Ambetter Health Insurance Review 2023| Pros & Cons | Legit & Scam

The goal of Ambetter Health Insurance reviews is to cut down on the cost of healthcare. Ambetter health insurance can be accessed through the Federal Health Insurance Marketplace. It provides crucial healthcare coverage plans as required by the Affordable Care Act and other services like Telemedicine.

Ambetter health insurance is owned by the Centene Corporation, which is reputable for providing programs for uninsured and underinsured individuals. When providing health care insurance marketplace plans, every state functions differently under Ambetter; this includes Medicaid and the Children’s Health Insurance Program (CHIP). Centene acquired Wellcare Health Plans and provides its services to Medicaid and Medicare members.

Centene provides health insurance through Ambetter in 15 States and covers areas like prescription drugs, behavioral and mental health services, maternity and newborn care, and optional vision and dental insurance policies. The company also provides 24/7 nurse advice lines, laboratory services, ambulatory services, and many more.

Regarding insurance policies, Ambetter provides some of the cheapest rates compared to other health insurance policies in the state. However, Ambetter services are not available in all states. Accessing health insurance from Ambetter is useful for people who want basic coverage and additional member benefits.

Many Ambetter Insurance reviews are available that provide information about the insurance company. However, this Ambetter insurance review will help you understand better how it works, its pros and cons, and why you should consider using the service.

Ambetter Health Insurance Historical Facts

Ambetter was founded in 1984 and has a market share percentage of 20% with a Better Business Bureau (BBB) rating of A+ for its financial strength and an NAIC complaint (1.12%), which means it has received over the median amount of complaints.

How Does Ambetter Work?

There are three different insurance packages from Ambetter health Insurance and they include:

  • Gold
  • Silver
  • Bronze

Each of these plans has its pros and cons. Therefore, you need to decide which package is best for you before signing up for a package.


Gold package is also known as “Secure Care” and ensures that most of your Healthcare challenges are taken care of so you worry less.

However, this also requires higher monthly premiums to reduce the cost that may accumulate over time. The premiums for Ambetter Secure Care are the highest.

Conversely, the deduction and out-of-pocket rates are very affordable. The low rates allow you to leverage the benefits of coinsurance.

For those with high medical bills (e.g., Recurring cost of medication that requires monthly refills), Ambetter Secure Care is their best choice.


Silver plan, also called the “Balanced Care,” is designed to balance your monthly expenses with your monthly premium. While this plan has lower deductibles, its monthly premium is expensive.

Different products fall under Balanced Care; each comes with an option of dental and vision add-ons.


The “Essential Care” bronze plan covers basic healthcare requirements. The bronze plan offers the lowest monthly premium. Though, out-of-pocket fees are usually high with this plan.

The Bronze plan is best for those in great health that do not require frequent medical care and expenses. The plan is great for a one-time medical expense that may be on the high side.

Every state has different plans and services, currently run in only 17 states. Which 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 only a marketplace plan that connects insurance companies to clients and does not sell premiums directly.

Ambetter collaborates with different insurance companies and provides customers with suitable offers according to their states and requirements.

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Benefits of Becoming an Ambetter Member

There are some benefits that you enjoy when you become an Ambetter policyholder like nursing tips and Ambetter reward programs.

The Ambetter MyHealthPays reward programs let Ambetter policyholders receive rewards for finishing wellness exercises and events.

Once a policyholder completes an exercise, the system automatically credits his MyHealthPay card with some rewards/points.

The exercise/activities include taking a flu vaccine, getting examined by a doctor to ascertain your wellness, and taking some time to answer Ambetter wellness survey questions.

The rewards you gain from these activities can be used to carter for the following expenses:

  • Settlement of monthly premium
  • Expenses on medical bills
  • Policy deductions
  • Coinsurance
  • Purchasing household items at Walmart
  • Settlement of utility bills
  • Settlement of phone bills
  • Rental fees, transportation, and training fees

Ambetter nurse advice lines are available 24/7 to answer questions concerning health issues. Customers with questions about their health can also call the nurse advice line for assistance. 

Ambetter online portal provides you with the opportunity to access all your benefits as well as make premium payments and apply for an insurance Identity Card.

