What are Private Fee-For-Service plans and how are they different from other Medicare Advantage plans?
Historically, all Medicare Advantage plans were managed care products, under which beneficiaries were limited, at least to some extent, to a specific network of providers. The biggest difference between Private Fee-For-Service plans and other Medicare Advantage plans is that in Private Fee-For- Service plans, a beneficiary is free to seek services from any provider who is willing to accept the plan s terms and conditions of payment. Plans are required to provide their terms and conditions on their Web site. If a provider does not agree to accept the terms of the fee-for-service plan, the provider may not provide health care services to the patient, except in the case of an emergency. In Private Fee-For-Service plans, patients do not need to designate a primary care physician, nor do they need a referral to see a specialist. By law, Private Fee-For-Service plans must provide enrollees with the same benefits they would receive under traditional Medicare. Lastly, it is important to note t
