2012 Plans
Emerald Connect(PFFS)
Gold Connect (PFFS)
Gold Plus (PPO)
Silver Connect (PFFS)

Service Area for WindsorSterling Emerald Connect Plan (PFFS)
Benton, Clark, Island, Jefferson, King, Kittitas, Lewis, Lincoln, Mason, Okanogan, Pend Oreille, Pierce, Skagit, Snohomish, Spokane, Whatcom Counties

Service Area for WindsorSterling Gold Connect Plan (PFFS)
Benton, Clark, Island, Jefferson, King, Kittitas, Lewis, Lincoln, Mason, Okanogan, Pend Oreille, Pierce, Skagit, Snohomish, Spokane, Whatcom Counties

Service Area for WindsorSterling Gold Plus Plan (PPO)
Columbia, Ferry, Garfield, Island, Jefferson, King, Kitsap, Kittitas, Lincoln, Mason, Pacific, Pend Oreille, Pierce, San Juan, Skagit, Snohomish, Spokane, Wahkiakum, Walla Walla, Whatcom Counties

Service Area for WindsorSterling Silver Connect Plan (PFFS)
Benton, Clark, Island, Jefferson, King, Kittitas, Lewis, Lincoln, Mason, Okanogan, Pend Oreille, Pierce, Skagit, Snohomish, Spokane, Whatcom Counties

Schedule of Benefits
Emerald Connect Summary of Benefits (PDF)
Gold Connect Summary of Benefits (PDF)
Gold Plus Summary of Benefits (PDF)
Silver Connect Summary of Benefits (PDF)

Evidence of Coverage
Emerald Connect (PDF)
Gold Connect (PDF)
Gold Plus (PDF)
Silver Connect (PDF)

Applications
Emerald Connect (PDF)
Gold Connect (PDF)
Gold Plus (PDF)
Silver Connect (PDF)
MedicareAdvantage Replacement Form (PDF)

Other Information
PPO Online Provider Directory
PFFS Online Provider Directory
Online Formulary
2012 Comprehensive Formulary (PDF)
Appeals Grievance (PDF)
Appeals Grievance Part D (PDF)

Medicare Advantage Preferred Provider Organization (PPO) plans - Available in selected areas only.

• WindsorSterling Gold Plus^® (PPO) - features contracted providers, includes In and Out-of-Network benefits and prescription drug coverage.

Medicare Advantage In-Network Private Fee-for-Service Plans - features a network of contracted providers

• WindsorSterling Silver Connect In-Network (PFFS) - Low monthly premiums, low copayments, many extra benefits.
• WindsorSterling Emerald Connect In-Network (PFFS) - Low monthly premiums, low copayments, key extra benefits – includes prescription drugs.
• WindsorSterling Gold Connect In-Network (PFFS) - Affordable monthly premiums, low copayments, prescription drug coverage, many extra benefits.

WindsorSterling Medicare Advantage
WindsorSterling contracts with the Federal Government for the following plans:

Traditional PFFS Plan Options

WindsorSterling Gold Access (PFFS) and Silver Access (PFFS) are Non-Network Medicare Advantage Private Fee-for-Service (PFFS) plans authorized by the Centers for Medicare & Medicaid Services (CMS).

These non-network Medicare Advantage Private Fee-for-Service plans work differently than a Medicare supplement plan. Your provider is not required to agree to accept the plan's terms and conditions of payment, and thus may choose not to treat you, with the exception of emergencies. If your provider does not agree to accept our payment 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 by clicking "Providers" on the homepage, then clicking "Terms and Conditions" in the left column.

Network PFFS Plan Options

WindsorSterling Gold Connect (PFFS), Silver Connect (PFFS) and Emerald Connect (PFFS) are Network Medicare Advantage Private Fee-for-Service (PFFS) plans authorized by the Centers for Medicare & Medicaid Services (CMS).

These network Medicare Advantage Private Fee-for-Service plans work 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, and 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.