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Ambetter vs. Molina Insurance
Which health insurance company is the best option for you and your family? Compare Ambetter and Molina side by side.
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Ambetter vs. Molina: 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.
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.
To learn more about each company, you can check out the Ambetter Overview and Molina Overview.
What is Ambetter and Molina Insurance Rating?
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.
| Comparison | Ambetter | Molina |
|---|---|---|
| Year Founded | 1984 | 1980 |
| Medicare Star Rating | 3.5 stars (out of 5) | |
| BBB Rating | A+ | F |
| NAIC Complaint Index | 1.12% for individual health insurance | |
| Market Share Percentage | 20% | |
| Financial Strength | Excellent |
Pros & Cons of Ambetter or Molina
Pros
Ambetter
- Ambetter provides coverage to individuals who don’t qualify for traditional plans.
- Very high market share.
Molina
- Affordable coverage for underserved communities, like Medicaid and Medicare recipients.
- Affordable marketplace plans for people who do not qualify for Medicaid or Medicare.
- Popular mobile app makes it easy to stay on top of your account.
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.
Molina
- Molina Healthcare only offers Medicaid plans in California, Florida, Illinois, Michigan, New Mexico, New York, Ohio, Puerto Rico, South Carolina, Texas, Utah, Washington and Wisconsin.
Ambetter and Molina Mobile Apps Options
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 | ||
|---|---|---|
| iOS | 4.6 | 1.6K users |
| Android | 2.9 | 351 users |
Ambetter and Molina 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/.
Molina
Molina 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 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.
How to File a Claim with Ambetter and Molina 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.
Molina
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.
Common Questions About Molina and Ambetter Insurance
Ambetter
What is Ambetter My Health Pays® Rewards Program?
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.
Does Ambetter cover out of state?
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.
How do I find my Ambetter member ID?
Your member ID # is on the front of your insurance card.
Does Ambetter cover the surgery?
Ambetter covers necessary surgery but not cosmetic surgery or other elective types of surgery and procedures, including infertility treatment.
Molina
Is health insurance from Molina healthcare good?
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.
What are Molina’s dual options?
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.
Does Walgreens accept Molina’s insurance?
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.
Which dentists take Molina insurance?
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 and Molina Insurance Contact Info
| Ambetter Contact Info | |
|---|---|
| Address | Ambetter from Coordinated Care, 1145 Broadway, Suite 300, Tacoma, WA 98402 |
| Phone | 1 (877) 687-1197 |
| Website | https://www.ambetterhealth.com/ |
| https://www.facebook.com/AmbetterHealthcare/ | |
| Youtube | https://www.youtube.com/channel/UC1fien5XXb1voeybJcWr6kQ |
| https://twitter.com/Centene | |
| https://www.linkedin.com/company/centene-corporation/ | |
| Molina Contact Info | |
|---|---|
| Address | 200 Oceangate, Suite 100, Long Beach, CA 90802 |
| Phone | 1 (562) 435-3666 |
| Website | https://www.molinahealthcare.com/ |
| https://www.facebook.com/groups/Molinaheathcare/ | |
| Youtube | https://www.youtube.com/user/MolinaHealthcare |
| https://twitter.com/molinahealth | |
| https://www.linkedin.com/company/molina-healthcare/ | |
Fran Majidi manages content on SmartFinancial's website. She's had nearly a decade's worth of experience writing about insurance-related topics. Prior, she was an arts and entertainment editor in New York City. She has a B.A. from Barnard College and an M.F.A. in writing from The New School. She writes books under her given name, Afarin Majidi.
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