Plans

Ambulance
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 $3

Medical equipment 
Purchase $0
Rental $0

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

Outpatient hospital
Per visit $0

Prescriptions 
Generic $1
Brand name $3

X-rays
Per service $1

Care Coordination: Assistance making appointments, getting medicines, arranging rides, eating healthy foods and meeting all your needs. You may need extra help with your health needs and we will support you.

Wellness Coaching: Improve your health! Talk directly to a coach who can help make a plan just for you. Get tools to make lifestyle changes and care for the whole you.

Telehealth Care: Gateway doctor visits covered by phone or video at no additional cost!

Member Portal: Talk to Gateway, learn about your health risks, find doctors or pharmacies and connect to helpful programs and tools to help you stay healthy.

MOM Matters: Help with appointments, transportation and connection to community programs for mom and baby during pregnancy and beyond. Phone and in-person support at no cost. Earn gift cards.

Caring for Kids: Help to coordinate visits to make sure that your child has all the recommended screenings, tests or shots.

24-hour Nurse Line: Talk directly to a nurse to get answers to your health questions and receive real-time advice. 7 days a week at no cost!

Urgent Care: Need care right away when your PCP office is closed? Go to a participating urgent care center at no cost.

Goodness Rewards Gift Card Program: Earn an easy to use gift card for completing certain health activities.

Gateway Health Connection Centers: In the communities of East Liberty and Harrisburg, open 5 days a week at no cost. Talk to a Case Manager about your health needs or learn about programs or services that you could receive.

GED Exam: Gateway members can take the GED exam 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.