Formulary Medications

What are Formulary Medications?

Formulary drugs are reviewed and recommended by Gateway Health's P&T Committee. They are are chosen based on safety, efficacy, quality and cost. Doctors and pharmacists should use formulary drugs when appropriate. Gateway ONLY covers Food and Drug Administration (FDA) approved drugs.

Direct Member Reimbursement Claim Request (DMR)

Gateway Health offers HMO plans with a Medicare Contract. Some Gateway Health plans have a contract with Medicaid in the states where they are offered. Enrollment in these plans depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premiums and/or copayments/coinsurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium – The State pays the Part B premium for full dual members. Please contact the plan for further details. The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.


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