With a PFFS plan, can a member seek treatment from any Medicare eligible provider?

A PFFS, or Private Fee-for-Service, plan allows members to seek treatment from any Medicare-eligible provider who agrees to the terms and conditions set by the PFFS plan. This means that as long as the provider is willing to accept the plan's payment structure and follows its rules, the member has the flexibility to receive care from nearly any provider who is eligible for Medicare.

This is a key characteristic of PFFS plans, distinguishing them from other types of Medicare Advantage plans that may have more restrictive provider networks or requirements. The provider's agreement to the plan’s conditions is vital, as it allows the member the freedom of choice while ensuring that the billing and payment processes are understood and accepted by both the member and provider.

The other responses suggesting restrictions, such as requiring referrals or limiting options to in-network providers, do not apply to PFFS plans, which are intended to offer members a broader range of choices regarding their healthcare providers.