With so many different Medicare plans to choose from, it is often difficult to make sense of which plan does what and more importantly, which plan meets your particular coverage needs. In this article, we will exam Private Fee-for-Service Plans, which may be something you want to consider if Original Medicare Part A and Part B do not cover all of your health care needs.
Medicare Fee-for-Service plans are Medicare Advantage Plans that are offered by private insurance companies. Medicare Advantage is sometimes referred to as Medicare Plan C, so be aware that those terms of interchangeable. Private Fee-for-Service plans are not the same as Medigap plans, even though the latter are likewise third-party coverage solutions designed to augment existing Original Medicare coverage. Private Fee-for-Service plans are unique in that the plan itself determines how much doctors, hospitals, and other health care providers will be paid as a result of their services. The plan also determines how much you must pay for this care.
You can choose your own doctor
Private Fee-for-Service plans also differ from other Medicare plans by allowing you to choose any doctor, health care specialist, or hospital from which to receive the services you need, rather than restricting you to doctors and hospitals that are approved by Medicare and that function inside of Medicare’s ecosystem. Since it is beyond the scope of this document to specify which doctors or facilities will work with Private Fee-for-Service plans, you must contact your preferred provider and ask if they accept the terms of your particular Private Fee-for-Service plan. You may also join a Private-Fee-for-Service plan that has its own network, in which case you will be able to view information on network providers who have agreed to treat plan members. You can still opt for an out-of-network provider, but you may have to pay higher service costs.
Some Private Fee-for-Service plans offer prescription drug coverage, so again, you should shop around for your ideal plan by contacting your local health insurance providers. If your preferred Private Fee-for-Service plan does not cover prescription drugs, you can join a Medicare Prescription Drug plan to get supplementary coverage.
Since each Private Fee-for-Service plan is different, there are many considerations to take into account when deciding if they are right for you. You can find answers to many frequently asked questions about Private Fee-for-Service, including information about co-payments, co-insurance, and the likelihood of being treated by out-of-network doctors and specialists. You can also find even more information on the official Medicare site. Medicare stresses that you must “make sure that your doctors, hospitals, and other providers agree to treat you under the plan, and accept the plans payment terms.” You will also be given a plan membership ID card which you will need to furnish instead of your original red, white, and blue Medicare card, so be sure you keep it in a safe place.