For many residents, Gateway Health Plan is the keystone to health care coverage in Pennsylvania. The company provides managed health care services (as an HMO) to residents in 28 counties. Its Medicaid HMO serves some 220,000 eligible recipients. In addition, the company serves about 25,000 members who qualify for both Medicare and Medicaid assistance through its Medicare Assured HMO special needs program (Medicare Assured�HMO SNP). Gateway's services include primary care, dental, prescriptions, disease management, and mental health services. Gateway, an affiliate of Highmark, was founded in 1992 as an alternative to the Department of Public Welfare's Medical Assistance Program in Pennsylvania.