In a Private Fee-For-Service (PFFS) plan, which statement is true?

In a Private Fee-For-Service (PFFS) plan, which statement is true?

• A. Deemed providers are those who agree to accept the plan's terms and payment
• B. PCP is required
• C. Referrals are required for specialists
• D. They are widely available in urban areas

Answer: (A)

In a Private Fee-For-Service plan, there is no fixed provider network. Providers can treat you if they agree to the plan’s terms and payment. Those providers are called deemed providers. This is why the statement that deemed providers are those who agree to accept the plan’s terms and payment is true. Because there’s no required PCP or referral system in PFFS, you can see specialists without referrals and you’re not bound to a primary care physician. Availability isn’t defined as “widely available in urban areas,” since plan availability depends on location and can vary.

In a Private Fee-For-Service plan, there is no fixed provider network. Providers can treat you if they agree to the plan’s terms and payment. Those providers are called deemed providers. This is why the statement that deemed providers are those who agree to accept the plan’s terms and payment is true. Because there’s no required PCP or referral system in PFFS, you can see specialists without referrals and you’re not bound to a primary care physician. Availability isn’t defined as “widely available in urban areas,” since plan availability depends on location and can vary.