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Gateway Health Plan, Inc.

Are you interested in finding out if a health insurance policy from Gateway Health Plan, Inc. might be right for you?

Read through this Gateway Health Plan review, check out the customer reviews of Gateway Insurance at the bottom of this page, and then make sure to compare health insurance quotes online from top health insurance providers by using the free tool on the side of this page.

Read on to learn more about Gateway Health Plan and see if they might be a good fit for your health insurance needs (although similar in name be sure not to confuse Gateway Health Plan, Inc. with the “other Gateway”. Click to read the review of the Gateway Accident & Health Insurance Company).

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, access and financial sense. They endeavor to provide a proactive approach by evaluating all aspects of a patient’s life to identify factors that contribute to some medical issues. These factors can be medical, social, environment, spiritual or behavioral in nature.

Gateway Health Plan, Inc. provides two types of products. The first is called Medicaid HMO and it is available in Pennsylvania to those who qualify for Medicaid. The second is called Medicare Assured, it is available in 27 counties in Pennsylvania and 12 counties in Ohio, and it is for those who qualify for both Medicare and Medicaid. Gateway Health Plan, Inc. currently serves upwards of 244,000 people with 24,000 members in the Medicare Assured plan. They work within a network of 100 hospitals, 8,000 health care professionals, and home health care agencies and have a pharmacy network as well.

This company’s Medicaid HMO product does not require co-payments for visits to Preferred Care Physicians, Dentists or Obstetrics and Gynecologists. They do not limit the number of times you can see your general practitioner or OB/GYN. Routine eye exams are part of this plan as well as coverage for select prescription eye wear. Routine dental exams are covered including x-rays and cleanings. Provided you get a prescription for them, vitamins and over the counter medications are covered on this plan. Other prescription drug coverage is dependent on the category of coverage for which you qualify.

Medicaid HMO also provides some special programs for participants with particular health needs. The Mom Matters program is designed to assist Moms during pregnancy and promote healthy babies. AIR Gateway is geared towards helping those members with asthma. Adults that suffer from congestive heart failure, heart attack, or coronary artery disease can benefit from the Help Your Heart program. Finally, the Health Return Diabetes program seeks to inform patients on ways that diet and medication can control diabetes.

Medicare Assured combines health and prescription coverage in one health plan. In order to qualify for this plan you must be eligible for both Medicaid and Medicare Part A and be enrolled in Medicare Part B. In Pennsylvania this plan provides, the same benefits of original Medicare plus prescription coverage, hearing, vision, dental, health and wellness information and a health club membership. In Ohio, this plan has similar coverage but excludes dental and adds transportation and vitamins and other over the counter medications. There are no monthly premiums for this plan.

This company claims that they strive to meet the ever changing needs of their health insurance customers. They also claim to be committed to high standards of quality and customer service. For this reason they have appointed a panel of eighteen medical experts to regularly review their performance, guidelines and protocols.

This provider has a reputation for its community involvement. This commitment shows as they are working as a community partner to sponsor events, provide free educational programs on health related topics and develop and implement programs that improve health and help people understand the health care system.

US News and World Reports and the National Committee for Quality Assurance (NCQA) ranked Gateway Health Plans among the top 20 Medicaid plans in the nation four years in a row. The NCQA also gave Gateway a rating of excellent for their Medicaid HMO plan. This rating indicates that the plan meets or exceeds requirements in the areas of quality improvement and customer focus, service and protection.

Michael Blackwood, Gateway Health Plans’ President and CEO, was selected by the Pennsylvania Health Conference as the State Rural Health Leader of the year back in 2004. This award acknowledged his contributions to improving health care delivery and his progressive and innovating ideas. Gateway Health Plans is also well rated by their members. A survey of plan participants gave the company a five star quality rating for excellence in quality and service.

You can get free rate quotes from any number of health insurance providers by entering your zip code into the free quote tool above. Why not start with some free quotes today?

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4 reviews

  • Esther Jackson /
    • 11111
    • 11111
    • 33333
    • 22222

    Gateway used to be really good. I don’t know what happened to them. They ARE NOT the same.

    I had Gateway for a long time and then turned 65. They treated me really good at first until 2010. I used to meet their sales folk in the community, and even though I was a member already, they always went out of their way to help me understand my plan and my options.

    I even met one of their big shots who was at an event who took time to introduce himself and tell me he would be available to help me with anything. I called him and he really did help me several times. I tried this year but now he ain’t there no more. Since then they changed.

    I can’t get no one to help me no more. They just don’t seem to care no more. I Hope they get good like they were, but I tell everyone that they ain’t good no more.

  • Paul Bella /
    • 11111
    • 11111
    • 11111
    • 11111

    This company will die with their leadership and medical director. They refused my doctor on this plan when he is ranked one of the top 50 in his field.

    When you have complaints of customer service and can’t get anyone on the phone, then you know what troubles lie ahead.

  • Melvin Aber /
    • 33333
    • 22222
    • 22222
    • 22222

    They raise the premium from $56.40 to $77.80 for Platinum in 2015 plan and they keep on messing up my billing statement always got it wrong.

    • 11111
    • 11111
    • 11111
    • 11111

    I had Gateway for 16 years. Now I’m thinking of leaving them.

    I asked for a grievance with a doctor and of course, they took the doctor’s side. I have fibromyalgia and have problems with my spine. I can’t get my PCP to do anything to help me. I called to do a second level grievance to be hung up on. This company does not care about its members.

    As soon as I find a new insurance I’m leaving them. You can’t get them to pay for anything anymore horrible, horrible company.

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