Ambetter Health Insurance Reviews | 2023

The purpose of Ambetter Health Insurance reviews is to reduce healthcare costs. The Federal Health Insurance Marketplace can help you get better health insurance.

It offers the essential healthcare coverage plans mandated by the Affordable Care Act and supplementary services such as telemedicine.

The Centene Corporation, known for delivering services for the uninsured and underinsured, owns Ambetter health insurance. Each state operates separately under Ambetter for deliver healthcare insurance marketplace alternatives, which include Medicaid and the Children’s Health Insurance Program (CHIP).

Centene recently purchased WellCare Health Plans and now offers its services to Medicaid and Medicare beneficiaries.

Centene offers health insurance in 15 states through Ambetter, which includes prescription medications, behavioral and mental health treatments, maternity and newborn care, and optional vision and dental insurance coverage.

The organization also offers services such as nurse advice lines available 24 hours a day, and laboratory and ambulatory services, among others.

For insurance, Ambetter offers some of the most affordable prices in the state when compared to other health insurance products. Ambetter services, however, are not available in all states.

People who desire basic coverage and additional member advantages might benefit from Ambetter’s health insurance.

There are a plethora of Ambetter Insurance reviews online that provide useful information about the organization.

This Ambetter insurance review will help you better understand how it operates, its benefits and drawbacks, and why you should use the service.

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What Is Ambetter Health Insurance?

Ambetter Health Insurance is a health insurance plan provider that sells health insurance products to various insurance companies, selling the plans on state exchanges.

If you want basic coverage and member benefits at a low monthly price, Ambetter’s health insurance plans are the ideal option.

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What Are Ambetter Insurance Historical Facts?

They created Ambetter in 1984 and have a 20% market share. It has an A+ Better Business Bureau (BBB) financial strength rating and an NAIC complaint (1.12 percent), which implies it has had more complaints than the industry average.

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How Does Ambetter Work?

Ambetter Health Insurance offers three different insurance packages, which include:

  • Gold
  • Silver
  • Bronze

Each program has advantages and disadvantages, so you must decide which package is ideal before enrolling.

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The Gold package, also known as “Secure Care,” ensures that most of your healthcare needs are met, allowing you to relax.

However, to avoid accumulating costs over time, this causes more significant monthly premiums. Ambetter Secure Care has the highest premiums.

The deduction and out-of-pocket costs are incredibly reasonable. Because of the cheap prices, you can take advantage of the coinsurance benefits.

Ambetter Secure Care is ideal for those with large medical bills (e.g., recurring drug costs requiring monthly refills).

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The Silver plan, known as “Balanced Care,” keeps your monthly spending and premiums balanced. While this plan has reduced deductibles, it has a high monthly price.

Balanced Care encompasses a variety of solutions, each of which has the option of dental and vision add-ons.


The bronze plan, often called “Essential Care,” covers essential medical needs. The bronze plan has the most affordable monthly payment. However, the plan’s out-of-pocket costs are typically considerable.

The Bronze plan is suitable for people in good health and do not require frequent medical attention. The plan is ideal for a one-time medical bill that is likely to be substantial.

Each state has its plan, and services are available only in 17 states. This includes:

  • Arizona (Ambetter from Arizona Complete Health)
  • Arkansas (Ambetter from AR Health & Wellness)
  • Florida (Ambetter from Sunshine Health)
  • Georgia (Ambetter from Peach State),
  • Illinois (Ambetter from IlliniCare Health)
  • Indiana (Ambetter from MHS)
  • Kansas (Ambetter from Sunflower Health)
  • Mississippi (Ambetter from Magnolia)
  • Missouri (Ambetter from Home State)
  • New Hampshire (Ambetter from NH Healthy Families)
  • Nevada (Ambetter from Silver Summit),
  • North Carolina (Ambetter of North Carolina Inc.)
  • Ohio (Ambetter from Buckeye Health Plan)
  • Pennsylvania (Ambetter from PA Health & Wellness)
  • South Carolina (Ambetter from Absolute Total Care)
  • Tennessee (Ambetter of Tennessee)
  • Texas (Ambetter from Superior)
  • Washington (Ambetter from Coordinated Care)

Ambetter is a marketplace plan that connects insurance carriers with customers, not a direct seller of premiums.

