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Are Medicare Advantage PFFS plans for you?
By Ron Griffin
Hometown Weekly Correspondent
Just three years ago Harvard Pilgrim introduced the first PFFS to Massachusetts Medicare seniors. That concept has grown in popularity with both patients and doctors. For 2009 there will be twenty Medicare PFFS plans to choose from in Massachusetts. Every major medical provider now offers at least one PFFS plan. Is a PFFS plan in your future?
PFFS stands for “Private Fee for Service”. These are Medicare Advantage plans, which are Medicare; approved medical plans offered by private companies as an alternative to traditional Medicare. Yes, choosing a Medicare Advantage plan un-enrolls you from Medicare. You will still continue to pay your Medicare Part B premium of $96.40 per month but you’ll get ALL your medical services from the Medicare Advantage Plan that you chose.
Medicare Advantage plans most often provide more coverage than Medicare. Some include dental, while most include physicals and eye exams and many help pay for gym memberships and weight loss programs.
Many seniors are familiar with other Medicare Advantage plans called HMO’s and PPOs’. HMO’s require that you to get your care through network doctors and hospitals. PPO’s offer the flexibility of getting your care through in-network as well as out-of-network doctors and hospitals. You’ll just pay higher co-pay’s for using doctors outside the network. PFFS plans let you receive services from any health care provider who agrees to the terms of the plan.
That statement is the attraction for PFFS plans but it is often promoted out of context. It does not say you can go to any doctor, it says you can go to any doctor who agrees to accept the plans payment terms. Nationwide PFFS plans have come under scrutiny for marketing schemes designed to confuse, mislead or defraud beneficiaries.
When enrolling you’ll notice several confirmations are required assuring you understand that not all doctors accept the plans terms. That’s because if you can’t find a doctor who will accept the plans payment terms, you essentially have useless insurance. Unlike HMO’s who have a list of doctors who accept their insurance, there isn’t any list for PFFS plan doctors. You’ll have to seek out and find a doctor and facility that will accept the PFFS plans payment.
Is that so difficult? Perhaps not as more and more doctors outsource their billing process to agencies that are familiar with multiple insurance providers. Doctors with a small billing staff just can’t keep up with all the different filing requirements of each company. The doctor after all does deserve to get paid so if the process to file for payment is easy and the payment to him quick he’ll be a pretty excited. Then again, if the process to submit for payment is time consuming or the doctor has to submit it multiple times resulting in delaying his payment, he’ll want to avoid that plan.
Of course doctors also care how much they get paid for a service. Doctors accept Medicare not because of its generous payment but because excluding Medicare patients exclude too many patients. Still doctors know exactly how much Medicare will pay for each service they provide. HMO’s, PPO’s and PFFS’s may pay differently, being less, the same or the preferred option more.
The other attraction of PFFS plans is that they are cheap. Three plans are offered for under $40 per month, which includes prescription coverage. Cheap may be a passing factor as all these companies compete for new members.
Before choosing a PFFS plan, call your doctors and facilities where you receive your care. If they do not accept the PFFS plan your considering ask why. It may be because they never heard of the plan or haven’t had any experience with it. Perhaps the Doctor can be encouraged to try it; after all he may like it. The PFFS plans terms for payments are generally available to the doctor for review on the Internet.
Then again, maybe the doctor already had an experience he prefers not to repeat. Remember there isn’t any contract between a PFFS plan and the doctor. That doctor is free to accept or refuse the PFFS plans terms on a case-by-case basis as well as on a patient-to-patient basis.
Lastly you should know there is thousands of satisfied seniors in Massachusetts who are currently enrolled in PFFS plans. If your not satisfied with any Medicare plan, you have an opportunity to reconsider your choice every year.
Are Medicare Advantage PFFS plans for you?
By Ron Griffin
Hometown Weekly Correspondent
Just three years ago Harvard Pilgrim introduced the first PFFS to Massachusetts Medicare seniors. That concept has grown in popularity with both patients and doctors. For 2009 there will be twenty Medicare PFFS plans to choose from in Massachusetts. Every major medical provider now offers at least one PFFS plan. Is a PFFS plan in your future?
PFFS stands for “Private Fee for Service”. These are Medicare Advantage plans, which are Medicare; approved medical plans offered by private companies as an alternative to traditional Medicare. Yes, choosing a Medicare Advantage plan un-enrolls you from Medicare. You will still continue to pay your Medicare Part B premium of $96.40 per month but you’ll get ALL your medical services from the Medicare Advantage Plan that you chose.
Medicare Advantage plans most often provide more coverage than Medicare. Some include dental, while most include physicals and eye exams and many help pay for gym memberships and weight loss programs.
Many seniors are familiar with other Medicare Advantage plans called HMO’s and PPOs’. HMO’s require that you to get your care through network doctors and hospitals. PPO’s offer the flexibility of getting your care through in-network as well as out-of-network doctors and hospitals. You’ll just pay higher co-pay’s for using doctors outside the network. PFFS plans let you receive services from any health care provider who agrees to the terms of the plan.
That statement is the attraction for PFFS plans but it is often promoted out of context. It does not say you can go to any doctor, it says you can go to any doctor who agrees to accept the plans payment terms. Nationwide PFFS plans have come under scrutiny for marketing schemes designed to confuse, mislead or defraud beneficiaries.
When enrolling you’ll notice several confirmations are required assuring you understand that not all doctors accept the plans terms. That’s because if you can’t find a doctor who will accept the plans payment terms, you essentially have useless insurance. Unlike HMO’s who have a list of doctors who accept their insurance, there isn’t any list for PFFS plan doctors. You’ll have to seek out and find a doctor and facility that will accept the PFFS plans payment.
Is that so difficult? Perhaps not as more and more doctors outsource their billing process to agencies that are familiar with multiple insurance providers. Doctors with a small billing staff just can’t keep up with all the different filing requirements of each company. The doctor after all does deserve to get paid so if the process to file for payment is easy and the payment to him quick he’ll be a pretty excited. Then again, if the process to submit for payment is time consuming or the doctor has to submit it multiple times resulting in delaying his payment, he’ll want to avoid that plan.
Of course doctors also care how much they get paid for a service. Doctors accept Medicare not because of its generous payment but because excluding Medicare patients exclude too many patients. Still doctors know exactly how much Medicare will pay for each service they provide. HMO’s, PPO’s and PFFS’s may pay differently, being less, the same or the preferred option more.
The other attraction of PFFS plans is that they are cheap. Three plans are offered for under $40 per month, which includes prescription coverage. Cheap may be a passing factor as all these companies compete for new members.
Before choosing a PFFS plan, call your doctors and facilities where you receive your care. If they do not accept the PFFS plan your considering ask why. It may be because they never heard of the plan or haven’t had any experience with it. Perhaps the Doctor can be encouraged to try it; after all he may like it. The PFFS plans terms for payments are generally available to the doctor for review on the Internet.
Then again, maybe the doctor already had an experience he prefers not to repeat. Remember there isn’t any contract between a PFFS plan and the doctor. That doctor is free to accept or refuse the PFFS plans terms on a case-by-case basis as well as on a patient-to-patient basis.
Lastly you should know there is thousands of satisfied seniors in Massachusetts who are currently enrolled in PFFS plans. If your not satisfied with any Medicare plan, you have an opportunity to reconsider your choice every year.
