Disclaimers
With the exception of Tennessee Choice and Tennessee Choice RX members, all routine care must be provided by plan providers, except in emergency situations and for out-of-town renal dialysis. If you obtain routine care from out-of-plan providers, neither Medicare nor Windsor Medicare Extra plans will be responsible for the costs.
For full information on Windsor Medicare Extra 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 Medicare Extra plan 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 Medicare Extra 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 Medicare Extra prescription drug benefit is available only to members with a Windsor Medicare Extra MA-PD plan. If a beneficiary is already enrolled in an MA-PD plan, the enrollee must receive his/her Medicare prescription drug benefit through that plan. Generally, pharmacy benefits are only available at the Windsor Medicare Extra contracted network pharmacies. In emergency circumstances, benefits may be obtained out-of-network.
The Windsor Medicare Extra 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 Medicare Extra 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 Medicare Extra Plans, Attn: Member Services Department, 7100 Commerce Way, Suite 285, Brentwood, TN 37027.
Windsor Medicare Extra is a Medicare Advantage Prescription Drug (MA-PD) organization with a Medicare Contract. Windsor Medicare Extra renews its contract with the Centers for Medicare and Medicaid Services (CMS) annually. Benefits beyond the current contract year are not guaranteed. Windsor Medicare Extra is authorized by law to refuse to renew its 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 Medicare Extra plans. In addition, the Windsor Medicare Extra 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 Group’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 Medicare Extra plans through the Centers for Medicare and Medicaid Services Online Enrollment Center located at www.medicare.gov. For more information, contact Windsor Medicare Extra 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.
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
Applications may also be filed at a local state Medicaid office.
Beneficiaries can also access the Medicare web site for requirements for the low income subsidy 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 Medicare Extra 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 Medicare Extra 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.
