Orlando Harmon
Ambetter is a health insurance company that offers individual and family health insurance plans in four different levels. They have a variety of plans and healthcare services, including wellness and preventive care, mental health and substance abuse services, maternity and newborn care, pediatric services, and prescription drug coverage. Ambetter has been praised for its affordable rates, but criticized for its poor customer service and limited doctor networks. While Ambetter does not explicitly mention group insurance rates, they offer plans through Centene, which provides Medicaid coverage and Medicare Advantage plans. Ambetter's rates vary by state and plan type, with additional factors such as age and metal tier influencing the cost.
| Characteristics | Values |
|---|---|
| Number of States Covered | 29 |
| Plan Types | HMO, PPO, EPO, POS |
| Metal Tiers | Bronze, Silver, Gold, Platinum |
| Plan Options | Individual, Family |
| Coverage | Preventative and emergency care, therapy, behavioural health help, medications, maternity, hospitalization |
| Perks | Discounts on gyms and healthy food, My Health Pays rewards program |
| Customer Service | Poor, issues with the online tool for finding doctors in-network |
| Average Monthly Rate | $526, varies by age, plan type, metal tier, smoker status, location |
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What You'll Learn
Ambetter's group insurance rates and coverage
Ambetter is a health insurance company that offers individual and family health insurance plans in four different levels: Bronze, Silver, Gold, and Platinum. They also offer dental and vision insurance plans, as well as Medicare Advantage and Part D plans through WellCare. Ambetter is available in 29 states nationwide, including Georgia, Indiana, Mississippi, Missouri, Ohio, and South Carolina.
Ambetter is known for its cheap rates and good coverage. Their plans include perks such as discounts on gyms and healthy food, as well as access to a nurse hotline and a primary care provider (PCP) within a Medical Group. However, Ambetter has been criticized for its poor customer service and issues with finding in-network doctors. Customers have reported that the online tool incorrectly lists doctors as in-network when they are not. As a result, it is recommended to call your doctors before buying a plan to ensure they accept Ambetter coverage.
Ambetter's rates vary by state, with New Hampshire having the cheapest rates at $368 per month for a Silver plan, while New York has the most expensive rates, with a Silver plan costing an average of $644 per month. The average monthly rate for a 40-year-old is $521 per month for a Silver plan. Ambetter also offers Value Plans, which are affordably priced and available in select counties in Texas.
In terms of group insurance rates, Ambetter does not explicitly mention group insurance on their website or marketing materials. However, it is worth noting that some providers, including Ambetter Telehealth, directly contract with groups of individuals, such as unions and associations, outside of an insurer's network. These contracts allow them to offer discounted rates on healthcare services to those they have contracted with. As such, it is possible that Ambetter may offer group insurance rates through these types of contracts, but this information is not readily available to the public.
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Ambetter's customer service
Ambetter is a health insurance company that offers plans with cheap rates and good coverage. The company provides individual and family health insurance plans in four different levels: Bronze, Silver, Gold, and Platinum. These plans have the same basic features, but some plans, such as Select, Value, and Virtual Access, offer extra benefits. Ambetter also offers dental and vision insurance plans, as well as Medicare Advantage and Part D plans through its parent company, Centene.
While Ambetter offers affordable rates, its customer service has received mixed reviews. According to the National Association of Insurance Commissioners (NAIC), Ambetter has an average rate of complaints for its size. However, there are variations across different states. For example, Ambetter from Magnolia Health in Mississippi has 75% fewer complaints than the average, while Ambetter in Michigan has over twice the average number of complaints.
One of the main issues with Ambetter's customer service is finding doctors within the plan's network. Customers have reported difficulties locating in-network doctors near them, and there are reports of the online tool incorrectly listing doctors as in-network. This issue has led to a class-action lawsuit against Centene and Ambetter, accusing them of having insufficiently large doctor networks and providing false information about in-network doctors.
To address this concern, Ambetter customers are advised to call their doctors before purchasing a plan to ensure they accept Ambetter coverage. Despite the challenges with finding in-network doctors, Ambetter offers 24/7 access to a nurse hotline, providing round-the-clock support and reassurance to its members. The company also has a mobile app that allows members to conveniently manage their healthcare anytime, anywhere. Through the app, members can check their coverage, view claims, search for in-network care, and access their digital Member ID Card.
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Ambetter's health plans
Ambetter offers a range of health insurance plans to cater to different needs and budgets. Their plans are available in 29 states across the country, including Georgia, Indiana, Mississippi, Missouri, Ohio, and South Carolina. Ambetter's health plans are divided into several categories, including Premier, Select, Value, Solutions, and Virtual plans, with each offering varying levels of coverage and benefits.
The Premier plans are ideal for individuals with extensive healthcare needs who can afford higher monthly premiums in exchange for lower deductibles and predictable overall healthcare expenses. Within the Premier category, there is the Silver plan, which is suitable for those seeking balanced out-of-pocket costs and monthly premiums. Additionally, the Premier Silver plan is tailored for diabetes care, offering $0 copays on select insulins, a free glucometer, and coverage for specific diabetic supplies.
