Gateway Health Contracting and Appointment

Gateway Health Plan was established in 1992 as an alternative to the Pennsylvania Department of Public Welfare’s Medical Assistance Program; members have benefited from services such as: Disease management, health and wellness programs and preventative care.

Today, Gateway has grown into a top-ranked managed care organization that serves over 500,000 members across 4 states. The network includes over 35,000 health care providers, 300 hospitals and more than 21,000 physicians, pharmacies and clinics.

In 2017, Gateway Health celebrated 25 years of advancing healthcare by empowering members and caregivers.

These are Gateway Health's current policies and state availability for 2018.

Medicare Advantage

KY NC OH PA

Gateway Health Medicare Assured Diamond and Ruby plans are Medicare Advantage HMO Special Needs Plans with a Medicare contract. These plans are designed specifically for people who have Medicare and who are also entitled to assistance from Medicaid.

Gateway Health Medicare Assured Diamond (HMO-SNP) is a Medicare Advantage Special Needs Plan created for individuals who are eligible for both Medicare and Medicaid (Full or QMB). Plan is packed with value. It offers $0 to low premium and copay options to ensure care is received when needed.

Gateway Health Medicare Assured Ruby (HMO-SNP) is a Medicare Advantage Special Needs Plan created for individuals who are eligible for both Medicare and Medicaid (SLMB, QI, or QDWI). Plan offers $0 to low premium and copay options to ensure care is received when needed.

Gateway Health Medicare Assured Prime and Select plans are Medicare Advantage HMO plans with a Medicare contract.

Gateway Health Medicare Assured Prime (HMO) is a Medicare Advantage Prescription Drug plan created for individuals who are eligible for Medicare Parts A and B. It’s an inclusive, convenient plan with fixed, manageable costs offering additional coverage. The Prime HMO MAPD plan has a monthly premium. 

Gateway Health Medicare Assured Select (HMO) is a Medicare Advantage Prescription Drug plan created for individuals who are eligible for Medicare Parts A and B. It’s an inclusive, convenient plan with fixed, manageable costs offering additional coverage. The Select HMO MAPD plan has no monthly premium. 

Gateway Health Medicare Assured Value is a Medicare Advantage HMO plan with a Point-of-Service option, with a Medicare contract. Point-of-Service means you can use providers outside the plan's network for an additional cost.

Gateway Health Medicare Assured Value (HMO-POS) is a Medicare Advantage Prescription Drug plan created for individuals who are eligible for Medicare Parts A and B. It provides flexibility that allows plan members to seek care outside of the traditional plan network. It’s an inclusive, convenient plan with fixed, manageable costs offering additional coverage. The Value HMO-POS plan has a monthly premium.

Plans may vary by state and county.

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