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 Advantage plan
- You cannot assume that a doctor or service that was covered in the past will be covered the next time
- Some Advantage 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.
