Ambetter Health Insurance Review: Cheap Rates, Questionable Service
Ambetter sells cheap health insurance, but customers report problems finding in-network doctors.
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Editor's Rating
Ambetter sells good cheap health insurance, but you should check with your doctors before you buy a plan to make sure they accept the coverage. Ambetter customers have reported issues with finding in-network doctors, even using the company's online search tool. Otherwise, Ambetter has cheap rates and good perks like discounts on gym memberships and mental health apps.
Pros and cons
Pros
Cheap rates
Extra perks like a nurse line
Sells several kinds of coverage
Cons
Can be hard to find covered doctors
Customer service is average
Ambetter health insurance rates
Ambetter health insurance is cheap, making it a good option if you are on a budget.
Ambetter is one of the cheapest health insurance companies for Bronze, Silver and Gold plans. However, its Platinum plans are much more expensive than the national average.
Find Cheap Health Insurance in Your Area
Ambetter is a cheap option in most of the states where it sells plans. Just be sure to call your doctor and ask if they accept the coverage before you buy a plan.
Cost of Ambetter health insurance
Plan tier | Ambetter rate | National rate |
|---|---|---|
| Bronze | $449 | $462 |
| Silver | $521 | $584 |
| Gold | $563 | $641 |
| Platinum | $987 | $813 |
Average monthly rates are for a 40-year-old.
Plan options
Ambetter sells individual and family health insurance plans in four different levels.
- Bronze
- Silver
- Gold
- Platinum
In some states, you may have other options within each plan tier. Ambetter sells plans called Select, Value and Virtual Access, but they're not available everywhere. These plans have the same basic features as Bronze, Silver, Gold or Platinum plans, but they have extra benefits.
Ambetter also sells dental and vision insurance plans. And Centene, the company that owns Ambetter, sells Medicare Advantage and Part D plans through WellCare. Centene also helps provide Medicaid coverage in some states, including Arkansas, Kentucky and Texas.
Ambetter Select plans
Select plans use a "selective" group of doctors and medical offices that have a history of providing a high level of care. While high-quality care is a concern for most people, Select plans limit the number of doctors who will take your Ambetter insurance. Before you choose a Select plan, make sure the doctors you go to are in the network. Select plans are HMOs, but you don't need a referral to see a specialist like you usually do with HMOs.
Ambetter Select plans are available in some parts of Arizona, Florida, Georgia and Tennessee.
Ambetter Value plans
Ambetter Value plans are cheaper than other similar plans. They are also HMOs, and unlike with Select plans, you do need to get a referral from your primary care doctor to see a specialist.
Value plans are sold in parts of Florida, Nevada and Texas.
Ambetter Virtual Access plans
While most of Ambetter's plans give you access to virtual care, the Virtual Access plans make telehealth visits the norm. You'll see your primary care doctor through video calls, but they can still order tests, write prescriptions and refer you to in-person appointments with other doctors.
Virtual Access plans are available in parts of Florida, Michigan, Mississippi, North Carolina, South Carolina and Texas.
Where can I buy Ambetter plans?
Ambetter sells health insurance in 29 states.
Sometimes Ambetter partners with other companies. In California, for example, Ambetter sells plans with a company called Health Net. And in New Jersey, Ambetter partners with WellCare.
Find Cheap Health Insurance in Your Area
You can buy Ambetter plans on HealthCare.gov or your state health insurance marketplace, if your state uses its own website.
You can also buy a plan on Ambetter's website, although you won't be able to qualify for rate discounts, called subsidies, if you buy a plan directly from Ambetter.
States where Ambetter sells health insurance
State | Company |
|---|---|
| Alabama | Ambetter of Alabama |
| Arizona | Ambetter from Arizona Complete Health |
| Arkansas | Ambetter from Arkansas Health & Wellness |
| California | Ambetter from Health Net |
| Delaware | Ambetter Health of Delaware |
Member resources and unique benefits
Ambetter's My Health Pays program lets you earn rewards for healthy living choices like exercising, eating a balanced diet and getting annual vaccines. As you complete activities, the rewards are automatically added to your My Health Pays card. You can use the reward money for health-related costs and a few other types of bills.
