Ambetter Insurance Review we provide here for you so that you can choose which is a better option for you. Ambetter Insurance is a health insurance provider whose goal is to keep healthcare costs low. That’s why they design health insurance plans that fit both your needs and your budget.
Purchasing your own health insurance can be daunting, especially if you are used to contracting with your company. However, if you are self-employed, recently unemployed or have some other reason for wanting or needing to purchase your own health insurance, be sure to weigh the cost and coverage.
Ambetter tries to do this by offering three different levels of plans in different states. In this Ambetter insurance review, I’m going to discuss the company in detail so you can determine if it’s right for you.
What is Ambetter insurance?
Ambetter Insurance is a health insurance provider whose goal is to keep healthcare costs low. That’s why they design health insurance plans that fit both your needs and your budget.
But Ambetter goes beyond their health insurance plans. They strive to make their clients’ wellness go beyond doctor visits and everyday life. As an organization, they claim to be actively involved in their local communities and are committed to helping their clients live well.
Each of its plans includes programs, tools, and support. Examples include telemedicine (medical visits via videoconference), a premium program, integrated care management, 24-hour nursing consultation, etc.
Their products are offered by Centene Corporation, a Fortune 500 multinational company with over 30 years of experience in the managed care industry. They also have a broad portfolio of specialized healthcare solutions in the organizations they work with, such as Ambetter.
How does the Ambetter insurance company work?
Ambetter offers you three different types of plans: bronze, silver, and gold. Each of them has advantages and disadvantages, and you have to decide which Ambetter Health Insurance is best for you and your situation. That’s why we write this article here about Ambetter Insurance Review for you.
Each plan will also vary slightly depending on where you live — assuming it is available in your state. You can find a brief description of each level below:
Bronze: This is what Ambetter considers your essential care plan. It covers your most basic health care needs. Monthly premiums are usually lower, but out-of-pocket costs are higher.
Silver: This is Ambetter’s “Balanced Care” plan, which balances the monthly premium you pay with the expenses you pay yourself.
Gold: This plan is called “Secure Care” from Ambetter Health insurance and is designed to take the worry out of your health care. To achieve this goal, you pay higher monthly premiums to limit the costs you may incur overtime.
This is how the three plans work from a cost perspective:
Each state has its own plans within these three tiers, and you can view full details of your state’s plans here. Currently, plans are offered in the states mentioned below:
- New Hampshire
- North Carolina
- South Carolina
Ambetter Insurance Review: Our Thoughts
Ambetter Health Insurance is a marketplace plan provider that offers health insurance. This company is only a health insurance option on the exchange, which means they do not sell the product directly to you. Instead, depending on the state you live in, health plans are offered by an insurance company that works with Ambetter.
To enroll in Ambetter health insurance, you must enroll in your state’s health insurance marketplace during the Obamacare enrollment period. However, you can also enroll in Ambetter health insurance if you have an eligible event. So, this Ambetter Insurance Review will tell you about the best options.
Ambetter health insurance plans can be purchased in some states and are offered by several insurance companies. Among them are:
Once you have determined your status and the plan you want, fill in the required information and receive a quote for your policy. Regardless of the plan and coverage you choose, each plan offers coverage for:
- Outpatient or home treatment
- Preventive and restorative care
- Care of newborns and mothers
- Pediatric care
- Mental health and addiction care
- Laboratory services
- Prescription drugs
- Therapeutic services
Unique member resources and benefits
As an Ambetter policyholder, you have access to additional member benefits, such as the rewards program and nursing tips. In addition, Ambetter’s MyHealthPays rewards program allows you to earn rewards for completing wellness tasks and activities. Upon completion of activities, rewards are automatically credited to your MyHealthPays card.
These activities include taking the Ambetter Wellness Survey, getting an annual wellness exam with your doctor, or getting a flu shot. Rewards can be used for a variety of expenses, including.
- Payment of your monthly premiums
- Medical expenses
- Everyday items at Walmart
- Utilities (gas, electricity, water)
- Cell phone bill
- Transportation, training, or rental
The Nurse Advice Line is a 24-hour telephone service you can call to ask questions or raise concerns about your health. An experienced nurse will listen to your problem and advise you on what to do next. For example, if you have back problems, you can call the nurse, explain your problem and get an answer about whether you should see a chiropractor.
You can access all of your member benefits through Ambetter’s online portal. Here you can access your account, pay all premiums, view your health insurance benefits, and request an insurance ID card.
Ambetter Insurance Review: Customer comments and complaints
If you are looking for the cheapest health insurance rates, Ambetter health insurance is a good choice. However, Ambetter health insurance reviews are below average to poor. Many policyholders complain about long wait times for phone calls when contacting Ambetter employees, as well as the fact that providers do not charge for medical services. In addition, many participants report being billed incorrectly and not finding providers in their area who accept Ambetter insurance.
These customer reviews are supported by Ambetter Insurance Review ratings. The Better Business Bureau has rated the company a “D,” meaning it rarely interacts with customers or responds to complaints in a timely manner. Ambetter also received an NAIC complaint rating of 1.12, meaning the company received more complaints than average for its size.
