2012 Medicare Advantage Plan Details | |||||
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Medicare Plan Name: | WindsorSterling Gold Access Plan (PFFS) | ||||
Location: | Vernon, Missouri Click to see other locations | ||||
Plan ID: | H5006 - 017 - 0 Click to see other plans | ||||
Member Services: | |||||
— This plan information is for research purposes only. — Click here to see plans for the current plan year | |||||
Medicare Contact Information: | Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options. TTY users 1-877-486-2048 or contact your local SHIP for assistance |
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Email a copy of the WindsorSterling Gold Access Plan (PFFS) benefit details | |||||
— Medicare Plan Features — | |||||
Monthly Premium: | $59.00 | ||||
Annual Deductible: | $50 | ||||
Annual Initial Coverage Limit (ICL): | $2,930 | ||||
Health Plan Type: | PFFS | ||||
Maximum Out-of-Pocket Limit for Parts A & B (MOOP): | $4,000 | ||||
Additional Gap Coverage? | No additional gap coverage, only the Donut Hole Discount | ||||
Total Number of Formulary Drugs: | 2,699 drugs | Browse the WindsorSterling Gold Access Plan (PFFS) Formulary | |||
This plan has 5 drug tiers. See cost-sharing highlights below. | |||||
Formulary Drug Details: | Tier 1 | Tier 2 | Tier 3 | Tier 4 | Tier 5 |
• Preferred Pharmacy Cost-Sharing during initial coverage phase: | $5.00 | $15.00 | $34.00 | $84.00 | 30% |
• Number of Drugs per Tier: | 218 | 1187 | 324 | 703 | 267 |
Plan Offers Mail Order? | Yes | ||||
Number of Members enrolled in this plan in (H5006 - 017): | 2,972 members | ||||
Plan’s Summary Star Rating: | 2.5 out of 5 Stars. | ||||
• Customer Service Rating: | 3 out of 5 Stars. | ||||
• Member Experience Rating: | Insufficient data to rate this plan. | ||||
• Drug Cost Accuracy Rating: | 3 out of 5 Stars. | ||||
— Plan Health Benefits — |