At Windsor Health Plan, Inc., we understand that there are many different choices of insurance companies available to help cover your health care needs. Thank you for choosing us.
We cover the ACCU-CHEK products (ACCU-CHEK Aviva, ACCU-CHEK Compact Plus) at no charge to you. All other brands will require a prior authorization and if approved, will be covered at your Part B diabetic supply coinsurance.
Not only is the ACCU-CHEK meter covered at no cost, it is supported by the ACCU-CHEK Customer Care Service Center, which is available 24 hours a day to serve your needs. That includes a toll-free number, Web site and customized e-mails on topics of interest to you, if you choose. You also have access to important diabetes information, news, troubleshooting tips and answers to questions, as well as complete instructions on using your new meter at https://www.accu-chek.com/index.html or through calling 1-888-355-4242.
Find your plan and key documents. See Chapter 9 of your plan’s Evidence of Coverage (EOC) for information about the grievance, coverage determination (including exceptions), and appeals processes.
Members may enroll in the plan only during specific times of the year. Contact WindsorSterling for more information: 1-888-858-8551, TTY: 711, 8:00 a.m. – 8:00 p.m., seven days a week.
Medicare beneficiaries may enroll in WindsorSterling plans through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov.
A Medicare Advantage Private Fee-for-Service plan works differently than a Medicare supplement plan. We have network providers (that is, providers who have signed contracts with our plan) for all services covered under Original Medicare. These providers have already agreed to see members of our plan. If your provider is not one of our network providers, then the provider is not required to agree to accept the plan’s terms and conditions, of payment, they may choose not to provide health care services to you, except in emergencies. If this happens, you will need to find another provider that will accept our terms and conditions of payment. Providers can find the plan’s terms and conditions of payment on our website.
If you choose to utilize services from a provider outside of the network, except for emergency or urgent situations, you are more likely to pay more for your care.
Members must use network pharmacies to access their prescription drug benefit, except in non-routine circumstances. Benefits, formulary, pharmacy network, premium and/or copayments/co-insurance may change on January 1, 2013. You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call 1-800-325-0778; or your Medicaid Office.
A Medicare Advantage organization with a Medicare contract and a Medicare-approved Part D sponsor.