Ambetter health insurance is a Marketplace plan offered by CeltiCare Insurance, a subsidiary of Centene Corp. When you purchase an Ambetter policy, your point of contact for any questions is Celticare. For example, in Florida, Ambetter plans are sold under the Ambetter name by Sunshine Health but are administered and underwritten by CeltiCare Insurance.
How much does Ambetter’s insurance cost?
The cost of any type of insurance, but especially health insurance, varies considerably. For this reason, it is difficult to determine the exact price or even the range of prices that might be expected.
Some websites try to give you a concrete price for Ambetter: do a Google search if you don’t believe us, but honestly, we wouldn’t trust it. It’s a ballpark figure based on a fictitious person, not you.
The only way to really understand the cost is to fill in the basic information, including your location, and get a quote tailored specifically to you.
Ambetter Insurance Review features
My Health Pays® Program
Get rewards for healthy actions such as eating right, exercising more, managing your savings wisely, and simply living a healthier lifestyle. The more actions you take, the more rewards you get.
Ambetter works with providers and pharmacists to make sure your medications are covered for a variety of medical conditions. Ambetter covers prescription drugs and some over-the-counter medications when prescribed by an Ambetter provider.
Please note that Ambetter’s pharmacy program does not cover all medications: some require prior authorization or have age, dosage, and maximum quantity restrictions. Preferred drug lists are available on their website.
Nurse call number
At Ambetter, you can speak to a registered nurse at any time. They are open 24 hours a day, seven days a week, and 365 days a year. The nurse call line can help you and your family get the care you need when you really need it. There, experienced nurses are ready to help you with follow-up appointments, emergencies (such as pregnancy pain), or the need to go to the emergency room.
Nursing care management
If you have complex medical or behavioral issues, Ambetter offers care management services that are “member-centered, family-centered and culturally competent.” Care managers are registered, nurses or social workers. They can help you better understand and manage chronic illness, find resources in the community, and much more.
And if you have a serious illness, Ambetter has Care Managers who work with you personally, your doctor, and your providers to develop a care plan that meets your needs and those of your caregivers.
Health management programs
If you have a chronic illness, Ambetter works with your disease management company to provide you with solutions to manage your condition. Ambetter wants you to lead a healthy lifestyle. Therefore, Ambetter will contact you by phone, provide educational materials and otherwise help you better understand and manage your disease and reduce complications. Ambetter also offers behavioral health services, such as depression treatment.
Start Smart for your baby
Start Smart for Your Baby® (Start Smart) is Ambetter’s exclusive program for pregnant women that helps you take care of yourself and your baby every step of the way. To enroll in this program, simply contact Member Services or login to your Ambetter member account to complete a Pregnancy Notification Form (PNF).
Starting this year, Ambetter Telehealth is a new service offered by Teladoc. Telehealth is simple and provides 24/7 access to healthcare providers in the Ambetter network for non-emergency health issues.
You can use it when you are at home, at work, or even on vacation. You can get medical information, a diagnosis, or even a prescription over the phone or by video conference. You can use Ambetter Telehealth when you need it or make an appointment at a time that is convenient for you.
Who is Ambetter’s insurance best suited for?
Ambetter coverage is suitable for individuals who do not have health insurance through their company, whose plans are available through Ambetter in their state, and who are looking for competitive rates. If you are looking for answers to these questions, then this Ambetter Insurance Review is for you.
In addition, people with chronic diseases will benefit from the various programs offered, such as care management. In addition, those who wish to access their providers virtually through Teledoc will be able to easily access this service.
Finally, individuals who prefer to call an on-call nurse to have the peace of mind of being able to speak with a registered nurse 24 hours a day about any issue.
Who should not insure with Ambetter?
If you have health insurance through your company, you probably don’t need to worry about Ambetter, as you will probably be sufficiently covered by that insurance. If not, or if you need dental or vision insurance, Ambetter may be a good fit.
But if you are reading this article, chances are you are not insured by your company. So if you live in a state where no insurance plan is offered, you won’t have Ambetter, because there’s nothing you can do.
Finally, you may not get the best price when using Ambetter’s services. They don’t offer basic services, so you’ll have to pay for the extra services they offer. So if you’re looking for something simpler, you should look elsewhere.
Strengths and weaknesses
The many benefits included in all plans – such as care management, telehealth, Smart Start, and a rewards program – are standard in all plans, regardless of the level you choose.
Multiple tiered plans: You can choose from three different tiered plans, allowing you to find the best balance for you between your monthly premiums and your total billable expenses.
Many free resources – Ambetter offers many free resources to help you better understand your coverage and your plan.
Not offered in all states: unfortunately, Ambetter plans are currently only available in 18 of the 50 states, and it is unclear whether they will be expanded to other states in the near future.
Pricing is opaque: this is partly the nature of the insurance industry, as pricing is largely dependent on the individual, but I was disappointed that Ambetter did not at least give ballpark figures on their website or how their pricing compares to their competitors.
Overall, Ambetter offers a pretty good deal. They offer affordable health insurance in several states and several different options for you to choose from. And the enrollment process is very simple.
Despite some drawbacks, if your area is covered and you need to purchase health insurance, it’s a good idea to at least get a quote from Ambetter, especially since you don’t have to provide an email address or phone number.
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