Ambetter vs. Kaiser Permanente Insurance

Ambetter vs. Kaiser Permanente: 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 new acquisition, Wellcare Health Plans, serve Medicaid and Medicare members.

After the war ended the shipyard workforce fell from 90,000 to 13,000. Only 12 of 75 medical group providers remained. On July 21, 1945, the Permanente Health Plan opened to the public to continue the health care delivery set up by Kaiser and Garfield. In 10 years, more than 300,000 people enrolled in Northern California with the support of two unions, the International Longshoremen’s and Warehousemen’s Union and the Retail Clerks Union.

In 1953, the name of the health plan and the hospitals were changed from Permanente to Kaiser Permanente. Even today, there are ties between the nonprofit Kaiser Foundation Health Plan and Hospitals and the Permanente Medical Groups.

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

What is Ambetter and Kaiser Permanente Insurance Rating?

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

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Ambetter and Kaiser Permanente Mobile Apps Options

The Kaiser Permanente app allows users to find doctors, hospitals, and pharmacies, view claims, and pay your bill. They also offer an app called Humana Pharmacy which helps you to manage your prescriptions.

Ambetter and Kaiser Permanente Enrollment Process

Ambetter

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

Kaiser Permanente

Kaiser Permanente offers plans through the health insurance marketplace. You can begin searching plans here or you can get several free health insurance quotes here.

Each state has their own marketplace. If you’re not sure where to begin, visit https://www.healthcare.gov/. You can also schedule a personal appointment with a local Kaiser Permanente Medicare specialist: 1-866-973-4588.

How to File a Claim with Ambetter and Kaiser Permanente 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.

Kaiser Permanente

To submit claims for reimbursement, contact member services at 1-888-901-4636. Otherwise, you should be covered except for copay. If you need reimbursement for Medicare Part D prescriptions, you must use the Member reimbursement drug claim form (PDF). For all other prescriptions (non-Medicare and Medicare without Part D) you must use this Prescription claim form (PDF).

Common Questions About Kaiser Permanente and Ambetter Insurance

Ambetter

Kaiser Permanente

Ambetter and Kaiser Permanente Insurance Contact Info