Q&A

Is Gateway a Medicare or Medicaid?

Is Gateway a Medicare or Medicaid?

Through our leading Medicaid and Medicare programs, Gateway Health is coordinating healthcare that goes beyond doctors and medicine that helps members achieve not just physical health, but also delivers whole person care.

Does Gateway take Medicare?

Gateway Health offers HMO plans with a Medicare Contract. You must continue to pay your Medicare Part B premium – The State pays the Part B premium for full dual members. Please contact the plan for further details. The Formulary, pharmacy network, and/or provider network may change at any time.

Is Gateway a Medicare Advantage Plan?

Your Guide to Medicare The following Gateway Health Medicare Assured plans offer Medicare Advantage Prescription Drug plan coverage to Pennsylvania residents.

Who develops the Medicare formulary?

The health plan generally creates this list by forming a pharmacy and therapeutics committee consisting of pharmacists and physicians from various medical specialties. This committee evaluates and selects new and existing medications for what is called the (health plan’s) formulary.

What type of insurance is Gateway?

Gateway Health is a managed care company dedicated to partnering with employers in order to provide them with affordable, well managed health insurance.

What is Medicare Assured?

Gateway Health Medicare Assured Diamond is a Medicare Advantage Special Needs Plan created for individuals who are eligible for both Medicare and Medicaid. This plan is packed with value. It offers $0 premium and multiple $0 copay options to ensure that you get the care you need — when you need it.

Does Gateway cover vision?

Because we provide both medical and routine eye care, each office accepts a number of insurance plans to help cover the cost depending on your individual needs. Here are just some of the plans that we accept: VSP. Medicare.

Does Medicare have a drug formulary?

Most Medicare drug plans (Medicare drug plans and Medicare Advantage Plans with prescription drug coverage) have their own list of what drugs are covered, called a formulary. A tiering exception is a drug plan’s decision to charge a lower amount for a drug that’s on its non-preferred drug tier.

What if my drug is not on the formulary?

If a medication is “non-formulary,” it means it is not included on the insurance company’s “formulary” or list of covered medications. A medication may not be on the formulary because an alternative is proven to be just as effective and safe but less costly.

Is Gateway Health a Medicaid plan?

Gateway Health offers HMO plans with a Medicare Contract. Some Gateway Health plans have a contract with Medicaid in the states where they are offered. Enrollment in these plans depends on contract renewal.

What is gateway health care plan?

Gateway Health Plan, Inc. began in Pennsylvania in 1992 as an alternative to the Public Welfare Assistance Program. They focus heavily on preventative care, health and wellness programs and disease management. Gateway Health Plan, Inc. strives to provide the best possible health care with regard to quality,…

What is gateway health insurance?

Gateway Health is a managed care company dedicated to partnering with employers in order to provide them with affordable, well managed health insurance. Gateway Health is organized as a free-standing corporation, operating separately from the hospitals, physician practices, pharmacies, mental healthfacilities and other providers.

What is Gateway Medical Assistance?

Gateway Health Plan is Medical Assistance (Medicaid) managed care plan. Gateway Health Plan Medicare Assured serves those eligible for both Medicare and Medicaid in Pennsylvania. Gateway Medical Center is a 270-bed hospital in Clarksville TN that serves the residents of Upper Middle Tennessee and South Central Kentucky.