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Private Fee For Service (PFFS)

UnitedHealthcare MedicareDirect health care plans are Private Fee For Service (PFFS) plans offered under the federal Medicare Advantage program. PFFS plans provide Medicare beneficiaries a wider array of health care choices, often with more benefits and at a lower cost than original Medicare. Members of UnitedHealthcare MedicareDirect plans are still covered under the Medicare program and have federally regulated rights and protections.

While the exact benefits will vary depending on the specific plan, UnitedHealthcare MedicareDirectSM plans offer comprehensive medical coverage and provide:

  • Freedom to seek care from any Medicare-eligible provider without a referral as long as the provider agrees to the plan's terms, conditions and payment rates
  • No or low monthly premiums
  • Low co-payments for doctor visits and inpatient hospital care
  • Limits on annual out-of-pocket expenses
  • A lower-cost option than most Medigap coverage
  • Financial protection due to limits on annual out-of-pocket expenses
  • Medicare Part D prescription drug coverage (not available with all plans)

If you are interested in learning more about Medicare Part D prescription drug coverage or accessing related forms, please see the section entitled "Forms and information for plans with Part D prescription drug coverage" at UHCMedicareSolutions.com. Available topics and forms include direct member reimbursement, medication prior authorization, and the prescription drug transition process.

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