PFFS Plans Vs. Med Supps

[bill3173]

What are the selling points of med supps vs. Pffs plans?​

Just bi-curious, I do med supps for health clients ageing in to medicare and don't really know much about the rest of it.​

Had a lady call me today, to let me know that she got a pffs plan based on the reccomendation of a friend, and what do I think about it? Nothing, I don't know ****.​

 

[maleman2045]

I do not sell any PFFS plans for the simple reason that a doctor or facility can determine "at will" whether to accept patients from the health insurance plan.
For that reason alone, I do not sell them. If a client really wants a PFFS plan, I inform them I cannot help them.

Here is what I know about PFFS plans:

1. PFFS plans are similar to Med Supp plans, except the doctor must agree to accept the carrier's payment.

2. PFFS plans may or may not have a Rx benefit. Those that do not have a Rx benefit must purchase a PDP plan if they wish to have Rx coverage, but those that have a Rx benefit you cannot sell a separate PDP.

I do not know too much about them as I do not care to sell them.

Here is a link to a document I referenced sometime ago on PFFS:
http://www.cms.hhs.gov/PrivateFeeforServicePlans/Downloads/Provqa.pdf

As I see it, one could obtain similar benefits from a PPO plan using out of network benefits and enjoy a much lower monthly premium as their isn't a significant difference in the MOOP between a PPO and a PFFS.

My two cents...
Mike

 

[DS4]

Adv Med supp
1) Little or no out of pocket cost
2) Chose any physician or hospital
Dis Adv Med supp
1) Cost(when compared to a PFFS)

Adv PFFS,
1) Little or no cost
Dis Adv,
1) Provider way not be willing to bill ins
2) PFFS=Unstable marketplace
3) Copays and out of pocket maxiums

 

[Winter_123]

What are the selling points of med supps vs. Pffs plans?​

Just bi-curious, I do med supps for health clients ageing in to medicare and don't really know much about the rest of it.​

Had a lady call me today, to let me know that she got a pffs plan based on the reccomendation of a friend, and what do I think about it? Nothing, I don't know ****.​

Ask her why her friend recommended it. Is it because the premium is low and it is supposed to cover everything or has she actually had treatment and likes the way the plan pays. Lots of plans are great if you have not had to use them.

 

[hope33709]

I thought they were doing away with PFFS in June?

 

[iaminsman]

My wife works as a billing specialist and just received an email that has a list of 3 pages worth of PFFS plans that are no longer going to be around in FL...

 

[MedSuppPro]

The fate of 2011 PFFS will be decided county by county and are currently contracted through 2010. That's December 31, 2010.

Hello, my clinic doesn't accept 2009 PFFS cards!

 

[G.Gordon]

PFFS; new to the market relative to supp
PFFS; change every friggin year
PFFS; call your doctor/clinic/provider before every visit to make sure they still take it and didn't get pissed off for slow pay
PFFS;what do you mean you didn't know you have that much out of pocket... didn't your agent review the plan changes with you during AEP... oh... you haven't seen him since he signed you two years ago... jeeez


MEDSUPP; been the exact same since 1992
MEDSUPP; any provider that takes medicare takes any supplement
MEDSUPP; you don't need a college degree to understand your plan changes from year to year... oh... see #1
MEDSUPP; if $100-130/mo doesn't break the budget that is pretty much your out of pocket expense

 

[Guest]

It really seems to be the availibility of providers in the area.
PFFS if the provider or facitity agrees to accept the payment offered you are in. The pffs is a MA plan The Sup I assume a MAPD. not a medigap . If there is not a widely held carrier in the area a PFFS would be a logiccal choice

 

[jody108]

It really seems to be the availibility of providers in the area.
PFFS if the provider or facitity agrees to accept the payment offered you are in. The pffs is a MA plan The Sup I assume a MAPD. not a medigap . If there is not a widely held carrier in the area a PFFS would be a logiccal choice

You kinda lost me