Medicare Advantage

2019 Gateway Medicare Plans

For more information on Medicare, please call the number below to speak with a healthcare specialist:

1-800-810-1437 TTY 711

Gateway Health Plan was founded in 1992 to provide customers with an alternative to the Pennsylvania Department of Welfare Medical Assistance Program. Since that time, Gateway has grown into a top-ranked company that serves over 500,000 people in six states. Their network includes 78,000 physicians, 475 hospitals and more than 85,000 pharmacies throughout the country.

The Centers for Medicare and Medicaid Services issues star ratings to let consumers know how a plan is doing compared to other plans. For 2018, Gateway Health Medicare Assured received a 3.5 star rating overall while both the health plan and drug plan services were ranked at 3.5 Stars.

Where Are 2019 Gateway Medicare Plans Available?

Currently, Gateway offers Medicare plans in Pennsylvania, Ohio and North Carolina. In all three states, the company offers a Ruby and a Diamond Plan. In addition to medical care and prescription drug coverage, the plans also offer vision, dental and hearing coverage. Each plan includes wellness coaching over the phone at no additional charge. Coaches include certified rehabilitation experts, dietitian nutritionists and diabetes counselors.

Gateway plans also include membership in SilverSneakers healthcare facilities in an effort to promote a healthier lifestyle among senior citizens. Gateway members are also eligible for the Goodness Rewards program, which provides them with a reloadable gift card that can be used at over 100 locations. Each time a member completes an eligible activity, rewards are added to the gift card. Plans also include access to a 24/7 nurse hotline.

Pricing and availability for Gateway Medicare Advantage plans in 2019 will vary based on your eligibility, where you live and other factors. These plans are only available to people who meet certain income requirements as described below. For example here’s what you might find in Ohio from Gateway Health Plan.

Gateway Medicare Advantage Plans in 2019

Gateway Medicare Advantage (2019)
OH Diamond Plan* OH Ruby Plan*
Monthly premium $0 $33
Copay (primary) $0 $0
Deductibles $0 for medical $0 to $85 for drug $0 for medical $0 to $85 for drug
Network In-network coverage only In-network coverage only
Rx coverage? Yes Yes
Rx cost $0 copay for tier 1 $0 copay for tier 1
Special features Preventive and comprehensive dental, hearing aids and eyewear; transportation, chiropractic and credit for over-the-counter items; home safety devices, a disease management program, and meals after hospitalization Preventive and comprehensive dental, hearing aids and eyewear; transportation, chiropractic and credit for over-the-counter items
Out-of-pocket max $3,400 $6,700
CMS Star Rating 2.5 2.5
*Both plans require enrollment in original Medicare plus eligibility for Medical Assistance.

Some Medicare plans require you to meet income or special needs eligibility for enrollment. In 2019, Gateway Health Plan only sells products to people who meet specific guidelines for eligibility.

The Diamond plan requires you to have Medicare Parts A and B and qualify for the QMB program with Medicare. The Ruby plan also requires enrollment in Parts A and B and eligibility for a Medicare assistance program (FBDE, SLMB, QI or QDI). To learn more about these assistance programs and what those initials stand for, check out the website for eligibility information and the specifics of each program.

Not sure if you qualify for these or other Medicare programs? We can help you sort it out. Medicare Advantage doesn’t have to be a headache when you talk to a licensed Medicare professional about your options. Get a personalized quote today from a licensed medicare professional to learn what’s out there for you.