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.