Frequently Asked Questions

Note: Information on this page is for the following Medicare Advantage Plan: PFFS (Private Fee For Service)

Q: Can I use the plan anywhere?

A: Yes, as long as the provider accepts Medicare and the plan. This is especially beneficial to seniors who travel a lot or snowbirds who go to Florida in the winter.

Q: What happens if I move?
A: In most cases, you will be able to replace the PFFS with a similar plan in your new service area location.  

Q: How can I have such a low or ZERO premium?
A: The federal government pays a subsidy to the PFFS (Private Fee For Service) plan at a cost of 119% of original Medicare. Therefore, the company passes the savings on to you. The plan acts like original Medicare with a Medicare supplement except for very low doctor and hospital co-pays.

Q: I thought a Medicare Advantage Plan was an HMO?
A: Actually the HMO was the first Medicare Advantage plan that was available but because of rather obvious shortcomings the options have been greatly improved upon. Here is a list of the three main types.
1. HMO (Home Maintenance Organization)
2. PPO (Personal Provider Organization)
3. PFFS (Private Fee For Service)

Q: Can I go to any doctor in my area?
A: You can go to any doctor, any hospital, anywhere in the United States with NO questions asked, as long as they accept Medicare and the PFFS plan.

Q: If I have no premium, what do I pay for?
A: You only pay small co-pays for your medical services (below are the 5 most used benefits and all other services have equally low co-pays):
1. Routine doctor visit -$5 co-pay   
2. Specialists - $15 co-pay                           
3. Foot doctor - $20 co-pay
4. Emergency room - $35 co-pay
5. Hospital - $150 co-pay

Q: What about outpatient prescription drugs?
A: The U.S. Government Part D prescription drug program is available only at certain times of the year. In addition, changes to any drug plans can only be made at specific times of the year. When available, if you take advantage of our Part D drug plan, we have one of the best Formularies in the industry and very low priced.

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