Disclaimers
Windsor Health Plan, Inc.:
- Abides by all Federal and State laws regarding confidentiality and disclosure of medical records or other health and enrollment information, including the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the privacy rule promulgated under HIPAA;
- Ensures that medical information is released only in accordance with applicable Federal or State law;
- Maintains the records and information in an accurate and timely manner; and ensures timely access by enrollees to records and information pertaining to them.
Generally, pharmacy benefits are only available at the Windsor RX and RX Plus contracted network pharmacies. In emergency circumstances, benefits may be obtained out-of-network. If you obtain routine care from out-of-plan pharmacies, neither Medicare nor Windsor RX and RX Plus plans will be responsible for the costs.
For full information on Windsor RX and RX Plus, prescription drug plans, call 1-877-243-5844 (or TTY for the hearing impaired 1-800-848-0298) from 7 a.m. to 8 p.m. Central Standard Time, 7 days a week.
Members may enroll in a Windsor RX and RX Plus drug plans only during specific times of the year. Please contact us at 1-877-243-5844 (or TTY for the hearing impaired 1-800-848-0298) from 7 a.m. to 8 p.m. Central Standard Time, 7 days a week, to obtain more information on plan benefits.
Individuals are eligible to enroll in Windsor Rx and RX Plus plans if they are entitled to Medicare benefits under Medicare Part A or enrolled in Part B and if they reside in the Windsor Medicare Extra service area. All beneficiaries must continue to pay their Part B premium. Windsor Medicare Extra plan premiums may vary by service area or plan.
The Windsor Rx and RX Plus pharmacy network includes retail, mail order, long-term care and home infusion pharmacies. Members may obtain mail order information and additional information about network pharmacies by contacting the Windsor Rx and RX Plus Member Services Department at 1-800-316-2273 (or TTY for the hearing impaired 1-800-848-0298 from 7 a.m. to 8 p.m. Central Standard Time, 7 days a week. Information may also be obtained by writing to Windsor RX and/or RX Plus plans, Attn: Member Services Department, 7100 Commerce Way, Suite 285, Brentwood, TN 37027.
Windsor RX and RX Plus are stand alone PDP organizations with a Medicare Contract. Windsor Medicare RX and RX Plus renew their contract with the Centers for Medicare and Medicaid Services (CMS) annually. Benefits beyond the current contract year are not guaranteed. Windsor RX and RX Plus are authorized by law to refuse to renew the contract with CMS. CMS also may refuse to renew the contract. Termination or non-renewal of this contract may result in termination of the beneficiary???s enrollment in the Windsor RX or RX Plus plans. In addition, the Windsor RX and RX Plus plans may reduce its service area and no longer offer services in the area where you reside. Should a change occur to the status of Windsor Health Plan’s contract with Medicare, all affected members will be notified in advance of the changes and the options available to them.
Medicare beneficiaries may also enroll in Windsor RX and RX Plus plans through the Centers for Medicare and Medicaid Services Online Enrollment Center located at www.medicare.gov. For more information, contact Windsor RX or RX Plus Member Services at 1-800-316-2273 (or TTY for the hearing impaired 1-800-848-0298) from 7 a.m. to 8 p.m. Central Standard Time, 7 days a week.
You may be able to get extra help to pay for your prescription drug premiums and costs. The low income subsidy is extra help with prescription drug costs for Medicare-eligible individuals whose income and resources are limited. This help is in the form of payments to the Part D Plan that you join. Persons eligible for Medicaid, Supplemental Security Income (SSI), or a Medicare Saving Program qualify for the extra help automatically and do not need to apply. All others may apply with the Social Security Administration (SSA) by mail, by telephone at 1-800-772-1213, (TTY/TDD users should call, 1-800-325-0778) on the Internet at http://www.socialsecurity.gov or in person at an SSA office between 7 a.m. and 7 p.m., Monday through Friday. Beneficiaries can also contact the Social Security Administration web site entitled ?Help with Medicare Prescription Drug Plan Costs? at http://www.ssa.gov/pubs/10108.html .
Applications may also be filed at a local state Medicaid office.
Beneficiaries can also access the following Medicare web site for requirements for the low income subsidy: http://www.cms.hhs.gov/medicarereform/lir.asp, or call the Medicare Service Center @ 1-800-MEDICARE (1-800-633-4227,) TTY Toll-Free: 866-226-1819.
If you have qualified for additional assistance for your Medicare prescription drug plan costs, the amount of your premium and cost at the pharmacy will be less. Once you have enrolled in a Windsor RX or RX Plus plan, Medicare will tell us how much assistance you are receiving, and we will send you information on the amount you will pay. Please contact Windsor RX or RX Plus plan Member Services at 1-800-316-2273 (or TTY for the hearing impaired 1-800-848-0298) from 7 a.m. to 8 p.m. Central Standard Time, 7 days a week.
