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Gateway Health Plan


TTY: 711


Per trip $0

Dental care $0

Inpatient hospital 
Per day $3
Maximum with limits $21

Medical centers
Ambulatory surgical center $3
Federal Qualified Health Center / Regional Health Center $0
Independent medical / surgical center $2
Short procedure unit $2

Medical equipment 
Purchase $0
Rental $0

Medical visits
Certified nurse practitioner $0
Chiropractor $2
Doctor $0
Optometrist $0
Podiatrist $2

Outpatient hospital
Per visit $2

Generic $1
Brand name $3

Per service $1

Coordination of Care

Wellness Coaching: Want help meeting your health care goals? We offer wellness coaching over the phone. Our Wellness Coaches can help you make lifestyle changes to improve your health and well-being.

Transition Management: Going to the hospital is hard enough. It can be even harder to understand when to see your doctor or how to take your medications once
you return home. Our Transition Managers are here to answer your questions and guide you in the right direction.

Care Management Programs

Gateway to Lifestyle Management℠: Our dedicated Care Management team can help you understand your medications, know when to see your doctor, and help you find community services. Receive educational materials in the mail, get health tips by phone, or talk with one of our Care Managers.

Member digital tools

Member Portal: Our online Member Portal is your go-to center for health management. You can view claims, complete a wellness profile, find a doctor or pharmacy, and more.

Pregnancy Benefits

MOM Matters®: Our maternity program provides education and support throughout your pregnancy. Earn rewards when you attend maternity and well-baby visits.

Healthy Kids Programs

No extra services.

Vision Benefits

No extra services.

24 Hour Medical Help Line

No Cost, 24-Hour Nurse Line: Have health questions and need answers now? You can talk with a registered nurse 7 days a week, 365 days a year.

Urgent Care Benefits

If you need medical attention when your PCP’s office is closed, you can go to a participating urgent care center.

Healthy Living and Health Education

Goodness Rewards℠ Gift Card Program: Earn a gift card for completing certain health activities. The card is easy to use and works just like money.

Other Benefits

Safelink Cell Phone: No cost smartphones with minutes, data, and unlimited texts every month.

GED Exam: Many jobs require a high school diploma or GED. Gateway Health offers members a chance to take the GED test at no cost.

*Co-pays do not apply to the following: members who are pregnant, members under age 18, members age 18 through 20 who are in foster care, emergency services, or certain drugs for specific diseases. The information about the benefits from each plan was current at the time of printing. Please call the plan directly for the most up-to-date information.