Sterling Health Plans. Real people. Wise choices

Plan Member

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.

Windsor Rx Information

• Find your plan information
• Find your drugs (PDP formulary)
• Drug Safety Notices
• Drug Archive  

Find a Pharmacy

• Alabama 
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• Minnesota 
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• North Dakota 
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• Oregon 
• South Carolina 
• South Dakota 
• Tennessee 
• Texas 
• Utah 
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• Wyoming 

Member forms and documents

• Authorization to Release Protected Health Information Form
• CMS Appointment of Representation Form (Form CMS-1696) 
• Coverage Determinations Form
• Individual Credit Card Form
• Individual Account Bank Draft Form
• FAQ
• Grievance and Appeal Form 
• How to Spot and Report Medicare Fraud and Abuse
• Medical Release Form
• Medicare Complaint Form
• Part D Coverage Provider Determination Request Form
• Pharmacy Coverage Determination Form
• Potential Contract Termination and Disenrollment 
• Scope of Appointment Form

  Complete forms should be mailed to:
  
  Windsor Rx
  Attention: Customer Service
  7100 Commerce Way Suite 285
  Brentwood, TN 37027
  
  Or fax to: Customer Service: 615-782-7828

  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.

About Enrollment

Members may enroll in the plan only during specific times of the year. Contact Windsor Rx for more information:1-800-264-1587, TTY: 711, 24 hours a day, seven days a week.

Medicare beneficiaries may enroll in Windsor Rx plans through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov.

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.