Question

During a sales presentation in Ms. Sullivan’s home, she tells you that she has heard about a type of Medicare health plan known as Private Fee-for- Service (PFFS). She wants to know if this would be available to her. What should you tell her about PFFS plans? Choose one answer. a. Original Medicare and PFFS plans are essentially the same thing. b. PFFS plans are a type of Medicare Advantage plan offered by private companies. c. PFFS is a form of supplemental coverage that fills in the gaps where Original Medicare leaves off. d. PFFS plans primarily cover drugs that Original FFS Medicare does not cover.

Answer 1

Private Fee-for-Service (PFFS) plans are a type of Medicare Advantage plan offered by private companies, not the government. They differ from Original Medicare (Parts A & B). Option D.

Step-by-step explanation:

Private Fee-for-Service (PFFS) plans are a type of Medicare Advantage Plan. They are offered by private companies, rather than the government. If Ms. Sullivan qualifies for Medicare, then yes, she would potentially be eligible for a PFFS plan.

It's important to note that these plans don’t have to follow Original Medicare services’ costing; providers are paid by the plan whether network-based or not.

Original Medicare includes Part A (Hospital Insurance) and Part B (Medical Insurance), covering hospital stays, care in a skilled nursing facility, hospice care, and some home health care (Part A), and certain doctors’ services, outpatient care, medical supplies, and preventive services (Part B).

However, a PFFS plan determines how much it will pay providers and how much the patient must pay when care is received. So, while they're part of Medicare, they function differently to Original Medicare.

Learn more about Private Fee-for-Service