Who operates the Medicare private fee-for-service plan?

The private fee-for-service (PFFS) plans under Medicare are operated by private contracted insurance companies. These companies create their own plan structures and agreements, allowing them to set specific terms for how they provide services to enrollees and the payment framework they use.

In this arrangement, beneficiaries can seek care from any provider who accepts the plan's terms, offering flexibility in choosing healthcare providers while still receiving Medicare benefits. The involvement of private insurance companies allows for competition, potentially leading to a diverse range of plan options for consumers.

The other options, such as healthcare providers, state governments, and CMS (Centers for Medicare & Medicaid Services), play different roles in the Medicare ecosystem. While CMS oversees and regulates Medicare, it does not directly operate the PFFS plans; rather, it sets the guidelines within which private insurers can provide these plans. Similarly, healthcare providers deliver services under these plans, but they do not operate the plans themselves, and state governments do not manage PFFS plans. This structure underscores the role of private insurers in enhancing accessibility and variety in Medicare options for beneficiaries.