Are Medicare Advantage PFFS plans for you?
By Ron Griffin
Hometown Weekly Correspondent
Just three years ago Harvard Pilgrim introduced the first PFFS to Massachusetts Medicare seniors. That concept has grown in popularity with both patients and doctors. For 2009 there will be twenty Medicare PFFS plans to choose from in Massachusetts. Every major medical provider now offers at least one PFFS plan. Is a PFFS plan in your future?
PFFS stands for “Private Fee for Service”. These are Medicare Advantage plans, which are Medicare; approved medical plans offered by private companies as an alternative to traditional Medicare. Yes, choosing a Medicare Advantage plan un-enrolls you from Medicare. You will still continue to pay your Medicare Part B premium of $96.40 per month but you’ll get ALL your medical services from the Medicare Advantage Plan that you chose.
Medicare Advantage plans most often provide more coverage than Medicare. Some include dental, while most include physicals and eye exams and many help pay for gym memberships and weight loss programs.
Many seniors are familiar with other Medicare Advantage plans called HMO’s and PPOs’. HMO’s require that you to get your care through network doctors and hospitals. PPO’s offer the flexibility of getting your care through in-network as well as out-of-network doctors and hospitals. You’ll just pay higher co-pay’s for using doctors outside the network. PFFS plans let you receive services from any health care provider who agrees to the terms of the plan.
That statement is the attraction for PFFS plans but it is often promoted out of context. It does not say you can go to any doctor, it says you can go to any doctor who agrees to accept the plans payment terms. Nationwide PFFS plans have come under scrutiny for marketing schemes designed to confuse, mislead or defraud beneficiaries.
When enrolling you’ll notice several confirmations are required assuring you understand that not all doctors accept the plans terms. That’s because if you can’t find a doctor who will accept the plans payment terms, you essentially have useless insurance. Unlike HMO’s who have a list of doctors who accept their insurance, there isn’t any list for PFFS plan doctors. You’ll have to seek out and find a doctor and facility that will accept the PFFS plans payment.
Is that so difficult? Perhaps not as more and more doctors outsource their billing process to agencies that are familiar with multiple insurance providers. Doctors with a small billing staff just can’t keep up with all the different filing requirements of each company. The doctor after all does deserve to get paid so if the process to file for payment is easy and the payment to him quick he’ll be a pretty excited. Then again, if the process to submit for payment is time consuming or the doctor has to submit it multiple times resulting in delaying his payment, he’ll want to avoid that plan.
Of course doctors also care how much they get paid for a service. Doctors accept Medicare not because of its generous payment but because excluding Medicare patients exclude too many patients. Still doctors know exactly how much Medicare will pay for each service they provide. HMO’s, PPO’s and PFFS’s may pay differently, being less, the same or the preferred option more.
The other attraction of PFFS plans is that they are cheap. Three plans are offered for under $40 per month, which includes prescription coverage. Cheap may be a passing factor as all these companies compete for new members.
Before choosing a PFFS plan, call your doctors and facilities where you receive your care. If they do not accept the PFFS plan your considering ask why. It may be because they never heard of the plan or haven’t had any experience with it. Perhaps the Doctor can be encouraged to try it; after all he may like it. The PFFS plans terms for payments are generally available to the doctor for review on the Internet.
Then again, maybe the doctor already had an experience he prefers not to repeat. Remember there isn’t any contract between a PFFS plan and the doctor. That doctor is free to accept or refuse the PFFS plans terms on a case-by-case basis as well as on a patient-to-patient basis.
Lastly you should know there is thousands of satisfied seniors in Massachusetts who are currently enrolled in PFFS plans. If your not satisfied with any Medicare plan, you have an opportunity to reconsider your choice every year.
Are Medicare Advantage PFFS plans for you?
By Ron Griffin
Hometown Weekly Correspondent
Just three years ago Harvard Pilgrim introduced the first PFFS to Massachusetts Medicare seniors. That concept has grown in popularity with both patients and doctors. For 2009 there will be twenty Medicare PFFS plans to choose from in Massachusetts. Every major medical provider now offers at least one PFFS plan. Is a PFFS plan in your future?
PFFS stands for “Private Fee for Service”. These are Medicare Advantage plans, which are Medicare; approved medical plans offered by private companies as an alternative to traditional Medicare. Yes, choosing a Medicare Advantage plan un-enrolls you from Medicare. You will still continue to pay your Medicare Part B premium of $96.40 per month but you’ll get ALL your medical services from the Medicare Advantage Plan that you chose.
Medicare Advantage plans most often provide more coverage than Medicare. Some include dental, while most include physicals and eye exams and many help pay for gym memberships and weight loss programs.
Many seniors are familiar with other Medicare Advantage plans called HMO’s and PPOs’. HMO’s require that you to get your care through network doctors and hospitals. PPO’s offer the flexibility of getting your care through in-network as well as out-of-network doctors and hospitals. You’ll just pay higher co-pay’s for using doctors outside the network. PFFS plans let you receive services from any health care provider who agrees to the terms of the plan.
That statement is the attraction for PFFS plans but it is often promoted out of context. It does not say you can go to any doctor, it says you can go to any doctor who agrees to accept the plans payment terms. Nationwide PFFS plans have come under scrutiny for marketing schemes designed to confuse, mislead or defraud beneficiaries.
When enrolling you’ll notice several confirmations are required assuring you understand that not all doctors accept the plans terms. That’s because if you can’t find a doctor who will accept the plans payment terms, you essentially have useless insurance. Unlike HMO’s who have a list of doctors who accept their insurance, there isn’t any list for PFFS plan doctors. You’ll have to seek out and find a doctor and facility that will accept the PFFS plans payment.
Is that so difficult? Perhaps not as more and more doctors outsource their billing process to agencies that are familiar with multiple insurance providers. Doctors with a small billing staff just can’t keep up with all the different filing requirements of each company. The doctor after all does deserve to get paid so if the process to file for payment is easy and the payment to him quick he’ll be a pretty excited. Then again, if the process to submit for payment is time consuming or the doctor has to submit it multiple times resulting in delaying his payment, he’ll want to avoid that plan.
Of course doctors also care how much they get paid for a service. Doctors accept Medicare not because of its generous payment but because excluding Medicare patients exclude too many patients. Still doctors know exactly how much Medicare will pay for each service they provide. HMO’s, PPO’s and PFFS’s may pay differently, being less, the same or the preferred option more.
The other attraction of PFFS plans is that they are cheap. Three plans are offered for under $40 per month, which includes prescription coverage. Cheap may be a passing factor as all these companies compete for new members.
Before choosing a PFFS plan, call your doctors and facilities where you receive your care. If they do not accept the PFFS plan your considering ask why. It may be because they never heard of the plan or haven’t had any experience with it. Perhaps the Doctor can be encouraged to try it; after all he may like it. The PFFS plans terms for payments are generally available to the doctor for review on the Internet.
Then again, maybe the doctor already had an experience he prefers not to repeat. Remember there isn’t any contract between a PFFS plan and the doctor. That doctor is free to accept or refuse the PFFS plans terms on a case-by-case basis as well as on a patient-to-patient basis.
Lastly you should know there is thousands of satisfied seniors in Massachusetts who are currently enrolled in PFFS plans. If your not satisfied with any Medicare plan, you have an opportunity to reconsider your choice every year.