Pros and Cons of Ambetter Insurance Policy


  • Rates are very affordable
  • Ambetter also provides quality vision and dental coverage


  • The company does not have a mobile App yet
  • The number of states it covers is limited, with no idea whether the company will be expanding to cover the other 50 states or not.
  • Resources are available only to members.
  • Customer service is below standard

Ambetter Insurance Customer Reviews and Complaints

For customers looking for health insurance coverage with cheap rates for their health coverage, Ambetter Insurance is a good place to start from. Nonetheless, customers’ Ambetter insurance reviews rank from below average to poor.

One of the major complaints from policyholders includes poor customer care and long wait hours on the phone to get a response.

Also, other complaints include non-prompt payment of healthcare providers for services.

Again, some members reported wrong billing by Ambetter and the lack of available providers who accept Ambetter insurance in their location.

Due to poor customer relationships, Ambetter has a very poor rating of a D from the Better Business Bureau (BBB). This means that their interaction with customers is very poor, and they hardly respond to queries promptly. 

Ambetter Health Insurance is operated by CeltiCare Insurance, which is a subsidiary company of Centene Corp. for clients who sign up for Ambetter policy, their point of contact is CeltiCare.

For instance, in Texas, Ambetter plans are marketed by Superior Healthplan but underwritten and operated by CeltiCare Insurance.

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Exclusive Member Features of Ambetter Insurance Reviews

1. My Health Pays Program

Awards policyholders for taking healthy actions ranging from exercising more to eating right and living a healthier lifestyle. The more actions a policyholder completes, the more your rewards from the company.

2. Pharmaceutical Program

 Ambetter collaborates with different pharmacies and healthcare providers to provide coverage for different health conditions.

Ambetter covers take care of the cost of most prescription drugs and some over-the-counter medications that Ambetter collaborators prescribe.

It is essential to understand that Ambetter services may not cover all kinds of medication and treatments. Some treatments have age limits, while others require an Ambetter collaborator/partner authorization.

For a comprehensive list of the supported drugs, you can visit Ambetter’s official website for a detailed list.

3. Nurse Call Number

Ambetter policyholders get the opportunity to speak to a registered nurse at any time of the day to seek assistance when the need becomes pressing.

Ambetter registered nurses are available to help and assist you with booking appointments and emergencies like pregnancy troubles.

4. Nursing Care Management

For people with complicated medical conditions or behavioral problems, Ambetter helps to provide care management services that are either:

  • Member or family-centered or
  • Culturally competent

Social workers and registered nurses act as care managers. They help policyholders understand how to manage chronic illnesses better, locate community aid, etc.

Policyholders with severe health conditions can access personal care managers from Ambetter to help them draw a care plan in collaboration with their doctors and other care providers.

5. Health Management Program

Ambetter can also work with disease management companies to provide policyholders with solutions to better cope with their conditions. One of Ambetter’s goals is to help its customers lead healthier lifestyles. 

Ambetter can go as far as contacting customers by phone and providing necessary educational materials to help them better understand and manage their health condition.

Ambetter also assists with depression and behavioral health.

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6. Start Smart for Your Baby (Start Smart)

Start Smart is an exclusive program offered by Ambetter for pregnant women that provides care for mothers and their babies in every stage of their pregnancy. You can log into your Ambetter member account or contact Ambetter member Services to fill a Pregnancy Notification Form (PNF).

7. Ambetter Telemedicine

Ambetter Telemedicine is a relatively new service provided by Teladoc. Telemedicine is designed to provide simple round-the-clock access to healthcare providers that collaborate with Ambetter.

Telemedicine handles only non-emergency health-related issues. You can use telemedicine at your convenience to get information, prescription, and even diagnosis through the phone or video conference call.

Is Ambetter Legit Or A Scam?

With a presence in 17 states and over 30 years of experience, Ambetter is certainly one insurance company registered its presence.

You may have come across different negative reviews about the company online.

Notwithstanding, Ambetter Health Insurance remains reputable and dedicated to offering affordable health insurance.


Ambetter insurance reviews show that the company is suitable for those who do not have medical insurance provided by their company and can access Ambetter plans from their states.

Ambetter has reasonable rates and provides different packages and some optional coverages. It is also a good option for those with chronic diseases looking for ways to reduce the cost of medication.  

It provides educational assistance and the ability for policyholders to reach their providers via a phone call or Teledoc.

Ambetter also provides privacy for those who do not like making their health conditions a public subject. However, it is essential to note that if you already have health insurance provided by your company, you do not require extra health insurance from Ambetter.

We hope you enjoyed reading Ambetter health insurance reviews.  

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