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Medical ExpenseVerified · outline & fact-checked · Sep 2026Difficulty 3/5

A Private Fee-for-Service (PFFS) Medicare Advantage plan differs from other MA plan types because it:

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Answer & full 3-part explanation (select an option above, or peek)

Why A is correct

A Private Fee-for-Service plan is a type of Medicare Advantage plan that sets its own payment amounts and terms and pays providers on a fee-for-service basis. A provider may treat the member if the provider agrees to accept the plan's terms and payment schedule for that service — even without a formal network contract. Members are not tied to a gatekeeper or referral process. PFFS plans must cover all Original Medicare benefits, and their network-less provider model is what distinguishes them from HMO, PPO, and SNP products under Part C.

Why the other options are wrong

  • B) Requiring a single primary care physician gatekeeper describes an HMO-type MA plan, not a PFFS plan, so this option transplants the HMO model onto the wrong product.
  • C) A PFFS plan is comprehensive medical coverage under Medicare Advantage, not a discount card, so this option mistakes a full plan for a limited discount product.
  • D) PFFS members face normal Medicare cost-sharing and the plan's own terms; the payment schedule is set by the plan, and members do share costs, so this option is wrong on both points.

Memory hook

PFFS = the MA plan that lets providers decide case by case: accept the terms, treat the member, no network card needed.

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