Ambetter Health Insurance Review for 2022

Ambetter is an affordable health insurance product offered on the ACA marketplace. Ambetter is less expensive than other more well-known health insurance companies, but it is only available in 26 states. This health insurance option suffers from a significant number of critical customer reviews. Insurance seekers interested in applying for Ambetter health insurance should exercise caution and thoroughly research their options.

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Melissa Morris has a BS and MS in exercise science and a doctorate in educational leadership. She is an ACSM certified exercise physiologist and an ISSN certified sports nutritionist. She teaches nutrition and applied kinesiology at the University of Tampa. She has been featured on Yahoo, HuffPost, Eat This, Bulletproof, Vitacost, LIVESTRONG, Toast Fried, The Trusty Spotter, Best Compa...

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Laura Walker graduated college with a BS in Criminal Justice with a minor in Political Science. She married her husband and began working in the family insurance business in 2005. She became a licensed agent and wrote P&C business focusing on personal lines insurance for 10 years. Laura serviced existing business and wrote new business. She now uses her insurance background to help educate...

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Reviewed by Laura Walker
Former Licensed Agent Laura Walker

UPDATED: Apr 24, 2022

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The Rundown

  • 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

If you are in the market for a new health insurance plan, then Ambetter may have cropped up on your radar. With the numerous critical reviews, you may be wondering, “Is Ambetter health insurance a scam?” Ambetter itself is not an insurance provider but a Health Insurance Marketplace product line offered through Centene Corporation.

This option is only available in select states, and its pricing is competitive. Because of its limitations, you need to be cautious and conduct adequate research before signing up for health insurance through an Ambetter provider. To get the best health insurance for your situation at affordable rates, you should compare quotes from top health insurance companies in your area.

Ambetter Health Insurance Plans

Ambetter has health insurance plans available for very competitive rates. This product is less expensive than the more well-known health insurance providers like Cigna and Aetna. Ambetter’s limited coverage availability and subpar customer service seem to be the trade-off.

Ambetter offers the three tiers of health insurance plans as determined by the Affordable Care Act. Ambetter’s Bronze, Silver, and Gold plans are named Essential, Balanced, and Secure, respectively.

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.

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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.

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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.

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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