicare Advantage plan that allows you to receive care without being restricted to a provider network. With a PFFS plan, you pay the plan’s premiums along with applicable copayments and coinsurance for covered services.

Unlike HMO or PPO plans, PFFS plans do not rely on a defined network of doctors or hospitals. Instead, you present your PFFS plan ID card to a provider before receiving care. The provider must agree to the plan’s terms and payment conditions in order to treat you. Because of this flexibility, PFFS plans are often a good option for individuals who travel frequently. However, providers who are not contracted with the plan are not required to accept the plan, except in emergency situations.

• You may present your PFFS ID card to any Medicare-participating provider in the U.S. and ask if they will accept the plan.
• PFFS plans may include prescription drug coverage, or you may choose a separate Part D plan.
• If you have questions about whether a Medicare PFFS plan is right for you, contact our agents to discuss your options and learn more.