Ambetter Health Insurance Review & Ratings (2024)
Discover the Best Ambetter Health Insurance Plans that suit your budget and requirements. Compare quotes from top insurance providers to find competitive rates, comprehensive coverage options, and explore the limited availability in your state. Make an informed decision for your health insurance needs.
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Kalyn Johnson
Insurance Claims Support & Sr. Adjuster
Kalyn grew up in an insurance family with a grandfather, aunt, and uncle leading successful careers as insurance agents. She soon found she has similar interests and followed in their footsteps. After spending about ten years working in the insurance industry as both an appraiser dispatcher and a senior property claims adjuster, she decided to combine her years of insurance experience with another...
Insurance Claims Support & Sr. Adjuster
UPDATED: May 14, 2024
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Advertiser Disclosure: We strive to help you make confident insurance decisions. Comparison shopping should be easy. We are not affiliated with any one insurance company and cannot guarantee quotes from any single insurance company.
Our insurance industry partnerships don’t influence our content. Our opinions are our own. To compare quotes from many different insurance companies please enter your ZIP code above to use the free quote tool. The more quotes you compare, the more chances to save.
Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything insurance related. We update our site regularly, and all content is reviewed by insurance experts.
UPDATED: May 14, 2024
It’s all about you. We want to help you make the right coverage choices.
Advertiser Disclosure: We strive to help you make confident insurance decisions. Comparison shopping should be easy. We are not affiliated with any one insurance company and cannot guarantee quotes from any single insurance company.
Our insurance industry partnerships don’t influence our content. Our opinions are our own. To compare quotes from many different insurance companies please enter your ZIP code above to use the free quote tool. The more quotes you compare, the more chances to save.
On This Page
- Ambetter is a low-cost health insurance product available on the health insurance exchange
- Ambetter is not a health insurance provider, but a product line offered through Centene Corporation
- Ambetter health insurance has limited availability and more negative reviews than average
Welcome to our comprehensive guide on Ambetter Health Insurance and its key features. In this article, we will delve into various aspects of Ambetter Health Insurance, including its plans, coverage options, availability in different states, and customer reviews. Whether you’re seeking affordable health insurance, exploring dental and vision add-ons, or looking for cashback rewards programs, we’ve got you covered.
To make the best decision for your health insurance needs, enter your zip code below and compare rates from top insurance providers in your area. Secure the ideal coverage that fits your budget and ensures peace of mind for you and your loved ones.
Ambetter Health Insurance Plans
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Ambetter Essential Care (Bronze)
Ambetter Essential Care is the most affordable option for health insurance. This bronze plan is most suitable for individuals who do not anticipate regular medical visits. The monthly rates are inexpensive, and the deductibles are very high. Because of this pricing breakdown, this type of insurance is best used by healthy individuals to cover one-time significant medical expenses like catastrophes.
| Ambetter Plan | Monthly Rates | Deductible | MOOP |
|---|---|---|---|
| Ambetter Essential Care 1 | $314.14 | $8,600 | $8,600 |
| Ambetter Essential Care 10 | $328.84 | $7,200 | $8,400 |
| Ambetter Essential Care 5 | $337.60 | $8,300 | $8,700 |
| Ambetter Essential Care 2 | $342.74 | $6,900 | $6,900 |
Ambetter Balanced Care (Silver)
Ambetter Balanced Care is an excellent compromise between monthly rates and out-of-pocket costs. Balanced Care allows the insured to cover average use expenses like regular doctor’s visits while also allowing lower out-of-pocket costs if any expensive one-off procedures are needed.
| Ambetter Plan | Monthly Rates | Deductible | MOOP |
|---|---|---|---|
| Ambetter Balanced Care 31 | $375.05 | $5,450 | $6,450 |
| Ambetter Balanced Care 30 | $375.25 | $6,100 | $6,100 |
| Ambetter Balanced Care 32 | $382.81 | $8,100 | $8,700 |
| Ambetter Balanced Care 12 | $393.81 | $6,500 | $8,400 |
| Ambetter Balanced Care 11 | $398.35 | $6,000 | $8,500 |
| Ambetter Balanced Care 24 | $405.80 | $7,450 | $7,450 |
Ambetter Secure Care (Gold)
Ambetter Secure Care is the highest-level health insurance plan offered through Ambetter. This plan is excellent for individuals who anticipate spending a lot on their health insurance throughout the year. Secure Care is ideal for people who need regular doctor’s visits and expensive medications. While the monthly rates are the highest, the out-of-pocket expenses and deductibles are low for Ambetter Secure Care.
