Does gateway offer Medicare or Medicaid plans?
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. This information is not a complete description of benefits. Contact the plan for more information.
What are the different types of gateway health plans?
If you’re eligible for both Medicaid and Medicare, we offer two types of complete plans - the Ruby Plan and the Diamond Plan. As a Gateway Health plan member, you’ll get access to our team of helpful problem solvers, and all kinds of different benefits and programs to help make your life better. Here are some our most popular benefits:
What benefits do gateway health plan members get?
As a Gateway Health plan member, you’ll get access to our team of helpful problem solvers, and all kinds of different benefits and programs to help make your life better. Here are some our most popular benefits: Dental for preventive and comprehensive services Vision that covers your exam and eyewear needs
How many tiers are there in Gateway Health?
This helps the plan to organize and manage the prescription cost-sharing. The Gateway Health Medicare Assured Diamond (HMO D-SNP)’s formulary is divided into 5 tiers. Every plan can name their tiers differently, and can place medications on any tier.
How much is the Medicare deductible for 2021?
So, you are 100% responsible for the first $445 in medication costs for drugs not on the excluded tiers. After you have met the deductible, the Gateway Health Medicare Assured Diamond (HMO D-SNP) will share the costs of your medications with you -- see cost-sharing below. $445 is the maximum deductible for 2021.
What is H5932 001?
The following Medicare Advantage plan benefits apply to the Gateway Health Medicare Assured Diamond (HMO D-SNP) (H5932 - 001) in Washington, Pennsylvania . This plan is administered by GATEWAY HEALTH PLAN, INC.. To switch to a different Medicare Advantage plan or to change your location, click here. Click here to see the Gateway Health Medicare ...
How much does the Donut Hole pay for generic drugs?
Healthcare Reform mandates that the insurance carrier pay 75% of your generic drug prescription costs in the donut hole on your behalf. The brand-name drug manufacturer will pay 70% and your plan will pay an additional 5% of the cost of your brand-name drugs purchased in the Donut Hole, for a total of 75% discount.
What is the initial coverage phase?
The Initial Coverage Phase (ICP) can be thought of as the cost-sharing phase of the plan. During this phase, you and the insurance company share your prescription costs. Once you have spent $445, your initial coverage phase will start. All medication are divided into tiers within the plans formulary.
Does Medicare Part D count toward TROOP?
The portion paid by your plan, does not count toward TrOOP. Some Medicare Part D plans offer coverage during the Coverage Gap that is beyond the mandated discounts. Any drug not covered by the plan’s Gap Coverage will still receive the discounts noted above -- even if the plan has "No Gap Coverage".