Medicare Advantage private fee–for–service (PFFS) plans are authorized by the Centers for Medicare & Medicaid Services (CMS). A PFFS plan is different than Original Medicare or an HMO, PPO, or Medicare supplement plan.

Private–Fee–For–Service Plans, (PFFS) Plans, give you the ability to choose your health care provider. However not all providers may accept the plan you choose, even Medicare providers may not accept the plan. If you choose one of these plans, it is very important that all the providers you choose know, before providing services to you, that you have this plan’s coverage in place of Medicare. This gives your provider the right to choose whether or not to accept the plan's terms and conditions of payment for treating you. Providers have the right to decide if they will accept the plan each time they see you. This is why you must show your plan’s ID card every time you visit a health care provider.

A provider may decide not to accept your plan’s terms and conditions of payment. If this happens, you will need to find another provider that will. You may contact your plan for assistance locating another provider in your area willing to accept your plan’s terms and conditions of payment.