In which circumstance can a beneficiary utilize a PFFS plan?

A beneficiary can utilize a Private Fee-For-Service (PFFS) plan as long as the provider accepts the plan's conditions. PFFS plans are structured to allow beneficiaries more flexibility in choosing healthcare providers compared to other types of Medicare plans. This means that beneficiaries can visit any provider who is willing to accept the payment terms set forth by the PFFS plan.

In this model, while some services can be accessed in-network or out-of-network, the critical factor is the provider's willingness to accept the payment from the PFFS plan. This not only includes routine care but extends to a range of services as long as the provider agrees to the conditions of the specific plan. This characteristic sets PFFS plans apart, providing beneficiaries with a broader choice in their healthcare providers compared to plans that restrict access to only in-network services.