Is a PCP required to be selected in a PFFS plan?

In a Private Fee-for-Service (PFFS) plan, selecting a primary care provider (PCP) is not a requirement. PFFS plans offer more flexibility compared to other types of Medicare Advantage plans, allowing members to seek care from any Medicare-approved provider who agrees to the plan's terms. This means that beneficiaries are not bound to a specific PCP and can choose to see specialists or different providers without needing referrals or a designated primary care physician.

This characteristic of PFFS plans differentiates them from Health Maintenance Organizations (HMOs) or Preferred Provider Organizations (PPOs), where having a designated PCP is typically necessary. The absence of a PCP requirement in PFFS plans aligns with the plans' design to empower members with more autonomy in managing their healthcare services.