Which health insurance company is the best option for you and your family? Compare Ambetter and Molina 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 new acquisition, Wellcare Health Plans, serve Medicaid and Medicare members.
Molina Healthcare was founded in 1980 by C. David Molina, an emergency room physician in Long Beach, CA. After seeing that patients were being turned away because the hospital would not accept Medi-Cal, he established his first primary care clinic in Wilmington, California in 1980. His goal was to treat the lowest-income patients. For 20 years, his son and fellow physician, J. Mario Molina, ran the company while he served as president and CEO. His younger son, John, was the CFO of Molina Healthcare. The two sons took over the company after their father’s death in 1996.
Which health insurance company is better? We've made it easy to compare companies side by side. See how Ambetter and Molina ranked among the industry ratings.
|Medicare Star Rating||3.5 stars (out of 5)|
|NAIC Complaint Index||1.12% for individual health insurance|
|Market Share Percentage||20%|
|A.M. Best Rating||bb|
The Molina app allows users to find doctors, hospitals, and pharmacies, view claims, and pay your bill.
|Ambetter Mobile App|
|Ambetter does not currently have a mobile app.|
|Molina 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/. You can also schedule a personal appointment with a local Kaiser Permanente Medicare specialist: 1-866-973-4588.
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.
To submit claims for reimbursement, contact member services at 1-888-898-7969. You can only inquire about 3 or fewer claims per call. You can also submit claim to: Molina Healthcare, P.O. Box 22668, Long Beach, CA 90801. You must make timely submissions of your claims or else you may forfeit your right to payment. For filing limits and instructions about electronic claims submissions with Molina Healthcare visit here.
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.
Ambetter covers necessary surgery but not cosmetic surgery or other elective types of surgery and procedures, including infertility treatment.
While complaints are common on BBB, Molina offers a competitive managed care option for Medicaid and Medicare recipients. It is generally well regarded by the underserved and lower-income communities who use it.
Molina Dual Options is a health plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to members. This plan is also called Cal MediConnect in California.
As of January 1, 2017, Molina’s Medicaid pharmacy network no longer accepts Walgreens. Molina Medicare members, however, may continue using Walgreens. Walgreens does not participate in the Molina Marketplace pharmacy network.
Molina Healthcare covers dental services including oral surgery, x-rays, sealants, fillings, crowns (caps), root canals, dentures and extractions. It also covers a dental exam and one cleaning every six months. To find a provider, visit here and at the top of the page pick your state. At the bottom of the page you’ll be directed to an online provider directory.
|Ambetter Contact Info|
|Address||Ambetter from Coordinated Care, 1145 Broadway, Suite 300, Tacoma, WA 98402|
|Phone||1 (877) 687-1197|
|Molina Contact Info|
|Address||200 Oceangate, Suite 100, Long Beach, CA 90802|
|Phone||1 (562) 435-3666|
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