Are Medicare Advantage PFFS plans for you?
By Ron Griffin
Hometown Weekly Correspondent
Just three years ago Harvard Pilgrim introduced the first PFFS to Massachusetts Medicare seniors. That concept has grown in popularity with both patients and doctors. For 2009 there will be twenty Medicare PFFS plans to choose from in Massachusetts. Every major medical provider now offers at least one PFFS plan. Is a PFFS plan in your future?
PFFS stands for “Private Fee for Service”. These are Medicare Advantage plans, which are Medicare; approved medical plans offered by private companies as an alternative to traditional Medicare. Yes, choosing a Medicare Advantage plan un-enrolls you from Medicare. You will still continue to pay your Medicare Part B premium of $96.40 per month but you’ll get ALL your medical services from the Medicare Advantage Plan that you chose.
Medicare Advantage plans most often provide more coverage than Medicare. Some include dental, while most include physicals and eye exams and many help pay for gym memberships and weight loss programs.
Many seniors are familiar with other Medicare Advantage plans called HMO’s and PPOs’. HMO’s require that you to get your care through network doctors and hospitals. PPO’s offer the flexibility of getting your care through in-network as well as out-of-network doctors and hospitals. You’ll just pay higher co-pay’s for using doctors outside the network. PFFS plans let you receive services from any health care provider who agrees to the terms of the plan.
That statement is the attraction for PFFS plans but it is often promoted out of context. It does not say you can go to any doctor, it says you can go to any doctor who agrees to accept the plans payment terms. Nationwide PFFS plans have come under scrutiny for marketing schemes designed to confuse, mislead or defraud beneficiaries.
When enrolling you’ll notice several confirmations are required assuring you understand that not all doctors accept the plans terms. That’s because if you can’t find a doctor who will accept the plans payment terms, you essentially have useless insurance. Unlike HMO’s who have a list of doctors who accept their insurance, there isn’t any list for PFFS plan doctors. You’ll have to seek out and find a doctor and facility that will accept the PFFS plans payment.
Is that so difficult? Perhaps not as more and more doctors outsource their billing process to agencies that are familiar with multiple insurance providers. Doctors with a small billing staff just can’t keep up with all the different filing requirements of each company. The doctor after all does deserve to get paid so if the process to file for payment is easy and the payment to him quick he’ll be a pretty excited. Then again, if the process to submit for payment is time consuming or the doctor has to submit it multiple times resulting in delaying his payment, he’ll want to avoid that plan.
Of course doctors also care how much they get paid for a service. Doctors accept Medicare not because of its generous payment but because excluding Medicare patients exclude too many patients. Still doctors know exactly how much Medicare will pay for each service they provide. HMO’s, PPO’s and PFFS’s may pay differently, being less, the same or the preferred option more.
The other attraction of PFFS plans is that they are cheap. Three plans are offered for under $40 per month, which includes prescription coverage. Cheap may be a passing factor as all these companies compete for new members.
Before choosing a PFFS plan, call your doctors and facilities where you receive your care. If they do not accept the PFFS plan your considering ask why. It may be because they never heard of the plan or haven’t had any experience with it. Perhaps the Doctor can be encouraged to try it; after all he may like it. The PFFS plans terms for payments are generally available to the doctor for review on the Internet.
Then again, maybe the doctor already had an experience he prefers not to repeat. Remember there isn’t any contract between a PFFS plan and the doctor. That doctor is free to accept or refuse the PFFS plans terms on a case-by-case basis as well as on a patient-to-patient basis.
Lastly you should know there is thousands of satisfied seniors in Massachusetts who are currently enrolled in PFFS plans. If your not satisfied with any Medicare plan, you have an opportunity to reconsider your choice every year.
Are Medicare Advantage PFFS plans for you?
By Ron Griffin
Hometown Weekly Correspondent
Just three years ago Harvard Pilgrim introduced the first PFFS to Massachusetts Medicare seniors. That concept has grown in popularity with both patients and doctors. For 2009 there will be twenty Medicare PFFS plans to choose from in Massachusetts. Every major medical provider now offers at least one PFFS plan. Is a PFFS plan in your future?
PFFS stands for “Private Fee for Service”. These are Medicare Advantage plans, which are Medicare; approved medical plans offered by private companies as an alternative to traditional Medicare. Yes, choosing a Medicare Advantage plan un-enrolls you from Medicare. You will still continue to pay your Medicare Part B premium of $96.40 per month but you’ll get ALL your medical services from the Medicare Advantage Plan that you chose.
Medicare Advantage plans most often provide more coverage than Medicare. Some include dental, while most include physicals and eye exams and many help pay for gym memberships and weight loss programs.
Many seniors are familiar with other Medicare Advantage plans called HMO’s and PPOs’. HMO’s require that you to get your care through network doctors and hospitals. PPO’s offer the flexibility of getting your care through in-network as well as out-of-network doctors and hospitals. You’ll just pay higher co-pay’s for using doctors outside the network. PFFS plans let you receive services from any health care provider who agrees to the terms of the plan.
That statement is the attraction for PFFS plans but it is often promoted out of context. It does not say you can go to any doctor, it says you can go to any doctor who agrees to accept the plans payment terms. Nationwide PFFS plans have come under scrutiny for marketing schemes designed to confuse, mislead or defraud beneficiaries.
When enrolling you’ll notice several confirmations are required assuring you understand that not all doctors accept the plans terms. That’s because if you can’t find a doctor who will accept the plans payment terms, you essentially have useless insurance. Unlike HMO’s who have a list of doctors who accept their insurance, there isn’t any list for PFFS plan doctors. You’ll have to seek out and find a doctor and facility that will accept the PFFS plans payment.
Is that so difficult? Perhaps not as more and more doctors outsource their billing process to agencies that are familiar with multiple insurance providers. Doctors with a small billing staff just can’t keep up with all the different filing requirements of each company. The doctor after all does deserve to get paid so if the process to file for payment is easy and the payment to him quick he’ll be a pretty excited. Then again, if the process to submit for payment is time consuming or the doctor has to submit it multiple times resulting in delaying his payment, he’ll want to avoid that plan.
Of course doctors also care how much they get paid for a service. Doctors accept Medicare not because of its generous payment but because excluding Medicare patients exclude too many patients. Still doctors know exactly how much Medicare will pay for each service they provide. HMO’s, PPO’s and PFFS’s may pay differently, being less, the same or the preferred option more.
The other attraction of PFFS plans is that they are cheap. Three plans are offered for under $40 per month, which includes prescription coverage. Cheap may be a passing factor as all these companies compete for new members.
Before choosing a PFFS plan, call your doctors and facilities where you receive your care. If they do not accept the PFFS plan your considering ask why. It may be because they never heard of the plan or haven’t had any experience with it. Perhaps the Doctor can be encouraged to try it; after all he may like it. The PFFS plans terms for payments are generally available to the doctor for review on the Internet.
Then again, maybe the doctor already had an experience he prefers not to repeat. Remember there isn’t any contract between a PFFS plan and the doctor. That doctor is free to accept or refuse the PFFS plans terms on a case-by-case basis as well as on a patient-to-patient basis.
Lastly you should know there is thousands of satisfied seniors in Massachusetts who are currently enrolled in PFFS plans. If your not satisfied with any Medicare plan, you have an opportunity to reconsider your choice every year.