- Monthly health plan payments
- Doctor copays, deductibles and coinsurance
- Child care
- Utilities, like your gas, electric and water bills
- Cellphone bills
- Transportation, education or rent
Ambetter also has a discount program. You can save on gym memberships, online fitness programs, meal delivery services like Blue Apron and Home Chef, and mental health programs like Calm and Talkspace.
Most Ambetter plans also include additional perks.
- 24/7 nurse line: Licensed nurses can answer medical questions, help you understand your treatment and help you decide if you need to go to an urgent care or emergency room.
- Care Management: This perk helps you coordinate your medical care from different doctors. It can also help you find resources in your community.
- Start Smart for Your Baby: If you're expecting a baby, this program can help you and your little one stay healthy throughout your pregnancy and after birth.
Customer reviews and complaints
Satisfaction ratings with Ambetter vary by plan and location but are generally average.
Ambetter is made up of different companies depending on where you live. This means that your customer service will vary based on what company your plan comes from.
For example, Ambetter from Peach State Health Plan in Georgia has an average rate of complaints for a company its size, according to the National Association of Insurance Commissioners (NAIC). Ambetter from Magnolia Health in Mississippi has 75% fewer complaints than average about its health insurance. But in Michigan, the Ambetter company has over twice as many complaints as average.
The biggest issue with Ambetter's customer service is finding doctors in the plan's network. Customers have reported difficulty finding in-network doctors near them. There are also reports that the online tool incorrectly lists doctors as in-network when they aren't.
Ambetter lawsuit
Centene and Ambetter are currently involved in a class action lawsuit about their doctor network information. The lawsuit accuses Ambetter of having doctor networks that are too small and violate Affordable Care Act protections, as well as falsifying in-network doctor information online.
Before you buy an Ambetter plan, call your doctors to make sure they accept the coverage. Ambetter is still a good choice for health insurance as long as you confirm with your doctors that your plan is accepted.
If you go to a doctor that is listed as in-network online and turns out not to be, you shouldn't have to pay more. Because the mistake wasn't your fault, you should only be charged your in-network deductible, coinsurance and copays.
That's because the No Surprises Act, which was effective in 2022, requires that health insurance companies keep their network information up to date and prevents the insurance company from charging you more for its mistake.
Frequently asked questions
Is Ambetter a good insurance company?
Ambetter is a good insurance company. Its plans have cheap rates and good coverage. But you should call your doctors before buying a plan and make sure they accept the coverage. Ambetter customers have reported issues with the company's search tool incorrectly saying a doctor is in the network.
What is the Ambetter lawsuit?
Ambetter has been accused of intentionally defrauding customers by providing incorrect information about which doctors are inside its network. That's why it's important to call your various doctors to make sure they accept Ambetter plans before buying coverage. If you rely on the search tool on Ambetter's website, it is possible that you might get incorrect information.
How much does Ambetter cost?
A Silver health insurance plan from Ambetter costs $521 per month for a 40-year-old. But rates vary by state. New Hampshire has the cheapest Ambetter rates, at $368 per month for a Silver plan. Ambetter plans are the most expensive in New York, where a Silver plan costs an average of $644 per month.
Methodology
Health insurance rates and data for 2024 are from the Centers for Medicare & Medicaid Services (CMS) public use files (PUFs). Using this data, ValuePenguin calculated average rates, deductibles and more for Ambetter and other health insurance companies. Plans and providers for which county-level data was included in the CMS Crosswalk file were used in our analysis; those excluded from this data set may not appear.
Other sources include Centene, the National Association of Insurance Commissioners (NAIC) and various Ambetter subsidiaries in different states.
Editorial note: The content of this article is based on the author's opinions and recommendations alone. It has not been previewed, commissioned or otherwise endorsed by any of our network partners.