2010 Medicare Advantage Plan Information Click here to jump to the Chart Legend & Search Tips | |||||||||||
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Plan Name | County | Monthly Prem. (Parts C & D) |
Deduct- ible |
(Donut Hole) Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance 30-Day Supply |
MOOP for Part A & B Benefits | |||||
Cust. Service Rating |
Member Plan Exper. |
RxCost Info Rating |
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Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Adams | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Attala | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Benton | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Carroll | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Claiborne | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Clarke | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Coahoma | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Copiah | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
DeSoto | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Forrest | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Hinds | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Kemper | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Lafayette | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Lamar | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Lauderdale | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Lawrence | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Leake | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Lincoln | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Lowndes | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Madison | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Marshall | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Newton | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Panola | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Pike | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Prentiss | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Rankin | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Scott | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Simpson | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Smith | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Sunflower | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Tate | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Tippah | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Tunica | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Union | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Walthall | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Warren | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Washington | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Winston | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Yalobusha | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Yazoo | $15.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
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