Selecting a Provider

As an Advantra Freedom (PFFS) member, you may obtain covered services from any Medicare-eligible provider anywhere in the United States. To be eligible to furnish services to an Advantra Freedom (PFFS) enrollee, providers must be state licensed and  have a Medicare billing number or be eligible to obtain one. The provider you select must also agree to accept Advantra Freedom’s (PFFS) Terms and Conditions of payment.

You must identify yourself as an Advantra Freedom (PFFS) Plan enrollee each time you seek covered services. Each time you go to the provider’s office for services, you should:
1. Show your Advantra Freedom (PFFS) Plan ID card.
2. Confirm that your Provider is Medicare-eligible and accepts Medicare Assignment as full payment.
3. Understand whether or not services you are about to receive are covered benefits. If you are at all unsure or have questions, you should contact Advantra Freedom (PFFS) Customer Service at 1-866-386-2330, TDD/TTY at 1-866-386-2335 for the hearing impaired, Monday through Friday 8:00 a.m. – 10:00 p.m ET, November 15 through March 1, additional Saturday hours 8:00 a.m. - 4:00 p.m., ET.

It is important to note that every provider has the right to decide whether or not to agree or to accept Advantra Freedom's (PFFS) terms and conditions of payment each time they furnish covered services to you.  Your doctor or hospital is not required to agree to accept the plan’s terms and conditions, and thus may choose not to treat you, with the exception of emergencies. If your doctor or hospital does not agree to accept our payment terms and conditions, they may choose not to provide health care services to you, except in emergencies.

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Your Advantra Freedom (PFFS) Identification (ID) Card

While you are enrolled in Advantra Freedom (PFFS), you must use your Advantra Freedom (PFFS) ID card instead of your red, white, and blue Medicare card whenever you get covered services. Don’t discard your Medicare card – keep it in a safe place. If you get medical services using your Medicare card while you are an Advantra Freedom (PFFS) enrollee, the Medicare program will not pay for these services and you may have to pay the full cost yourself.

Please carry your Advantra Freedom (PFFS) ID card with you at all times. You will need to show this card at every provider’s office, facility or emergency room. If your card is ever damaged, lost, or stolen, call Customer Service right away to get a new ID card.

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Advance Coverage Determination

If you have any questions whether Advantra Freedom (PFFS) will pay for a service, including inpatient hospital services and services obtained from providers not affiliated with our plan, you have the right under law to have a written/binding advance coverage determination made for the service.  Call Advantra Freedom (PFFS) Customer Service and tell us you would like a decision if the service or item will be covered.