Are Medicare Advantage PFFS plans for you?
By Ron Griffin
Hometown Weekly Correspondent
Just three years ago Harvard Pilgrim introduced the first PFFS to Massachusetts Medicare seniors. That concept has grown in popularity with both patients and doctors. For 2009 there will be twenty Medicare PFFS plans to choose from in Massachusetts. Every major medical provider now offers at least one PFFS plan. Is a PFFS plan in your future?
PFFS stands for “Private Fee for Service”. These are Medicare Advantage plans, which are Medicare; approved medical plans offered by private companies as an alternative to traditional Medicare. Yes, choosing a Medicare Advantage plan un-enrolls you from Medicare. You will still continue to pay your Medicare Part B premium of $96.40 per month but you’ll get ALL your medical services from the Medicare Advantage Plan that you chose.
Medicare Advantage plans most often provide more coverage than Medicare. Some include dental, while most include physicals and eye exams and many help pay for gym memberships and weight loss programs.
Many seniors are familiar with other Medicare Advantage plans called HMO’s and PPOs’. HMO’s require that you to get your care through network doctors and hospitals. PPO’s offer the flexibility of getting your care through in-network as well as out-of-network doctors and hospitals. You’ll just pay higher co-pay’s for using doctors outside the network. PFFS plans let you receive services from any health care provider who agrees to the terms of the plan.
That statement is the attraction for PFFS plans but it is often promoted out of context. It does not say you can go to any doctor, it says you can go to any doctor who agrees to accept the plans payment terms. Nationwide PFFS plans have come under scrutiny for marketing schemes designed to confuse, mislead or defraud beneficiaries.
When enrolling you’ll notice several confirmations are required assuring you understand that not all doctors accept the plans terms. That’s because if you can’t find a doctor who will accept the plans payment terms, you essentially have useless insurance. Unlike HMO’s who have a list of doctors who accept their insurance, there isn’t any list for PFFS plan doctors. You’ll have to seek out and find a doctor and facility that will accept the PFFS plans payment.
Is that so difficult? Perhaps not as more and more doctors outsource their billing process to agencies that are familiar with multiple insurance providers. Doctors with a small billing staff just can’t keep up with all the different filing requirements of each company. The doctor after all does deserve to get paid so if the process to file for payment is easy and the payment to him quick he’ll be a pretty excited. Then again, if the process to submit for payment is time consuming or the doctor has to submit it multiple times resulting in delaying his payment, he’ll want to avoid that plan.
Of course doctors also care how much they get paid for a service. Doctors accept Medicare not because of its generous payment but because excluding Medicare patients exclude too many patients. Still doctors know exactly how much Medicare will pay for each service they provide. HMO’s, PPO’s and PFFS’s may pay differently, being less, the same or the preferred option more.
The other attraction of PFFS plans is that they are cheap. Three plans are offered for under $40 per month, which includes prescription coverage. Cheap may be a passing factor as all these companies compete for new members.
Before choosing a PFFS plan, call your doctors and facilities where you receive your care. If they do not accept the PFFS plan your considering ask why. It may be because they never heard of the plan or haven’t had any experience with it. Perhaps the Doctor can be encouraged to try it; after all he may like it. The PFFS plans terms for payments are generally available to the doctor for review on the Internet.
Then again, maybe the doctor already had an experience he prefers not to repeat. Remember there isn’t any contract between a PFFS plan and the doctor. That doctor is free to accept or refuse the PFFS plans terms on a case-by-case basis as well as on a patient-to-patient basis.
Lastly you should know there is thousands of satisfied seniors in Massachusetts who are currently enrolled in PFFS plans. If your not satisfied with any Medicare plan, you have an opportunity to reconsider your choice every year.
Are Medicare Advantage PFFS plans for you?
By Ron Griffin
Hometown Weekly Correspondent
Just three years ago Harvard Pilgrim introduced the first PFFS to Massachusetts Medicare seniors. That concept has grown in popularity with both patients and doctors. For 2009 there will be twenty Medicare PFFS plans to choose from in Massachusetts. Every major medical provider now offers at least one PFFS plan. Is a PFFS plan in your future?
PFFS stands for “Private Fee for Service”. These are Medicare Advantage plans, which are Medicare; approved medical plans offered by private companies as an alternative to traditional Medicare. Yes, choosing a Medicare Advantage plan un-enrolls you from Medicare. You will still continue to pay your Medicare Part B premium of $96.40 per month but you’ll get ALL your medical services from the Medicare Advantage Plan that you chose.
Medicare Advantage plans most often provide more coverage than Medicare. Some include dental, while most include physicals and eye exams and many help pay for gym memberships and weight loss programs.
Many seniors are familiar with other Medicare Advantage plans called HMO’s and PPOs’. HMO’s require that you to get your care through network doctors and hospitals. PPO’s offer the flexibility of getting your care through in-network as well as out-of-network doctors and hospitals. You’ll just pay higher co-pay’s for using doctors outside the network. PFFS plans let you receive services from any health care provider who agrees to the terms of the plan.
That statement is the attraction for PFFS plans but it is often promoted out of context. It does not say you can go to any doctor, it says you can go to any doctor who agrees to accept the plans payment terms. Nationwide PFFS plans have come under scrutiny for marketing schemes designed to confuse, mislead or defraud beneficiaries.
When enrolling you’ll notice several confirmations are required assuring you understand that not all doctors accept the plans terms. That’s because if you can’t find a doctor who will accept the plans payment terms, you essentially have useless insurance. Unlike HMO’s who have a list of doctors who accept their insurance, there isn’t any list for PFFS plan doctors. You’ll have to seek out and find a doctor and facility that will accept the PFFS plans payment.
Is that so difficult? Perhaps not as more and more doctors outsource their billing process to agencies that are familiar with multiple insurance providers. Doctors with a small billing staff just can’t keep up with all the different filing requirements of each company. The doctor after all does deserve to get paid so if the process to file for payment is easy and the payment to him quick he’ll be a pretty excited. Then again, if the process to submit for payment is time consuming or the doctor has to submit it multiple times resulting in delaying his payment, he’ll want to avoid that plan.
Of course doctors also care how much they get paid for a service. Doctors accept Medicare not because of its generous payment but because excluding Medicare patients exclude too many patients. Still doctors know exactly how much Medicare will pay for each service they provide. HMO’s, PPO’s and PFFS’s may pay differently, being less, the same or the preferred option more.
The other attraction of PFFS plans is that they are cheap. Three plans are offered for under $40 per month, which includes prescription coverage. Cheap may be a passing factor as all these companies compete for new members.
Before choosing a PFFS plan, call your doctors and facilities where you receive your care. If they do not accept the PFFS plan your considering ask why. It may be because they never heard of the plan or haven’t had any experience with it. Perhaps the Doctor can be encouraged to try it; after all he may like it. The PFFS plans terms for payments are generally available to the doctor for review on the Internet.
Then again, maybe the doctor already had an experience he prefers not to repeat. Remember there isn’t any contract between a PFFS plan and the doctor. That doctor is free to accept or refuse the PFFS plans terms on a case-by-case basis as well as on a patient-to-patient basis.
Lastly you should know there is thousands of satisfied seniors in Massachusetts who are currently enrolled in PFFS plans. If your not satisfied with any Medicare plan, you have an opportunity to reconsider your choice every year.
