Gateway Health Plan Company
Gateway Health Plan
For many residents, Gateway Health Plan is the keystone to health care coverage in Pennsylvania. The company provides managed health care services (as an HMO) to residents in 28 counties. Its Medicaid HMO serves some 220,000 eligible recipients. In addition, the company serves about 25,000 members who qualify for both Medicare and Medicaid assistance through its Medicare Assured HMO special needs program (Medicare Assured®HMO SNP). Gateway's services include primary care, dental, prescriptions, disease management, and mental health services. Gateway, an affiliate of Highmark, was founded in 1992 as an alternative to the Department of Public Welfare's Medical Assistance Program in Pennsylvania.
Gateway expanded its territory in 2011 by opening enrollment in its Medicare Assured®HMO SNP product to Philadelphia residents who qualify with dual Medicare and Medicaid eligibility. To provide for this potential community of about 70,000, the company signed multi-year contracts with Albert Einstein Healthcare Network, Community Health System, Mercy Health System of Southeastern Pennsylvania, and Temple University Health System, expanding its local network of health care providers by about 1,500.
In 2010 the company had reduced the size of its service territory for the Medicaid HMO plan by withdrawing from certain voluntary counties previously served through the Department of Public Welfare program. The move came after Gateway Health Plan had experienced increased enrollment in its programs in 2009 due to rising unemployment levels in Pennsylvania and the US.
Gateway is a fully owned subsidiary of Gateway Health Plan, L.P., which holds about 25% of its consolidated capital reserves.