| Ambetter Plan | Monthly Rates | Deductible | MOOP |
|---|---|---|---|
| Ambetter Secure Care 20 | $419.30 | $750 | $7,500 |
| Ambetter Secure Care 5 | $446.11 | $1,450 | $6,300 |
Additional unique benefits of Ambetter’s care plans are the optional vision and dental add-ons. It can be hard to get comprehensive dental and vision coverage for health insurance plans offered through the marketplace. Even though this will cost a bit extra monthly, it can be worth it if you do not obtain private insurance for vision and dental.
Where is Ambetter insurance available?
Ambetter Insurance has a narrow range of coverage and is currently only available in 26 states. Something to keep in mind if you enroll in Ambetter insurance through your state’s exchange is that Ambetter is not a health insurance provider in and of itself. Ambetter is a health insurance marketplace product offered by Centene Corporation.
In each state where Ambetter is available, a state health insurance provider sells the Ambetter product. This provider will vary by name, and it is vital to know your state’s specific Ambetter plan to get the proper care.
Ambetter Health Insurance is Available in These 26 States
- Arizona
- Arkansas
- California
- Florida
- Georgia
- Illinois
- Indiana
- Kansas
- Kentucky
- Louisiana
- Michigan
- Mississippi
- Missouri
- Nebraska
- Nevada
- New Hampshire
- New Jersey
- New Mexico
- North Carolina
- Ohio
- Oklahoma
- Pennsylvania
- South Carolina
- Tennessee
- Texas
- Washington
The Ambetter plans go by a different name in each of these states. In Florida, the Ambetter insurance plan is Sunshine Health, while in Pennsylvania, it is PA Health and Wellness.
To apply for Ambetter Health Insurance, you must visit the health care exchange. Ambetter is only offered through the Health Insurance Marketplace and is not a private insurance option.
The History of Ambetter Health Insurance
Ambetter is a health insurance marketplace product offered through Centene Corporation. Centene Corporation has been in the health insurance business since 1984 and is currently the nation’s largest Medicaid managed care organization.
Centene Corporation is a Fortune 25 company, so you can rest assured that Ambetter Health Insurance is not a scam despite negative reviews. Centene Corporation works with states to provide inexpensive health insurance products for low-income individuals who may not qualify for Medicaid, Medicare, or CHIP.
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Ambetter Health Insurance Benefits
Ambetter offers their customers a few benefits on top of their health insurance products. Ambetter is one of the few marketplace insurance options offering optional dental and vision add-ons. This insurance product might be an ideal choice for individuals looking for this additional coverage who don’t want to seek private companies.
Another draw for some customers is the cashback rewards program that Ambetter offers for health challenges. Ambetter customers can get points by taking surveys and getting wellness check-ups throughout the year. These points are redeemable for cash and other prizes. Some customers have expressed difficulty using Ambetter cash rewards at stores. Many suggest using cashback rewards to pay monthly health insurance premiums, which reportedly poses fewer issues.
Another unique benefit of Ambetter is that Centene Corporation keeps all 26 states under a singular network. This setup is perfect for insured customers who travel often or have family in different states. Suppose you are a resident of New Jersey enrolled in Ambetter’s WellCare health insurance. If you go on vacation to Illinois and fall ill, you can see any doctor in-network for Ambetter’s Illinois Qualified Health Plans. Despite being out-of-state, you will not need to pay out-of-network costs.
Ambetter Health Insurance – Streamlined Claims Process
Ease of Filing a Claim
Ambetter Health Insurance offers multiple options for filing a claim, making it convenient for policyholders. You can file a claim online through their website, over the phone by contacting their customer service, or by using their mobile app. This flexibility ensures that policyholders can choose the method that suits them best.
