PFFS, a Medicare Advantage product, was established by the Balanced Budget Act of 1997, which offers eligible Medicare beneficiaries the opportunity to receive benefits that are covered under Original Medicare, as well as the flexibility to receive benefits beyond Original Medicare. It also affords PFFS subscribers the opportunity to receive covered services from any provider that is licensed and eligible to receive Medicare payment and meets and accepts the PFFS plan's Terms and Conditions of Participation.

This new Medicare Advantage Private Fee-For-Service (PFFS) PFFS is offered through private insurance companies and provides all of the benefits covered under the Original Medicare plan and more, such as unlimited hospitalization and full coverage of preventive services.  Most PFFS plans include prescription drug coverage. Providers that are “deemed” as participating in the Medicare Open Plan are paid Medicare-allowable rates for covered services rendered to Medicare members.