PFFS Medicare plans allow you to see any willing provider but ONLY IF that medical provider accepts the terms and pricing structure offered by your PFFS Medicare Advantage plan.
- For each medical service (including lab, X-ray, etc.) the provider must accept whatever limits your PFFS carrier places on the treatment plan
- If the doctor or medical provider does not agree to the terms your medical procedure is not a covered expense and you must pay out of pocket
- To avoid any penalty, you need to check with each provider BEFORE services are rendered, to see if they still agree to the terms and payment limits of your PFFS Advantage plan
- You cannot assume that a doctor or service that was covered in the past will be covered the next time
- Some PFFS plans require you to pay a copay every time you see a doctor or receive a medical service
- Some PFFS plans have a network just like PPO plans. If you use a non-par provider you pay a penalty.
Bob Vineyard, President of Georgia Medicare Plans, has decided to specialize in GA Medigap plans. We believe the flexibility and overall VALUE of original Medicare and a Medicare supplement plan are superior to the Advantage plans currently on the market. We invite you to compare GA Medigap quotes using our instant online quote engine or ask for a free, no obligation consult.