Program Overview
Gateway to Better Health is a temporary health care program for uninsured adults in St. Louis City and County. The program is designed to provide uninsured adults a bridge in care until they are able to enroll in health insurance coverage options available through the Affordable Care Act.
In mid-2017, the federal government tentatively approved extending the program until December 31, 2022, unless other long-term solutions become available.
The program covers primary, specialty and urgent care services for individuals up to 100% of the Federal Poverty Level.
Since the implementation of the Gateway to Better Health program in 2012, the program has provided:
- Access to coverage for more than 66,827 otherwise uninsured St. Louis area residents
- More than 312,700 primary care and dental visits
- Over 1.5 million medications to manage chronic conditions and other diseases
- Nearly 63,000 specialty care visits
- More than 350,000 diagnostic tests, procedures and ancillary services and
- More than 33,500 urgent care visits
Gateway to Better Health is sponsored by the Missouri Department of Social Services in partnership with the St. Louis Regional Health Commission.
For more information, please call the call the Gateway to Better Health call center at 1.888.513.1417.
Who is eligible?
Gateway to Better Health is available for adults who:
- Are between the ages of 19-64
- Are not eligible for MO HealthNet (Medicaid) or Medicare
- Are patients at one of the participating health centers
- Have no other insurance
- Have income at or below 100% of the federal poverty level ($12,760 per year for an adult living alone or $26,200 per year for a family of four)
- Live in St. Louis City or County
What are the benefits?
Gateway to Better Health covers:
- Primary care office visits (podiatry and eye exams included)
- Limited dental services (cleanings, x-rays, pulling of diseased teeth ONLY)
- Urgent care visits (maximum 5 visits per year at GBH provider)
- Specialty care referrals (from your primary care doctor to contracted providers ONLY)
- Non-emergency transportation (to and from GBH covered visits ONLY)
- Generic prescriptions and brand name insulin and inhalers available at your health center
- Substance use treatment (generic prescriptions and counseling services at your health center)
There are no premiums for the program. Copays for Gateway to Better Health are $0.50 - $3.00.
Please call the Gateway to Better Health Call Center at 1.888.513.1417 for additional information on program benefits.
Who’s in the provider network?
Primary Care Providers
- Betty Jean Kerr People’s Health Centers
- Family Care Health Centers
- Affinia Healthcare
- CareSTL Health
- St. Louis County Department of Public Health
Specialty Care Providers
In order to receive a specialty service, you must receive a referral from a primary care doctor at your health center.
Limited outpatient procedures are covered with an approved referral from a network physician. These services are provided in partnership with local in-network hospitals.