Ohio & Kentucky Diamond Plan Update

State Medicaid programs in Ohio and Kentucky do not pay the 20% coinsurance charge for diabetic supplies (such as test strips). To ensure our members have immediate access to the medical supplies they need, Gateway Health is covering the coinsurance for Diamond members in these states.

This means going forward, Diamond members should not have any out of pocket costs for their formulary-approved diabetic supplies from in-network pharmacies.

If you have Diamond members in Ohio or Kentucky who were charged for their diabetic supplies between January 1, 2017 and today, please send me their information so I can submit it for reimbursement. Email the details to nskubal@gatewayhealthplan.com.

Note this does not affect members in North Carolina or Pennsylvania – they should continue to show both their Gateway and Medicaid cards at the pharmacy.

As always, please direct members to Gateway's Member Services department at 1-800-685-5209 with any questions or concerns.