How It Works
What is a Private Fee-for-Service Plan?
  • It is a type of Medicare Advantage plan offered by a private insurance company like WellCare.
  • It is not the same as the Original Medicare plan that is offered by the Federal Government.
  • It is not a Medicare supplement, Medigap, Medicare Select, or Prescription Drug Plan.

How does a Private Fee-for-Service plan work?

  • The Private Fee-for-Service plan pays instead of Medicare. You will pay amounts that the Private Fee-for-Service plan does not pay, which are called copayments and coinsurance. A Private Fee-for-Service plan does not pay after Medicare pays its share.
  • Original Medicare will not pay for your health care while you are enrolled in a Private Fee-for-Service plan.

How do you obtain services from a Private Fee-for-Service plan?

  • You may receive health care services from any provider allowed to bill Medicare who agrees to accept the Private Fee-for-Service plan's payment terms and conditions.
  • You must use network pharmacies to obtain prescription drugs except in emergencies or urgent situations.
With WellCare PFFS Plans you may also have access to:
  • Low, predictable co-pays for services, so you always know what a doctor visit will cost.
  • Vision, dental, and hearing coverage.
  • Prescription drug coverage (Medicare Part D).
  • $0 co-pay for preventive care (such as annual checkups, mammograms and prostate exams).
  • Health club memberships and worldwide emergency coverage.
Make sure your doctors accept WellCare's terms and conditions of payment.

 

Last modified: 09/25/2007