Are Medicare Advantage PFFS plans for you?
By Ron Griffin
Hometown Weekly Correspondent
Just three years ago Harvard Pilgrim introduced the first PFFS to Massachusetts Medicare seniors. That concept has grown in popularity with both patients and doctors. For 2009 there will be twenty Medicare PFFS plans to choose from in Massachusetts. Every major medical provider now offers at least one PFFS plan. Is a PFFS plan in your future?
PFFS stands for “Private Fee for Service”. These are Medicare Advantage plans, which are Medicare; approved medical plans offered by private companies as an alternative to traditional Medicare. Yes, choosing a Medicare Advantage plan un-enrolls you from Medicare. You will still continue to pay your Medicare Part B premium of $96.40 per month but you’ll get ALL your medical services from the Medicare Advantage Plan that you chose.
Medicare Advantage plans most often provide more coverage than Medicare. Some include dental, while most include physicals and eye exams and many help pay for gym memberships and weight loss programs.
Many seniors are familiar with other Medicare Advantage plans called HMO’s and PPOs’. HMO’s require that you to get your care through network doctors and hospitals. PPO’s offer the flexibility of getting your care through in-network as well as out-of-network doctors and hospitals. You’ll just pay higher co-pay’s for using doctors outside the network. PFFS plans let you receive services from any health care provider who agrees to the terms of the plan.
That statement is the attraction for PFFS plans but it is often promoted out of context. It does not say you can go to any doctor, it says you can go to any doctor who agrees to accept the plans payment terms. Nationwide PFFS plans have come under scrutiny for marketing schemes designed to confuse, mislead or defraud beneficiaries.
When enrolling you’ll notice several confirmations are required assuring you understand that not all doctors accept the plans terms. That’s because if you can’t find a doctor who will accept the plans payment terms, you essentially have useless insurance. Unlike HMO’s who have a list of doctors who accept their insurance, there isn’t any list for PFFS plan doctors. You’ll have to seek out and find a doctor and facility that will accept the PFFS plans payment.
Is that so difficult? Perhaps not as more and more doctors outsource their billing process to agencies that are familiar with multiple insurance providers. Doctors with a small billing staff just can’t keep up with all the different filing requirements of each company. The doctor after all does deserve to get paid so if the process to file for payment is easy and the payment to him quick he’ll be a pretty excited. Then again, if the process to submit for payment is time consuming or the doctor has to submit it multiple times resulting in delaying his payment, he’ll want to avoid that plan.
Of course doctors also care how much they get paid for a service. Doctors accept Medicare not because of its generous payment but because excluding Medicare patients exclude too many patients. Still doctors know exactly how much Medicare will pay for each service they provide. HMO’s, PPO’s and PFFS’s may pay differently, being less, the same or the preferred option more.
The other attraction of PFFS plans is that they are cheap. Three plans are offered for under $40 per month, which includes prescription coverage. Cheap may be a passing factor as all these companies compete for new members.
Before choosing a PFFS plan, call your doctors and facilities where you receive your care. If they do not accept the PFFS plan your considering ask why. It may be because they never heard of the plan or haven’t had any experience with it. Perhaps the Doctor can be encouraged to try it; after all he may like it. The PFFS plans terms for payments are generally available to the doctor for review on the Internet.
Then again, maybe the doctor already had an experience he prefers not to repeat. Remember there isn’t any contract between a PFFS plan and the doctor. That doctor is free to accept or refuse the PFFS plans terms on a case-by-case basis as well as on a patient-to-patient basis.
Lastly you should know there is thousands of satisfied seniors in Massachusetts who are currently enrolled in PFFS plans. If your not satisfied with any Medicare plan, you have an opportunity to reconsider your choice every year.
Are Medicare Advantage PFFS plans for you?
By Ron Griffin
Hometown Weekly Correspondent
Just three years ago Harvard Pilgrim introduced the first PFFS to Massachusetts Medicare seniors. That concept has grown in popularity with both patients and doctors. For 2009 there will be twenty Medicare PFFS plans to choose from in Massachusetts. Every major medical provider now offers at least one PFFS plan. Is a PFFS plan in your future?
PFFS stands for “Private Fee for Service”. These are Medicare Advantage plans, which are Medicare; approved medical plans offered by private companies as an alternative to traditional Medicare. Yes, choosing a Medicare Advantage plan un-enrolls you from Medicare. You will still continue to pay your Medicare Part B premium of $96.40 per month but you’ll get ALL your medical services from the Medicare Advantage Plan that you chose.
Medicare Advantage plans most often provide more coverage than Medicare. Some include dental, while most include physicals and eye exams and many help pay for gym memberships and weight loss programs.
Many seniors are familiar with other Medicare Advantage plans called HMO’s and PPOs’. HMO’s require that you to get your care through network doctors and hospitals. PPO’s offer the flexibility of getting your care through in-network as well as out-of-network doctors and hospitals. You’ll just pay higher co-pay’s for using doctors outside the network. PFFS plans let you receive services from any health care provider who agrees to the terms of the plan.
That statement is the attraction for PFFS plans but it is often promoted out of context. It does not say you can go to any doctor, it says you can go to any doctor who agrees to accept the plans payment terms. Nationwide PFFS plans have come under scrutiny for marketing schemes designed to confuse, mislead or defraud beneficiaries.
When enrolling you’ll notice several confirmations are required assuring you understand that not all doctors accept the plans terms. That’s because if you can’t find a doctor who will accept the plans payment terms, you essentially have useless insurance. Unlike HMO’s who have a list of doctors who accept their insurance, there isn’t any list for PFFS plan doctors. You’ll have to seek out and find a doctor and facility that will accept the PFFS plans payment.
Is that so difficult? Perhaps not as more and more doctors outsource their billing process to agencies that are familiar with multiple insurance providers. Doctors with a small billing staff just can’t keep up with all the different filing requirements of each company. The doctor after all does deserve to get paid so if the process to file for payment is easy and the payment to him quick he’ll be a pretty excited. Then again, if the process to submit for payment is time consuming or the doctor has to submit it multiple times resulting in delaying his payment, he’ll want to avoid that plan.
Of course doctors also care how much they get paid for a service. Doctors accept Medicare not because of its generous payment but because excluding Medicare patients exclude too many patients. Still doctors know exactly how much Medicare will pay for each service they provide. HMO’s, PPO’s and PFFS’s may pay differently, being less, the same or the preferred option more.
The other attraction of PFFS plans is that they are cheap. Three plans are offered for under $40 per month, which includes prescription coverage. Cheap may be a passing factor as all these companies compete for new members.
Before choosing a PFFS plan, call your doctors and facilities where you receive your care. If they do not accept the PFFS plan your considering ask why. It may be because they never heard of the plan or haven’t had any experience with it. Perhaps the Doctor can be encouraged to try it; after all he may like it. The PFFS plans terms for payments are generally available to the doctor for review on the Internet.
Then again, maybe the doctor already had an experience he prefers not to repeat. Remember there isn’t any contract between a PFFS plan and the doctor. That doctor is free to accept or refuse the PFFS plans terms on a case-by-case basis as well as on a patient-to-patient basis.
Lastly you should know there is thousands of satisfied seniors in Massachusetts who are currently enrolled in PFFS plans. If your not satisfied with any Medicare plan, you have an opportunity to reconsider your choice every year.