Ambetter works with various insurance carriers to provide customers with the best possible deals based on their circumstances and needs.

What Are The Benefits Of Becoming An Ambetter Member?

When you become an Ambetter policyholder, you get some perks, including nursing tips and Ambetter incentive programs.

Ambetter policyholders can earn rewards for completing health exercises and events through the Ambetter MyHealthPays reward programs.

When a policyholder completes an exercise, the system credits specific rewards/points to his MyHealthPay card.

Getting a flu vaccine, having your health assessed by a doctor, and taking the time to complete the Ambetter wellness survey are among the exercises/activities.

You can use the awards you earn from these activities to pay for the following expenses:

  • Payment of the monthly premium
  • Expenses related to medical bills
  • Deductions from insurance policies
  • Coinsurance
  • Walmart is a great place to shop for household supplies.
  • They settle utility bills.
  • Payment of telephone bills
  • Fees for rentals, transportation, and training

Nurse advice lines are open 24 hours a day, 7 days a week, to address inquiries about health issues. For health-related inquiries, customers can also call the nurse advice line for help.

What Are The Pros And Cons Of Ambetter Insurance Policy?


The prices are quite reasonable.

Ambetter also offers comprehensive vision and dental care.


The company does not yet have a mobile app.

The number of states it covers is limited, and whether it will expand to cover the remaining 50 states is unclear.

Resources are only available to members.

Customer service is not up to par.

What Are The Ambetter Insurance Customer Reviews and Complaints?

Ambetter Insurance is a beautiful place to start for customers looking for health insurance coverage with low rates for their health coverage. Despite this, Ambetter insurance reviews range from mediocre to below average.

Poor customer service and excessive wait times on the phone are two of the most common complaints from policyholders.

Non-payment of healthcare professionals for services is also a source of dissatisfaction.

Again, some members complained about Ambetter’s incorrect billing and the absence of Ambetter-accepting providers in their area.

Ambetter has a D rating from the Better Business Bureau because of poor client relationships (BBB). This suggests that their customer service is poor, and they rarely react to inquiries quickly.

CeltiCare Insurance, a Centene Corp. subsidiary, operates Ambetter Health Insurance, and CeltiCare is the point of contact for clients who sign up for an Ambetter coverage.

In Texas, for example, Superior Healthplan markets Ambetter plans, but CeltiCare Insurance underwrites and operates them.

What Are The Exclusive Member Features Of Ambetter Insurance Reviews?

1. My Health Pays Program

They recognize policyholders for healthy behaviors, such as exercising more, eating better, and living healthier. The more actions a policyholder completes, the greater the company’s rewards.

2. Pharmaceutical Research and Development

Ambetter works with various pharmacies and healthcare professionals to provide coverage for various health issues.

Ambetter covers most prescription drugs and some over-the-counter treatments that are prescribed by Ambetter colleagues.

It’s important to remember that Ambetter’s services may not cover many medications and therapies. Some medicines have age restrictions, while others need approval from an Ambetter collaborator or partner.

You may see a thorough list of the supported medications on Ambetter’s official website.

3. Nurse Call Number

Ambetter policyholders can speak with a registered nurse of the day to seek help when the need arises.

Ambetter registered nurses are available to assist you with scheduling visits and dealing with situations such as pregnancy problems.

4. Nursing Care Administration

Ambetter assists people with complex medical diseases or behavioral issues with care management services that are free or low-cost.

Culturally competent or member or family-centered

Care managers are social workers and registered nurses. They assist policyholders in better understanding chronic conditions, locating community resources, and so on.

