Which health insurance company is the best option for you and your family? Compare Ambetter and CareSource side by side.
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 1989, CareSource was founded on the premise of providing quality health care coverage for Medicaid consumers. Today it offers one of the nation’s largest Medicaid managed care plans. CareSource also offers private health insurance plans on the Health Insurance Marketplace, including Medicare Advantage and MyCare Ohio plans. CareSource has more than 1.9 million members across five states. The company employs about 3,800 people and is considered a nonprofit organization.
Which health insurance company is better? We've made it easy to compare companies side by side. See how Ambetter and CareSource ranked among the industry ratings.
|Medicare Star Rating||2.5 stars (out of 5)|
|NAIC Complaint Index||1.12% for individual health insurance||7.17%|
|Market Share Percentage||20%|
The CareSource app allows you to view your digital ID Card, find a doctor, file claims, make payments and more.
|Ambetter Mobile App|
|Ambetter does not currently have a mobile app.|
|CareSource Mobile App|
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/.
Each state has its own marketplace. If you’re not sure where to begin, visit https://www.healthcare.gov/. Also, remember that CareSource only covers Ohio, Kentucky, Indiana Georgia, and West Virginia.
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.
CareSource accepts claims in various formats, including paper and electronic claims. Reimbursement is based on the prevailing state Medicaid or Medicare fee schedule. With Marketplace Plans, you can make claims inquiries at (866) 286-9949 (Indiana), (855) 852-5558 (Kentucky), (937) 224-3300 (Ohio), (678) 214 7500, (Georgia) and (855) 202-1091 (West Virginia). Visit your app or www.caresource.com to find the right claim forms for the state in which you live.
Out-of-network services and providers require prior authorization unless it’s an emergency service. You need a referral from a Primary Care Physician to see a specialist unless you’re seeing certain in-network doctors like an obstetrician, gynecologist or psychiatrist.
You can earn $500 in rewards with My Health Pays, just for doing health-related activities like moving more, saving and eating right and more. The more activities you participate in, the more rewards you earn.
Unless it’s an emergency Ambetter will only cover in-network providers so it’s highly likely that a doctor in another state will not be covered. If you have a hospital emergency you may be covered. It’s always best to check by speaking with an agent beforehand if you can.
Your member ID # is on the front of your insurance card.
CareSource’s focus is the underserved population. Most of their health plans have an income cap.
CareSource does offer government-subsidized plans and plans on the marketplace.
If you qualify for Medicare or Medicaid, you are eligible for CareSource. Your savings on their marketplace plans are also based on total household income. Government plans require that all incomes in the household be taken into consideration, unless the person is not required to file federal taxes.
CareSource covers Ohio, Kentucky, Indiana Georgia and West Virginia.
|Ambetter Contact Info|
|Address||Ambetter from Coordinated Care, 1145 Broadway, Suite 300, Tacoma, WA 98402|
|Phone||1 (877) 687-1197|
|CareSource Contact Info|
|Address||230 N. Main St., Dayton, OH 45402|
|Phone||1 (937) 224-3300|
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