Ambetter Health Insurance Review & Ratings (2024) | USInsuranceAgents.com (2024)

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

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 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 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.

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.

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 circ*mstances. 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.

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.