Average Claim Processing Time
The average claim processing time with Ambetter Health Insurance may vary depending on the nature of the claim and the specific circumstances. It is recommended to contact Ambetter directly or refer to your policy documents for information on the expected claim processing time for your particular situation.
Customer Feedback on Claim Resolutions and Payouts
Customer feedback on claim resolutions and payouts with Ambetter Health Insurance can provide valuable insights into their claims process. It’s essential to research and read reviews from policyholders to understand their experiences with claim resolutions and the timeliness of payouts. This information can help you make an informed decision when choosing health insurance.
Exploring Ambetter Health Insurance Digital and Technological Advancements
Mobile App Features and Functionality
Ambetter Health Insurance offers a mobile app that provides policyholders with convenient access to their insurance information. The app may include features such as the ability to view policy details, check claim status, find in-network healthcare providers, and even submit claims electronically. It’s essential to explore the app’s functionality to take full advantage of these digital tools.
Online Account Management Capabilities
Policyholders with Ambetter Health Insurance can manage their accounts online through the company’s website. This online account management platform allows users to update personal information, view and download policy documents, make premium payments, and track claims. The ease of online account management can simplify the insurance experience.
Digital Tools and Resources
Ambetter Health Insurance may offer various digital tools and resources to assist policyholders in managing their healthcare needs. These resources could include online health assessments, wellness programs, telehealth services, and educational materials. Exploring these digital tools can help individuals make informed decisions about their health and well-being.
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Ambetter Health Insurance Ratings and Reviews
Despite its benefits, Ambetter has a vast number of negative customer reviews. These negative reviews appear across multiple websites, including the Better Business Bureau. Many critical reviews complain about the narrow coverage and subpar customer service. Because Ambetter is an umbrella term for 26 distinct health insurance options across states, it would be wise to research the reviews in your area.
On the Better Business Bureau’s website, Ambetter insurance ratings range from D- to A+ depending on the state. Similarly, the customer reception varies significantly by the state as well.
Some billing professionals suggest that many of these negative reviews stem from customers not understanding that their specific plan may not be known as Ambetter to physicians. This lack of communication can confuse medical billing specialists at healthcare facilities.
Instead of only relying on the website’s list of providers, you should find your state’s Ambetter health insurance phone number and call them to get accurate coverage details.
Despite Ambetter’s website saying that this physician is in-network, the specialists might say they’ve never heard of Ambetter health insurance. Upon further inquiry, you may find that these facilities that claim to not work with Ambetter do work with your state’s specific Ambetter plan. Instead of only relying on the website’s list of providers, you should find your state’s Ambetter health insurance phone number and call them to get accurate coverage details.
In addition to negative customer reviews, Ambetter’s parent company Centene Corporation is currently involved in a class-action lawsuit. This lawsuit pertains to Centene Corporation allegedly providing fraudulent pricing to care providers. Throughout 2021 into early 2022, Centene Corporation was ordered to pay out $360 million to states and institutions regarding Medicaid overcharges. At the end of 2021, the CEO stepped down amidst these allegations.
Ambetter also suffers from a lack of providers due to being a low-income insurance option. Physicians and facilities cannot bill low-income insurance as much as they can charge standard insurance companies.
Comprehensive Overview of Ambetter Health Insurance
Ambetter Health Insurance
Ambetter health insurance is an affordable health insurance product offered on the ACA Health Insurance Marketplace. This option has an overwhelming number of negative customer reviews, so you should be wary of signing up for Ambetter Health Insurance without doing your due diligence.
Find out what name Ambetter goes by in your state and see if your preferred physicians work with this company. Before you sign up for any health insurance plan, you should speak with a professional. To get the best coverage for you and your family at the proper rates, you should always compare health insurance quotes in your area.
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Frequently Asked Questions
Do doctors accept Ambetter insurance?
Yes, doctors do accept Ambetter insurance.
Does Ambetter cover home health care?
Yes, Ambetter does cover home health care.
Does Ambetter have an app?
Yes, Ambetter has an app.
