October 28, 2021

Highmark Wholecare Medicare Dual Special Needs (D-SNP) 2022 Health Plan Benefits Announced

PITTSBURGH, Oct. 11, 2021 /PRNewswire/ — Gateway Health Plan, Inc. (“Gateway Health”), a leading managed care organization dedicated to caring for…

PITTSBURGH, Oct. 11, 2021 /PRNewswire/ — Gateway Health Plan, Inc. (“Gateway Health”), a leading managed care organization dedicated to caring for the total health of its members, today announced plan benefits and market expansion for its newly branded Highmark Wholecare Blue Cross and/or Blue Shield 2022 Medicare Dual Special Needs (D-SNP) health plans.

For the 2022 Annual Enrollment Period, Highmark Wholecare Blue Cross and/or Blue Shield Medicare D-SNP plans will be available in 12 additional counties across Pennsylvania. The expanded service area includes the following counties: Bradford, Carbon, Clinton, Lycoming, McKean, Monroe, Potter, Snyder, Sullivan, Tioga, Union, and Wyoming.

Highmark Wholecare plans earned a 4.5-star quality rating (out of 5 stars) for contract year 2022 from the Centers for Medicare and Medicaid Services (CMS) and offer supplemental benefits through its Highmark Wholecare Blue Cross and/or Blue Shield Medicare Assured Diamond and Ruby Plans. Both plans include $0 copay options.

“We are proud to introduce Highmark Wholecare Medicare D-SNP health plans to the communities we serve,” said Phil Barr, Chief Growth Officer, Gateway Health. “We remain fully committed to delivering whole person care to those who need it most. With Highmark Wholecare, our members will experience affordable and personalized care they can really count on.”



Highmark Wholecare Blue Cross and/or Blue Shield Medicare Assured Diamond and Ruby Plans (HMO SNP) were created for Medicare beneficiaries on a fixed income and who are eligible for full or partial Medicaid benefits. Plan enhancements and new benefits for those who qualify include:

  • Premium: as low as $0 per month
  • Medicare Covered Services: Low to $0 cost share
  • Medicare Preventive Services: $0 cost share
  • Supplemental Benefits beyond traditional Medicare include the following:
    • Dental: Full preventive care coverage and up to $5,000 for comprehensive coverage for other dental services, including dentures.
    • Vision: up to $600 allowance per year to be used for glass frames with additional lens options at no cost, including transitions or option of contact lens.
    • Hearing: Up to two hearing aids every two years at no cost. Includes 80 batteries per hearing aid, plus an additional box of 120 batteries per year. Unlimited follow-up provider visits within the first year are included for fitting and adjustments services.
    • Home safety items: Up to six home safety items for one year as well as additional product offerings.
    • Meals post-discharge: Up to 28 meals for two weeks post-discharge from an in- patient hospital, skilled nursing or rehab stay.
    • Nutrition counseling: Up to 14 nutrition counseling sessions for one year.
    • Over-the-counter (OTC) medication support: Up to $375 allowance per quarter for OTC medication and health-related products. Plan limitations apply.
    • Transportation: Up to 100 one-way trips to non-urgent medical appointments including the gym.

Highmark Wholecare plans offer special supplemental benefits through the Medicare Assured Diamond Plan for people who have certain chronic illnesses. Members with these conditions may be eligible to receive additional benefits, such as:

  • “Breathe Easy” air quality kit for members with Chronic Obstructive Pulmonary Disease (COPD), giving our members piece of mind while at home. 
  • “Comfort Meals” post-discharge for members with End-Stage Renal Disease (ESRD) to help our members recover quickly within the comfort of their home.
  • “Convenient Care” transportation for members with Diabetes. Allows for trips to the grocery store, social gatherings and more. 
  • “Fresh Delivery” food and produce box for members with Diabetes and ESRD, focused around caring for the whole person.

For more information, visit www.highmarkwholecare.com or call 1-877-428-3929.

About Highmark Wholecare

We believe in caring for the whole person in all communities where the need is greatest. We see a future in which everyone has equal opportunity to achieve their best health. Through our leading Medicaid and Medicare programs, we are coordinating healthcare that goes beyond doctors and medicine that helps members achieve not just physical health, but also delivers whole person care. Our associates are helping to drive this new kind of healthcare in collaboration with a network of 29,000 primary care physicians, specialists, hospitals, and other ancillary providers. We are also committed to supporting our neighbors through our many community outreach and engagement programs.

Gateway Health offers Medicare and Medicaid HMO plans in Pennsylvania. Enrollment in these plans depends on contract renewal. Every year, Medicare evaluates plans based on a 5-star rating system. Gateway Health complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Gateway Health does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-800-685-5209, (TTY: 711). ATENCIÓN: Si usted habla español, tenemos servicios de asistencia lingüística disponibles para usted sin costo alguno. Llame al 1-800-685-5209, (TTY: 711). 小贴士:如果您说普通话,欢迎使用免费语言协助服务。请拨 1-800-685-5209, (TTY: 711).

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SOURCE Gateway Health Plan