Are Medicare Advantage PFFS plans for you?
By Ron Griffin
Hometown Weekly Correspondent
Just three years ago Harvard Pilgrim introduced the first PFFS to Massachusetts Medicare seniors. That concept has grown in popularity with both patients and doctors. For 2009 there will be twenty Medicare PFFS plans to choose from in Massachusetts. Every major medical provider now offers at least one PFFS plan. Is a PFFS plan in your future?
PFFS stands for “Private Fee for Service”. These are Medicare Advantage plans, which are Medicare; approved medical plans offered by private companies as an alternative to traditional Medicare. Yes, choosing a Medicare Advantage plan un-enrolls you from Medicare. You will still continue to pay your Medicare Part B premium of $96.40 per month but you’ll get ALL your medical services from the Medicare Advantage Plan that you chose.
Medicare Advantage plans most often provide more coverage than Medicare. Some include dental, while most include physicals and eye exams and many help pay for gym memberships and weight loss programs.
Many seniors are familiar with other Medicare Advantage plans called HMO’s and PPOs’. HMO’s require that you to get your care through network doctors and hospitals. PPO’s offer the flexibility of getting your care through in-network as well as out-of-network doctors and hospitals. You’ll just pay higher co-pay’s for using doctors outside the network. PFFS plans let you receive services from any health care provider who agrees to the terms of the plan.
That statement is the attraction for PFFS plans but it is often promoted out of context. It does not say you can go to any doctor, it says you can go to any doctor who agrees to accept the plans payment terms. Nationwide PFFS plans have come under scrutiny for marketing schemes designed to confuse, mislead or defraud beneficiaries.
When enrolling you’ll notice several confirmations are required assuring you understand that not all doctors accept the plans terms. That’s because if you can’t find a doctor who will accept the plans payment terms, you essentially have useless insurance. Unlike HMO’s who have a list of doctors who accept their insurance, there isn’t any list for PFFS plan doctors. You’ll have to seek out and find a doctor and facility that will accept the PFFS plans payment.
Is that so difficult? Perhaps not as more and more doctors outsource their billing process to agencies that are familiar with multiple insurance providers. Doctors with a small billing staff just can’t keep up with all the different filing requirements of each company. The doctor after all does deserve to get paid so if the process to file for payment is easy and the payment to him quick he’ll be a pretty excited. Then again, if the process to submit for payment is time consuming or the doctor has to submit it multiple times resulting in delaying his payment, he’ll want to avoid that plan.
Of course doctors also care how much they get paid for a service. Doctors accept Medicare not because of its generous payment but because excluding Medicare patients exclude too many patients. Still doctors know exactly how much Medicare will pay for each service they provide. HMO’s, PPO’s and PFFS’s may pay differently, being less, the same or the preferred option more.
The other attraction of PFFS plans is that they are cheap. Three plans are offered for under $40 per month, which includes prescription coverage. Cheap may be a passing factor as all these companies compete for new members.
Before choosing a PFFS plan, call your doctors and facilities where you receive your care. If they do not accept the PFFS plan your considering ask why. It may be because they never heard of the plan or haven’t had any experience with it. Perhaps the Doctor can be encouraged to try it; after all he may like it. The PFFS plans terms for payments are generally available to the doctor for review on the Internet.
Then again, maybe the doctor already had an experience he prefers not to repeat. Remember there isn’t any contract between a PFFS plan and the doctor. That doctor is free to accept or refuse the PFFS plans terms on a case-by-case basis as well as on a patient-to-patient basis.
Lastly you should know there is thousands of satisfied seniors in Massachusetts who are currently enrolled in PFFS plans. If your not satisfied with any Medicare plan, you have an opportunity to reconsider your choice every year.
Are Medicare Advantage PFFS plans for you?
By Ron Griffin
Hometown Weekly Correspondent
Just three years ago Harvard Pilgrim introduced the first PFFS to Massachusetts Medicare seniors. That concept has grown in popularity with both patients and doctors. For 2009 there will be twenty Medicare PFFS plans to choose from in Massachusetts. Every major medical provider now offers at least one PFFS plan. Is a PFFS plan in your future?
PFFS stands for “Private Fee for Service”. These are Medicare Advantage plans, which are Medicare; approved medical plans offered by private companies as an alternative to traditional Medicare. Yes, choosing a Medicare Advantage plan un-enrolls you from Medicare. You will still continue to pay your Medicare Part B premium of $96.40 per month but you’ll get ALL your medical services from the Medicare Advantage Plan that you chose.
Medicare Advantage plans most often provide more coverage than Medicare. Some include dental, while most include physicals and eye exams and many help pay for gym memberships and weight loss programs.
Many seniors are familiar with other Medicare Advantage plans called HMO’s and PPOs’. HMO’s require that you to get your care through network doctors and hospitals. PPO’s offer the flexibility of getting your care through in-network as well as out-of-network doctors and hospitals. You’ll just pay higher co-pay’s for using doctors outside the network. PFFS plans let you receive services from any health care provider who agrees to the terms of the plan.
That statement is the attraction for PFFS plans but it is often promoted out of context. It does not say you can go to any doctor, it says you can go to any doctor who agrees to accept the plans payment terms. Nationwide PFFS plans have come under scrutiny for marketing schemes designed to confuse, mislead or defraud beneficiaries.
When enrolling you’ll notice several confirmations are required assuring you understand that not all doctors accept the plans terms. That’s because if you can’t find a doctor who will accept the plans payment terms, you essentially have useless insurance. Unlike HMO’s who have a list of doctors who accept their insurance, there isn’t any list for PFFS plan doctors. You’ll have to seek out and find a doctor and facility that will accept the PFFS plans payment.
Is that so difficult? Perhaps not as more and more doctors outsource their billing process to agencies that are familiar with multiple insurance providers. Doctors with a small billing staff just can’t keep up with all the different filing requirements of each company. The doctor after all does deserve to get paid so if the process to file for payment is easy and the payment to him quick he’ll be a pretty excited. Then again, if the process to submit for payment is time consuming or the doctor has to submit it multiple times resulting in delaying his payment, he’ll want to avoid that plan.
Of course doctors also care how much they get paid for a service. Doctors accept Medicare not because of its generous payment but because excluding Medicare patients exclude too many patients. Still doctors know exactly how much Medicare will pay for each service they provide. HMO’s, PPO’s and PFFS’s may pay differently, being less, the same or the preferred option more.
The other attraction of PFFS plans is that they are cheap. Three plans are offered for under $40 per month, which includes prescription coverage. Cheap may be a passing factor as all these companies compete for new members.
Before choosing a PFFS plan, call your doctors and facilities where you receive your care. If they do not accept the PFFS plan your considering ask why. It may be because they never heard of the plan or haven’t had any experience with it. Perhaps the Doctor can be encouraged to try it; after all he may like it. The PFFS plans terms for payments are generally available to the doctor for review on the Internet.
Then again, maybe the doctor already had an experience he prefers not to repeat. Remember there isn’t any contract between a PFFS plan and the doctor. That doctor is free to accept or refuse the PFFS plans terms on a case-by-case basis as well as on a patient-to-patient basis.
Lastly you should know there is thousands of satisfied seniors in Massachusetts who are currently enrolled in PFFS plans. If your not satisfied with any Medicare plan, you have an opportunity to reconsider your choice every year.
