Medical Expense✓ Verified · outline & fact-checked · Sep 2026Difficulty 2/5
A Medicare Advantage plan type that generally does not require members to select a primary care physician or obtain referrals, and that pays providers a set amount when they agree to the plan's terms, is the:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
A Private Fee-for-Service (PFFS) plan is a Medicare Advantage plan in which the plan decides the amount it will pay providers for services, and members may generally use any Medicare-approved provider who agrees to accept the plan's payment terms. PFFS plans typically do not use a provider network, and members do not need a primary care physician or referrals for most services. Providers who refuse the plan's terms may bill the member for charges above the plan's payment.
Why the other options are wrong
- B) A closed-panel HMO requires members to use employed or exclusively contracted physicians and typically involves a gatekeeper.
- C) Medigap Plan D is a standardized Medicare supplement policy, not a Medicare Advantage plan.
- D) A short-term limited-duration plan is an ACA-exempt temporary product, not a Medicare Advantage plan.
Memory hook
PFFS = the plan sets the fees; any doctor who accepts them treats you. No network, no gatekeeper.