Does Ambetter health insurance cover dental?
Some plans do, but coverage may vary.
Does Sunshine health cover vision?
Yes, Sunshine health covers vision.
How does Ambetter insurance work?
Ambetter operates as a health insurance marketplace offering plans with varying coverage levels.
How good is Ambetter health insurance?
It can vary depending on individual needs and preferences.
How much does Ambetter insurance cost?
Costs vary depending on the plan and location.
Is Ambetter a commercial health insurance?
Yes, Ambetter operates as a commercial health insurance provider.
Is Ambetter a good health insurance plan?
It depends on individual needs and preferences.
Is Ambetter a health care provider?
No, it’s an insurance provider.
Is Ambetter a marketplace insurance?
Yes, Ambetter is a marketplace insurance provider.
Is Ambetter accepted in all states?
No, it varies by state.
Is Ambetter dental insurance good?
It depends on individual preferences and needs.
Is Ambetter for low income?
Yes, for qualifying individuals.
Is Ambetter good health insurance?
It can be for some individuals depending on their needs.
Is Ambetter telehealth free?
It depends on the plan and coverage.
What are the benefits of Ambetter health insurance?
Coverage benefits vary by plan but can include medical, prescription, and preventive services.
What is Ambetter health insurance?
Ambetter provides individual and family health insurance plans.
What is the best Ambetter plan?
The best plan depends on individual needs and preferences.
What kind of insurance is Ambetter?
Ambetter offers individual and family health insurance plans.
What states does Ambetter cover?
Ambetter offers coverage in multiple states.
Who owns Ambetter health insurance?
Ambetter is owned by Centene Corporation.
Is Ambetter medicaid or medicare?
It provides medicaid plans in some states.
Is Ambetter public or private insurance?
Ambetter provides private health insurance plans.
Is Ambetter widely accepted?
Acceptance may vary depending on the provider and location.
What is Ambetter health plan?
Ambetter offers various health plans tailored to different needs.
Why is Ambetter so cheap?
Ambetter may be cheaper due to various factors like network limitations and plan options.
Is Ambetter nationwide?
Yes, Ambetter offers coverage nationwide.
What is Ambetter Health Insurance?
Ambetter Health Insurance is a health insurance provider that offers coverage in several states across the United States. They provide coverage for a range of health services, including medical, dental, and vision care.
Where is Ambetter Health Insurance available?
Ambetter Health Insurance is available in several states across the United States, including Arizona, Arkansas, Florida, Georgia, Illinois, Indiana, Kansas, Mississippi, Missouri, New Hampshire, Nevada, Ohio, Texas, and Washington.
What types of plans does Ambetter Health Insurance offer?
Ambetter Health Insurance offers a variety of health plans, including HMO, POS, and EPO plans. They also offer a range of metal tiers, including bronze, silver, and gold, which indicate the level of coverage provided by each plan.
How can I enroll in Ambetter Health Insurance?
You can enroll in Ambetter Health Insurance by visiting their website or by contacting their customer service team. You can also enroll during the open enrollment period, which typically takes place between November and December each year.
What benefits are included in Ambetter Health Insurance plans?
Ambetter Health Insurance plans include a range of benefits, such as coverage for medical, dental, and vision care, prescription drugs, and preventive care services. They also offer additional benefits, such as telehealth services, wellness programs, and 24/7 nurse advice lines.
What is the cost of Ambetter Health Insurance plans?
The cost of Ambetter Health Insurance plans varies depending on several factors, including the level of coverage, deductibles, and copayments. You can get a quote for a plan by visiting their website or contacting their customer service team.
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Kalyn Johnson
Insurance Claims Support & Sr. Adjuster
Kalyn grew up in an insurance family with a grandfather, aunt, and uncle leading successful careers as insurance agents. She soon found she has similar interests and followed in their footsteps. After spending about ten years working in the insurance industry as both an appraiser dispatcher and a senior property claims adjuster, she decided to combine her years of insurance experience with another...
Insurance Claims Support & Sr. Adjuster
Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything insurance related. We update our site regularly, and all content is reviewed by insurance experts.