PARTCRX

Plan Summary

Insurance Type
Medicare Advantage Plan (Part C w/ RX)
Insurance Provider
Gateway Health Plan
CMS Rating
Plan Type
HMO SNP
Annual Deductible
$310.00

What To Know About This Plan

  • This plan has health and drug coverage

Cost Sharing Information

Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit

30 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred GenericNot offeredsNot offeredNot offered
Tier 2: Non-Preferred Generic
Tier 3: Preferred Brand Name
Tier 4: Non-Preferred Brand Name
Tier 5: Specialty Tier
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred GenericNot offeredNot offeredNot offered
Tier 2: Non-Preferred Generic
Tier 3: Preferred Brand Name
Tier 4: Non-Preferred Brand Name
Tier 5: Specialty Tier

CMS Ratings

Staying healthy - screenings, tests and vaccines

Breast cancer screening
Not Rated
Colorectal cancer screening
Cholesterol screening for patients with heart disease
Glaucoma testing
Annual flu vaccine
Pneumonia vaccine
Improving or maintaining physical health
Improving or maintaining mental health
Monitoring physical ability
Access to primary care doctor visits
Adult BMI assessment

Managing Chronic Conditions

Care for older adults – medication review
Care for older adults – functional status assessment
Care for older adults – Pain screening
Osteoporosis management in women who had a fracture
Diabetes care – eye exam
Diabetes care – kidney disease monitoring
Diabetes care – blood sugar controlled
Diabetes care – cholesterol controlled
Controlling blood pressure
Rheumatoid arthritis management
Improving bladder control
Not Rated
Reducing the risk of falling
Plan all-cause readmissions

Ratings of Plan Responsiveness and Care

Getting needed care
Getting appointments and care quickly
Customer service
Overall rating of health care quality
Overall rating of plan

Member Complaints, Problems Getting Services, and Choosing to Leave the Plan

Complaints about the health plan
Beneficiary access and performance problems
Members choosing to leave the plan
Plan makes timely decision about appeals
Reviewing appeals decisions
Call center – foreign language interpreter and TTY/TDD availability

Physician Finder

Physicians that accept Gateway Health Medicare Assured Diamond (HMO SNP) for Pennsylvania

/
GOLDSTEIN, SCOTT
5501 OLD YORK RD
PHILADELPHIA, PA 19141
ALBURGER, PHILIP
3551 N BROAD ST
PHILADELPHIA, PA 19140
CAROLINE, DINA
3401 N BROAD ST
PHILADELPHIA, PA 19140
AKINYEMI, TOLULOPE
25 MONUMENT RD
YORK, PA 17403
PREWITT, JOSEPH
4943 GERMANTOWN AVE
PHILADELPHIA, PA 19144
PHOENIX PHYSICAL THERAPY
4943 GERMANTOWN AVE
PHILADELPHIA, PA 19144
LINCOW, ARNOLD
7622 OGONTZ AVE
PHILADELPHIA, PA 19150
FEASTER, CYDNI
3000 N 22ND ST
PHILADELPHIA, PA 19132
Details
SCOTT GOLDSTEIN, D.O.
Phone Number
(215) 456-6679
Office Locations
5501 OLD YORK RD
PHILADELPHIA, PA 19141
5501 OLD YORK RD PHILADELPHIA PA, 19141

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