c. Private fee for service plans

Official source

An MA private fee-for-service plan is an MA plan that pays providers of services at a rate determined by the plan on a fee-for-service basis without placing the provider at financial risk. A PFFS plan does not vary the rates for a provider based on the utilization of that provider's services, and does not restrict enrollees' choices among providers that are lawfully authorized to provide services and agree to accept the plan's terms and conditions of payment.

Enrollees in a PFFS plan are not limited to a provider network. Members of a PFFS plan can go to any doctor or hospital in the U.S. that is eligible to be paid by Medicare and is willing to accept the plan’s terms of payment. However, if the PFFS has a network of providers, the enrollee’s cost-sharing may be higher if the enrollee seeks care from non-network providers.

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c. Private fee for service plans

Official source

An MA private fee-for-service plan is an MA plan that pays providers of services at a rate determined by the plan on a fee-for-service basis without placing the provider at financial risk. A PFFS plan does not vary the rates for a provider based on the utilization of that provider's services, and does not restrict enrollees' choices among providers that are lawfully authorized to provide services and agree to accept the plan's terms and conditions of payment.

Enrollees in a PFFS plan are not limited to a provider network. Members of a PFFS plan can go to any doctor or hospital in the U.S. that is eligible to be paid by Medicare and is willing to accept the plan’s terms of payment. However, if the PFFS has a network of providers, the enrollee’s cost-sharing may be higher if the enrollee seeks care from non-network providers.