Are Medicare Advantage PFFS plans for you?
By Ron Griffin
Hometown Weekly Correspondent
Just three years ago Harvard Pilgrim introduced the first PFFS to Massachusetts Medicare seniors. That concept has grown in popularity with both patients and doctors. For 2009 there will be twenty Medicare PFFS plans to choose from in Massachusetts. Every major medical provider now offers at least one PFFS plan. Is a PFFS plan in your future?
PFFS stands for “Private Fee for Service”. These are Medicare Advantage plans, which are Medicare; approved medical plans offered by private companies as an alternative to traditional Medicare. Yes, choosing a Medicare Advantage plan un-enrolls you from Medicare. You will still continue to pay your Medicare Part B premium of $96.40 per month but you’ll get ALL your medical services from the Medicare Advantage Plan that you chose.
Medicare Advantage plans most often provide more coverage than Medicare. Some include dental, while most include physicals and eye exams and many help pay for gym memberships and weight loss programs.
Many seniors are familiar with other Medicare Advantage plans called HMO’s and PPOs’. HMO’s require that you to get your care through network doctors and hospitals. PPO’s offer the flexibility of getting your care through in-network as well as out-of-network doctors and hospitals. You’ll just pay higher co-pay’s for using doctors outside the network. PFFS plans let you receive services from any health care provider who agrees to the terms of the plan.
That statement is the attraction for PFFS plans but it is often promoted out of context. It does not say you can go to any doctor, it says you can go to any doctor who agrees to accept the plans payment terms. Nationwide PFFS plans have come under scrutiny for marketing schemes designed to confuse, mislead or defraud beneficiaries.
When enrolling you’ll notice several confirmations are required assuring you understand that not all doctors accept the plans terms. That’s because if you can’t find a doctor who will accept the plans payment terms, you essentially have useless insurance. Unlike HMO’s who have a list of doctors who accept their insurance, there isn’t any list for PFFS plan doctors. You’ll have to seek out and find a doctor and facility that will accept the PFFS plans payment.
Is that so difficult? Perhaps not as more and more doctors outsource their billing process to agencies that are familiar with multiple insurance providers. Doctors with a small billing staff just can’t keep up with all the different filing requirements of each company. The doctor after all does deserve to get paid so if the process to file for payment is easy and the payment to him quick he’ll be a pretty excited. Then again, if the process to submit for payment is time consuming or the doctor has to submit it multiple times resulting in delaying his payment, he’ll want to avoid that plan.
Of course doctors also care how much they get paid for a service. Doctors accept Medicare not because of its generous payment but because excluding Medicare patients exclude too many patients. Still doctors know exactly how much Medicare will pay for each service they provide. HMO’s, PPO’s and PFFS’s may pay differently, being less, the same or the preferred option more.
The other attraction of PFFS plans is that they are cheap. Three plans are offered for under $40 per month, which includes prescription coverage. Cheap may be a passing factor as all these companies compete for new members.
Before choosing a PFFS plan, call your doctors and facilities where you receive your care. If they do not accept the PFFS plan your considering ask why. It may be because they never heard of the plan or haven’t had any experience with it. Perhaps the Doctor can be encouraged to try it; after all he may like it. The PFFS plans terms for payments are generally available to the doctor for review on the Internet.
Then again, maybe the doctor already had an experience he prefers not to repeat. Remember there isn’t any contract between a PFFS plan and the doctor. That doctor is free to accept or refuse the PFFS plans terms on a case-by-case basis as well as on a patient-to-patient basis.
Lastly you should know there is thousands of satisfied seniors in Massachusetts who are currently enrolled in PFFS plans. If your not satisfied with any Medicare plan, you have an opportunity to reconsider your choice every year.
Are Medicare Advantage PFFS plans for you?
By Ron Griffin
Hometown Weekly Correspondent
Just three years ago Harvard Pilgrim introduced the first PFFS to Massachusetts Medicare seniors. That concept has grown in popularity with both patients and doctors. For 2009 there will be twenty Medicare PFFS plans to choose from in Massachusetts. Every major medical provider now offers at least one PFFS plan. Is a PFFS plan in your future?
PFFS stands for “Private Fee for Service”. These are Medicare Advantage plans, which are Medicare; approved medical plans offered by private companies as an alternative to traditional Medicare. Yes, choosing a Medicare Advantage plan un-enrolls you from Medicare. You will still continue to pay your Medicare Part B premium of $96.40 per month but you’ll get ALL your medical services from the Medicare Advantage Plan that you chose.
Medicare Advantage plans most often provide more coverage than Medicare. Some include dental, while most include physicals and eye exams and many help pay for gym memberships and weight loss programs.
Many seniors are familiar with other Medicare Advantage plans called HMO’s and PPOs’. HMO’s require that you to get your care through network doctors and hospitals. PPO’s offer the flexibility of getting your care through in-network as well as out-of-network doctors and hospitals. You’ll just pay higher co-pay’s for using doctors outside the network. PFFS plans let you receive services from any health care provider who agrees to the terms of the plan.
That statement is the attraction for PFFS plans but it is often promoted out of context. It does not say you can go to any doctor, it says you can go to any doctor who agrees to accept the plans payment terms. Nationwide PFFS plans have come under scrutiny for marketing schemes designed to confuse, mislead or defraud beneficiaries.
When enrolling you’ll notice several confirmations are required assuring you understand that not all doctors accept the plans terms. That’s because if you can’t find a doctor who will accept the plans payment terms, you essentially have useless insurance. Unlike HMO’s who have a list of doctors who accept their insurance, there isn’t any list for PFFS plan doctors. You’ll have to seek out and find a doctor and facility that will accept the PFFS plans payment.
Is that so difficult? Perhaps not as more and more doctors outsource their billing process to agencies that are familiar with multiple insurance providers. Doctors with a small billing staff just can’t keep up with all the different filing requirements of each company. The doctor after all does deserve to get paid so if the process to file for payment is easy and the payment to him quick he’ll be a pretty excited. Then again, if the process to submit for payment is time consuming or the doctor has to submit it multiple times resulting in delaying his payment, he’ll want to avoid that plan.
Of course doctors also care how much they get paid for a service. Doctors accept Medicare not because of its generous payment but because excluding Medicare patients exclude too many patients. Still doctors know exactly how much Medicare will pay for each service they provide. HMO’s, PPO’s and PFFS’s may pay differently, being less, the same or the preferred option more.
The other attraction of PFFS plans is that they are cheap. Three plans are offered for under $40 per month, which includes prescription coverage. Cheap may be a passing factor as all these companies compete for new members.
Before choosing a PFFS plan, call your doctors and facilities where you receive your care. If they do not accept the PFFS plan your considering ask why. It may be because they never heard of the plan or haven’t had any experience with it. Perhaps the Doctor can be encouraged to try it; after all he may like it. The PFFS plans terms for payments are generally available to the doctor for review on the Internet.
Then again, maybe the doctor already had an experience he prefers not to repeat. Remember there isn’t any contract between a PFFS plan and the doctor. That doctor is free to accept or refuse the PFFS plans terms on a case-by-case basis as well as on a patient-to-patient basis.
Lastly you should know there is thousands of satisfied seniors in Massachusetts who are currently enrolled in PFFS plans. If your not satisfied with any Medicare plan, you have an opportunity to reconsider your choice every year.