Personal care managers from Ambetter can assist policyholders with serious health issues in developing a care plan in consultation with their doctors and other care providers.

5. Health Management Program

Ambetter can also collaborate with disease management firms to help policyholders better manage their ailments. Ambetter’s mission is to assist its consumers in living healthy lifestyles.

Ambetter can even call customers and provide them with instructional materials to assist them in better understanding and managing their health conditions.

Ambetter can also help with depression and mental health issues.

6. Get Your Baby Off to a Good Start (Start Smart)

Ambetter’s Start Smart program is a unique program for pregnant women that provides care for moms and their newborns throughout their pregnancy. To complete a Pregnancy Notification Form, log into your Ambetter member account or contact Ambetter member Services (PNF).

7. Teladoc’s Ambetter

Telemedicine service is a relatively new service supplied by Teladoc. Telemedicine should give healthcare providers who work with Ambetter easy access to information at all hours of the day and night.

Telemedicine is only used for non-emergency medical conditions. Telemedicine allows you to gain information, prescriptions, and even diagnoses over the phone or by video conference call.

Is Ambetter Legit Or A Scam?

Ambetter is one insurance firm registered its presence in 17 states and has over 30 years of experience.

You’ve probably come across several critical reviews about the organization online.

Regardless, Ambetter Health Insurance is a respected company committed to providing affordable health insurance.

Final Verdict

According to Ambetter insurance reviews, the company is suitable for individuals who do not have medical insurance offered by their employer and who are eligible to get Ambetter plans through their states.

Ambetter has affordable rates and offers a variety of packages and certain optional coverages. It’s also a fantastic choice for people with chronic ailments who want to save money on their medications.

It offers policyholders educational resources and the ability to contact their providers via phone or Teledoc.

Ambetter also offers some privacy for people who want not to make their medical concerns a general topic. However, it is essential to note that if your work already provides health insurance, you do not need additional health insurance from Ambetter.

Ambetter Secure Care

The policies offered by Ambetter Secure Care are Gold metal tier policies, which feature the highest premiums but lower deductibles and out-of-pocket maximums.

These reduced deductibles allow you to take advantage of coinsurance benefits more quickly. As a result, if you have high medical bills, such as a monthly medicine prescription, the Ambetter Secure Care Gold plan is the ideal option.

Only one Gold plan from Ambetter: the Ambetter Secure Care 3. The policy has a $1,000 deductible and a $6,350 out-of-pocket limit. After you’ve satisfied your deductible, you’ll start paying 20% coinsurance to the insurer.

Then, much as with other Ambetter health insurance plans, the insurer covers all medical costs after you reach the out-of-pocket maximum.

For example, let’s say you had a $1,500 medical bill. To meet the Ambetter Secure Care 3 deductible, you’d have to pay $1,000. Then you’d pay $100, or 20% of the next $500. Your total bill would then be $1,100.


NIA will manage physical Medicine services for all Ambetter from Home State Health members who will be receiving them; NIA will manage Physical Medicine services through Ambetter from Home State Health’s network of physical medicine physicians.

For Ambetter from Home State Health members, this physical medicine solution encourages evidence-based and cost-effective Physical, Occupational, and Speech Therapy treatments.

Physical Medicine services (Physical, Occupational, and SpeechTherapy) will require Prior Authorization for all services provided to all Ambetter from Home State Health members beginning January 1, 2021, besides the current Home State Health Medicaid and Allwell from Home State Health program with NIA.

No. No authorization is necessary when Ambetter from Home State Health is used with another plan.

Ambetter is a health insurance company that operates in several states. They provide three distinct plan levels and excellent coverage options for those who must purchase their health insurance, but they have certain limitations.


As a Health Insurance Marketplace provider, Ambetter offers various qualifying health plans.

It’s crucial to mention that everyone should be enrolled with a health insurance business like Ambetter because “health is wealth,” as the saying goes. Protect your health to protect your life. 


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