Ambetter vs. Aetna Insurance

Ambetter vs. Aetna: What You Need to Know

Ambetter is a health insurance company owned by Centene Corporation, a multi-national company that provides programs and services to under-insured and uninsured individuals. Centene is the largest Medicaid managed care organization in the country and the number one insurer on the Health Insurance Marketplace. Each state works differently through Ambetter to provide health insurance marketplace plans, including Medicaid and Children’s Health Insurance Programs (CHIP). Both Centene and it’s a new acquisition, Wellcare Health Plans, serve Medicaid and Medicare members.

In 1850, Aetna Insurance Company created a fund to sell life insurance. In 1953 the life and health divisions of Aetna separated. The company’s first president was Eliphalet A. Bulkeley. The name “Aetna” was taken from an 11,000-foot volcano in Sicily, Italy, which was also the most active volcano in Europe.

To learn more about each company, you can check out the Ambetter Overview and Aetna Overview.

What is Ambetter and Aetna Insurance Rating?

Which health insurance company is better? We've made it easy to compare companies side by side. See how Ambetter and Aetna ranked among the industry ratings.

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Ambetter and Aetna Mobile Apps Options

The Aetna Health app allows you to find a doctor in your area and see estimates of what certain procedures may cost. You can also view your benefits, review account balances, and manage your claims. The App is available on ios and Android.

Ambetter and Aetna Enrollment Process

Ambetter

Ambetter is available through the health insurance marketplace or you can get several free quotes here. Each state has its own marketplace. If you’re not sure where to begin, visit https://www.healthcare.gov/.

Aetna

Aetna is available through participating employers. You can also buy an individual or family plan directly from Aetna, the health insurance marketplace or you can get several free quotes here.

At this time, Aetna offers Medicare, Medicaid, student health insurance and international insurance. For individual and family plans, they offer plans through eHealth, which compares rates from several companies for the Affordable Care Act plans, short-term plans, and medical indemnity plans.

How to File a Claim with Ambetter and Aetna Insurance

Ambetter

If you receive non-emergency services from an out-of-network provider, you may be responsible for the entire cost of the medical bill, unless otherwise required by state or federal regulations. To take full advantage of your Ambetter coverage, it is important to only use in-network providers. To appeal a claim that was denied by Ambetter, the member should contact 1-877-687-1197.

Aetna

If you use a network doctor or hospital, your claims will be submitted by that provider. If you see an out-of-network provider, you need to submit the claim yourself. You must submit a completed claim form or alternative documentation via fax or mailing address. As an alternative to sending a claim form, supply a description of services, a bill of charges from the provider and any medical documents you received from your provider.

Common Questions About Aetna and Ambetter Insurance

Ambetter

Aetna

Ambetter and Aetna Insurance Contact Info