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Gateway Health Medicare Assured Plans

Special Notice


SPECIAL NOTICE FROM GATEWAY HEALTH MEDICARE ASSUREDSM RE: DECLARATION OF A STATE OF EMERGENCY IN NORTH CAROLINA DATED SEPT. 7, 2018

In light of the recent disaster emergency declaration, Gateway Health Medicare AssuredSM has initiated temporary medical and pharmacy access guidelines for members residing North Carolina.

Beginning immediately, affected Gateway Health Medicare Assured members will be able to obtain medically necessary prescription drugs at out-of-network pharmacies if needed, and to obtain prescription refills sooner than would normally be necessary. Medical behavioral health, dental and vision services may be obtained at out-of-network providers, if medically necessary. Requirements for gatekeeper referrals will be waived in full, where applicable. Prior authorization rules are temporarily suspended.

For questions or concerns, please contact Gateway Health Medicare Assured SM

Member Services Department at:
1-800-685-5209 in PA
1-888-447-4505 in OH
1-855-847-6380 for KY
1-855-847-6430 in NC

TTY users should call 711.

Member Services’ Hours of Operation
Monday-Friday, 8 AM- 8 PM from February 15 – September 30
Weekends (Saturday & Sunday), after business hours and holidays: You may leave a voicemail message.

OR

7 days a week, 8 AM – 8 PM from October 1 – February 14 (AEP)
After business hours and holidays: You may leave a voicemail message.

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.

Y0097_1104 Approved

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