2014 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) Additional 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 | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Attala | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Bolivar | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional 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 | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Claiborne | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Clarke | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional 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 | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Copiah | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
DeSoto | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional 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 |
Grenada | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Hinds | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Holmes | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional 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 |
Humphreys | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Issaquena | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Jefferson | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional 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 |
Jefferson Davis | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Kemper | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Lafayette | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional 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 |
Lauderdale | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Lawrence | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Leake | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional 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 |
Lincoln | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Madison | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Marshall | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional 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 |
Neshoba | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Newton | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Panola | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional 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 |
Pike | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Quitman | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Rankin | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional 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 |
Scott | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Sharkey | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Simpson | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional 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 |
Smith | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Sunflower | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Tallahatchie | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional 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 | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Tunica | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Walthall | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional 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 |
Warren | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Washington | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) in MS - H5698-028-0 Benefit Details |
Yazoo | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
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