The Select plans are available in Bronze, Silver, and Gold metal levels, providing affordable monthly premiums and access to an exclusive network of providers and hospitals. However, it's important to note that Select plans utilise a "selective" group of doctors and medical offices renowned for delivering high-quality care, which may limit your choice of healthcare providers.
The Value plans are affordably priced and feature specific healthcare providers and hospitals. Members on Value plans are assigned a primary care provider (PCP) within a medical group who coordinates their care. Referrals are typically required for care outside the scope of the PCP, such as specialist visits. Value plans are offered in Bronze, Silver, and Gold metal levels and are available in select counties in Florida, Texas, and certain other states.
The Solutions plans are "off-exchange" options for individuals purchasing health insurance through defined contributions or health reimbursement arrangements, such as an individual coverage health reimbursement arrangement (ICHRA) or qualified small employer health reimbursement arrangement (QSHERA). These plans are designed for those who don't have health insurance and may not qualify for conventional plans.
Ambetter also offers Virtual plans, which provide 24/7 virtual care access. However, cost-sharing may apply when utilising this feature. Additionally, Ambetter provides dental and vision insurance plans, with benefits and availability varying by state.
While Ambetter offers affordable rates, some customers have reported issues with their customer service and challenges in finding in-network doctors. It is recommended to verify with your doctors whether they accept Ambetter plans before purchasing a policy.
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Ambetter's rewards program
Ambetter is a health insurance company that offers individual and family health insurance plans in four different levels. Ambetter is part of the Health Insurance Marketplace (HIM), which is intended for people who don't have health insurance and may not qualify for typical plans. They offer cheap health insurance plans with extra perks like discounts on gyms and healthy food.
The company also has a rewards program called My Health Pays®, which is available to Ambetter Health members in select states. The program incentivizes members to make healthy decisions by rewarding them for participating in wellness activities. Members can earn points by completing their annual wellness screening, learning new ways to be healthy, and focusing on their overall health. These points can then be converted into money to help cover health-related costs and monthly bills, such as cooking, fitness, and other everyday essentials.
To participate in the My Health Pays® program, members must log in to their Ambetter Health account and activate My Health Pays. Once activated, members can start earning rewards every time they complete a qualified activity. Members must qualify for and complete all activities to receive $500 or more in rewards. It's important to note that the rewards cannot be used for pharmacy copays, except at Walmart, and the funds expire immediately upon termination of insurance coverage.
In addition to the rewards program, Ambetter offers a convenient mobile app that allows members to manage their healthcare anytime, anywhere. The app provides access to all the features of their Online Member Account, including checking coverage, viewing claims, searching for in-network care, and more. The Ambetter website also offers a member portal with extra features, such as providing reminders for doctor's visits, health risk assessments, and member news alerts.
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Ambetter's availability
Ambetter is a good insurance company with affordable rates and good coverage. However, its customer service is not as good as that of other companies. Ambetter sells individual and family health insurance plans in four different levels. These include Bronze, Silver, Gold, and Platinum plans, with extra benefits like discounts on gyms and healthy food. The company also offers dental and vision insurance plans, with benefits and availability depending on the state and plan type. Ambetter is available in 29 states nationwide, including Georgia, Indiana, Mississippi, Missouri, Ohio, and South Carolina.
Ambetter's plans vary in price and benefits, with rates depending on age, plan type, metal tier, smoking status, and location. For example, a Silver health insurance plan costs $521 per month for a 40-year-old, while New Hampshire has the cheapest Ambetter rates at $368 per month for a Silver plan. Ambetter's Value Plans are affordably priced and available in select counties in Texas, with Silver and Gold plan options.
One advantage of Ambetter is that it operates on a National Network, meaning that if you are in a state where Ambetter is available, you are covered at hospitals outside of your "HMO". Ambetter offers PPOs, HMOs, and EPOs, but does not offer HSAs. The company provides 24/7 access to a nurse hotline and a digital platform for virtual visits with healthcare professionals.
While Ambetter offers a wide range of benefits and affordable rates, customers have reported issues with the company's search tool, which may incorrectly list doctors as being in-network. Therefore, it is important to verify with your doctors whether they accept Ambetter plans before purchasing a plan.
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Frequently asked questions
Ambetter offers individual and family health insurance plans in four different levels. Ambetter is part of the Health Insurance Marketplace (HIM), intended for people who don't have health insurance and may not qualify for typical plans.
Ambetter offers three metal tiers on the ACA marketplace: Bronze, Silver, and Gold. All three tiers cover "essential health benefits," including preventative and emergency care, therapy, behavioural health help, medications, maternity, and hospitalization.
Ambetter health insurance costs an average of $526 a month, but the exact amount varies by multiple factors, including age, plan type, metal tier, smoker status, and location. Ambetter's average premiums are lower than most competitors.
