Ambetter vs. Aetna Insurance

Which health insurance company is the best option for you and your family? Compare Ambetter and Aetna side by side.

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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.

ComparisonAmbetterAetna
Year Founded19841853
BBB RatingA+A+
NAIC Complaint Index1.12% for individual health insurance6.27 for individual health insurance
Market Share Percentage20%4.53%
Financial StrengthExcellentExcellent
A.M. Best RatingbbA+

Pros & Cons of Ambetter or Aetna

Pros

Ambetter
  • Ambetter provides coverage to individuals who don’t qualify for traditional plans.
  • Very high market share.
Aetna
  • Aetna is one of the largest insurance carriers and has a vast network of providers.

Cons

Ambetter
  • Even though premiums are low for a bronze plan, the out-of-pocket expenses are very high. You have more coverage with the Ambetter Balanced Care plan and even more coverage with the Ambetter Secure Care plan, which has higher monthly payments and low out-of-pocket expenses.
Aetna
  • It’s not very easy to buy Aetna Insurance unless it’s offered by an employer.

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 Mobile App
Ambetter does not currently have a mobile app.
Aetna Mobile App
iOS     4.529.3K users
Android     3.42,316 users

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

What states accept Ambetter health insurance?

Ambetter offers coverage for individuals in Arizona, Arkansas, Florida, Georgia, Illinois, Indiana, Kansas, Mississippi, Missouri, New Hampshire, Nevada, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas and Washington.

Is Ambetter good health insurance?

If you are under-insured or uninsured and need low-cost healthcare, Ambetter may be a good option because they offer affordable plans. Ambetter only offers insurance in 15 states (see company overview). Ambetter’s complaint ratio, however, is high in some states.

How does Ambetter insurance work?

Ambetter insurance has bronze, silver and gold plans. Ambetter Essential Care has bronze plans, which are cheapest but have the highest deductibles. Ambetter Balanced Care has silver plans, which have lower deductibles and out-of-pocket maximums. Ambetter Secure Care is the gold metal tier policy which has the most expensive premiums but the lowest out-of-pocket maximums.

Is Ambetter (Centene Corp) and WellCare the same company?

Ambetter and WellCare are owned by Centene Corporation. Centene’s acquisition of WellCare was expected to be finalized by the first half of 2020. As one entity, they will be one of the largest providers of Medicaid and Medicare.

Aetna

What type of health plans does Aetna offer?

Aetna offers Aetna Medicare, Aetna Medicaid, student health insurance and international insurance. They offer Affordable Care Act plans, short-term plans and medical indemnity plans through e-Health, which compares insurance partners’ rates for you. Or, you can just visit here for free health insurance quotes.

What pharmacy accepts Aetna insurance?

Medicare Part D plans have a network of participating pharmacies you can find here. For all other types of plans, visit here to find a pharmacy.

Does Aetna insurance cover hearing aids?

Most Aetna plans exclude coverage for hearing aids. Any applicable benefit plan exclusions and limitations for coverage of hearing aids would apply to air conduction hearing aids, implantable hearing aids and semi-implantable hearing aids.

Is Aetna insurance Medicaid?

Aetna offers Medicaid plans, which vary according to individual state Medicaid programs and has a different name in each state.

Ambetter and Aetna Insurance Contact Info

Ambetter Contact Info
AddressAmbetter from Coordinated Care, 1145 Broadway, Suite 300, Tacoma, WA 98402
Phone1 (877) 687-1197
Websitehttps://www.ambetterhealth.com/
Facebookhttps://www.facebook.com/AmbetterHealthcare/
Youtubehttps://www.youtube.com/channel/UC1fien5XXb1voeybJcWr6kQ
Twitterhttps://twitter.com/Centene
Linkedinhttps://www.linkedin.com/company/centene-corporation/
Aetna Contact Info
Address151 Farmington Ave., Hartford, CT 06156
Phone1 (800)-872-3862
Websitehttps://www.aetna.com/
Facebookhttps://www.facebook.com/aetna/
Youtubehttps://www.youtube.com/aetna
Twitterhttps://twitter.com/Aetna
Linkedinhttps://www.linkedin.com/company/aetna/

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