How do doctor visits work in a private fee for service plan?

Who is this for?

Learn more about your Medicare Plus Blue PPO plan.

If you're a Blue Cross® Medicare Private Fee for Service member, this information will tell you how doctor and hospital visits work with this plan.

When you have a Blue Cross Medicare PFFS plan, you don't need a primary care doctor to coordinate your health care. But where you choose to go for care can affect your out-of-pocket costs. If you're new to this plan, you'll first want to check if all your current doctors accept your new plan.

Be aware that your network choice can affect your costs. With this plan, we decide how much we'll pay doctors, other health care providers and hospitals, and how much you pay when you get care. Our network providers have accepted these terms. You'll pay the same amount for care whether you are in or out of network.

Going to the doctor or hospital

You'll need to show your Blue Cross ID card every visit. Before you get care, be sure to ask your doctor or hospital of they're willing to contact the plan with the information provided on your card to verify if you're covered.

Regardless of where you go for care, you'll want to be sure to find out if the doctor or hospital accepts the Blue Cross Medicare PFFS Plan.

You can search for doctors and hospitals in the PFFS network by typing in a doctor, hospital or specialty you're looking for and hitting Search.