Are Medicare Advantage PFFS plans for you?
By Ron Griffin
Hometown Weekly Correspondent
Just three years ago Harvard Pilgrim introduced the first PFFS to Massachusetts Medicare seniors. That concept has grown in popularity with both patients and doctors. For 2009 there will be twenty Medicare PFFS plans to choose from in Massachusetts. Every major medical provider now offers at least one PFFS plan. Is a PFFS plan in your future?
PFFS stands for “Private Fee for Service”. These are Medicare Advantage plans, which are Medicare; approved medical plans offered by private companies as an alternative to traditional Medicare. Yes, choosing a Medicare Advantage plan un-enrolls you from Medicare. You will still continue to pay your Medicare Part B premium of $96.40 per month but you’ll get ALL your medical services from the Medicare Advantage Plan that you chose.
Medicare Advantage plans most often provide more coverage than Medicare. Some include dental, while most include physicals and eye exams and many help pay for gym memberships and weight loss programs.
Many seniors are familiar with other Medicare Advantage plans called HMO’s and PPOs’. HMO’s require that you to get your care through network doctors and hospitals. PPO’s offer the flexibility of getting your care through in-network as well as out-of-network doctors and hospitals. You’ll just pay higher co-pay’s for using doctors outside the network. PFFS plans let you receive services from any health care provider who agrees to the terms of the plan.
That statement is the attraction for PFFS plans but it is often promoted out of context. It does not say you can go to any doctor, it says you can go to any doctor who agrees to accept the plans payment terms. Nationwide PFFS plans have come under scrutiny for marketing schemes designed to confuse, mislead or defraud beneficiaries.
When enrolling you’ll notice several confirmations are required assuring you understand that not all doctors accept the plans terms. That’s because if you can’t find a doctor who will accept the plans payment terms, you essentially have useless insurance. Unlike HMO’s who have a list of doctors who accept their insurance, there isn’t any list for PFFS plan doctors. You’ll have to seek out and find a doctor and facility that will accept the PFFS plans payment.
Is that so difficult? Perhaps not as more and more doctors outsource their billing process to agencies that are familiar with multiple insurance providers. Doctors with a small billing staff just can’t keep up with all the different filing requirements of each company. The doctor after all does deserve to get paid so if the process to file for payment is easy and the payment to him quick he’ll be a pretty excited. Then again, if the process to submit for payment is time consuming or the doctor has to submit it multiple times resulting in delaying his payment, he’ll want to avoid that plan.
Of course doctors also care how much they get paid for a service. Doctors accept Medicare not because of its generous payment but because excluding Medicare patients exclude too many patients. Still doctors know exactly how much Medicare will pay for each service they provide. HMO’s, PPO’s and PFFS’s may pay differently, being less, the same or the preferred option more.
The other attraction of PFFS plans is that they are cheap. Three plans are offered for under $40 per month, which includes prescription coverage. Cheap may be a passing factor as all these companies compete for new members.
Before choosing a PFFS plan, call your doctors and facilities where you receive your care. If they do not accept the PFFS plan your considering ask why. It may be because they never heard of the plan or haven’t had any experience with it. Perhaps the Doctor can be encouraged to try it; after all he may like it. The PFFS plans terms for payments are generally available to the doctor for review on the Internet.
Then again, maybe the doctor already had an experience he prefers not to repeat. Remember there isn’t any contract between a PFFS plan and the doctor. That doctor is free to accept or refuse the PFFS plans terms on a case-by-case basis as well as on a patient-to-patient basis.
Lastly you should know there is thousands of satisfied seniors in Massachusetts who are currently enrolled in PFFS plans. If your not satisfied with any Medicare plan, you have an opportunity to reconsider your choice every year.
Are Medicare Advantage PFFS plans for you?
By Ron Griffin
Hometown Weekly Correspondent
Just three years ago Harvard Pilgrim introduced the first PFFS to Massachusetts Medicare seniors. That concept has grown in popularity with both patients and doctors. For 2009 there will be twenty Medicare PFFS plans to choose from in Massachusetts. Every major medical provider now offers at least one PFFS plan. Is a PFFS plan in your future?
PFFS stands for “Private Fee for Service”. These are Medicare Advantage plans, which are Medicare; approved medical plans offered by private companies as an alternative to traditional Medicare. Yes, choosing a Medicare Advantage plan un-enrolls you from Medicare. You will still continue to pay your Medicare Part B premium of $96.40 per month but you’ll get ALL your medical services from the Medicare Advantage Plan that you chose.
Medicare Advantage plans most often provide more coverage than Medicare. Some include dental, while most include physicals and eye exams and many help pay for gym memberships and weight loss programs.
Many seniors are familiar with other Medicare Advantage plans called HMO’s and PPOs’. HMO’s require that you to get your care through network doctors and hospitals. PPO’s offer the flexibility of getting your care through in-network as well as out-of-network doctors and hospitals. You’ll just pay higher co-pay’s for using doctors outside the network. PFFS plans let you receive services from any health care provider who agrees to the terms of the plan.
That statement is the attraction for PFFS plans but it is often promoted out of context. It does not say you can go to any doctor, it says you can go to any doctor who agrees to accept the plans payment terms. Nationwide PFFS plans have come under scrutiny for marketing schemes designed to confuse, mislead or defraud beneficiaries.
When enrolling you’ll notice several confirmations are required assuring you understand that not all doctors accept the plans terms. That’s because if you can’t find a doctor who will accept the plans payment terms, you essentially have useless insurance. Unlike HMO’s who have a list of doctors who accept their insurance, there isn’t any list for PFFS plan doctors. You’ll have to seek out and find a doctor and facility that will accept the PFFS plans payment.
Is that so difficult? Perhaps not as more and more doctors outsource their billing process to agencies that are familiar with multiple insurance providers. Doctors with a small billing staff just can’t keep up with all the different filing requirements of each company. The doctor after all does deserve to get paid so if the process to file for payment is easy and the payment to him quick he’ll be a pretty excited. Then again, if the process to submit for payment is time consuming or the doctor has to submit it multiple times resulting in delaying his payment, he’ll want to avoid that plan.
Of course doctors also care how much they get paid for a service. Doctors accept Medicare not because of its generous payment but because excluding Medicare patients exclude too many patients. Still doctors know exactly how much Medicare will pay for each service they provide. HMO’s, PPO’s and PFFS’s may pay differently, being less, the same or the preferred option more.
The other attraction of PFFS plans is that they are cheap. Three plans are offered for under $40 per month, which includes prescription coverage. Cheap may be a passing factor as all these companies compete for new members.
Before choosing a PFFS plan, call your doctors and facilities where you receive your care. If they do not accept the PFFS plan your considering ask why. It may be because they never heard of the plan or haven’t had any experience with it. Perhaps the Doctor can be encouraged to try it; after all he may like it. The PFFS plans terms for payments are generally available to the doctor for review on the Internet.
Then again, maybe the doctor already had an experience he prefers not to repeat. Remember there isn’t any contract between a PFFS plan and the doctor. That doctor is free to accept or refuse the PFFS plans terms on a case-by-case basis as well as on a patient-to-patient basis.
Lastly you should know there is thousands of satisfied seniors in Massachusetts who are currently enrolled in PFFS plans. If your not satisfied with any Medicare plan, you have an opportunity to reconsider your choice every year.
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