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Ambetter vs. WellCare Insurance
Which health insurance company is the best option for you and your family? Compare Ambetter and WellCare side by side.
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 Written & Edited by Fran Majidi Fran MajidiFran Majidi manages content on SmartFinancial's website. She's had nearly a decade's worth of experience writing about i... Read more |
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Ambetter vs. WellCare: 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 1985, Wellcare began as a Medicaid provider for the state of Florida, with operations in Tampa, Florida. After the Balanced Budget Act of 1997 was passed, WellCare began offering Medicare Part C, now called Medicare Advantage. In 2003, it offered Medicare Advantage plans with prescription drug coverage. In 2004, Wellcare went public. In November 2013, WellCare appointed Chairman David Gallitano to serve as interim CEO. He increased spending on technology and famously dorned the walls with photographs and portraits of health plan members, including people who suffer from chronic conditions like cancer, homelessness, and hunger. In 2014, WellCare hired Kenneth Burdick as the new CEO and board member. He’d originally joined the company as the president of national health plans but was promoted first to president and COO and eventually CEO. In September 2017, Wellcare announced a rebrand with a focus on holistic health: “Beyond Healthcare: A Better You.” In October 2017, Wellcare announced the UNC Health Alliance primary care physicians and specialists into its Medicare Advantage network. Wellcare operates in 20 states and was recognized by Fortune Magazine as One of the World’s Most Admired Companies in January 2018. In January 2020, Wellcare was acquired by Centene Corporation.
To learn more about each company, you can check out the Ambetter Overview and WellCare Overview.
What is Ambetter and WellCare Insurance Rating?
Which health insurance company is better? We've made it easy to compare companies side by side. See how Ambetter and WellCare ranked among the industry ratings.
| Comparison | Ambetter | WellCare |
|---|---|---|
| Year Founded | 1984 | 1985 |
| Medicare Star Rating | 3.57 stars (out of 5) | |
| BBB Rating | A+ | A+ |
| NAIC Complaint Index | 1.12% for individual health insurance | |
| Market Share Percentage | 20% | |
| Financial Strength | Excellent |
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Pros & Cons of Ambetter or WellCare
Pros
Ambetter
- Ambetter provides coverage to individuals who don’t qualify for traditional plans.
- Very high market share.
WellCare
- Affordable Medicare plans with many options for savings.
- Offers PPO plans for Medicare Advantage, allowing for more freedom in choosing 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.
WellCare
- The PPO plans are only available in select counties in New York, Georgia, Florida, and South Carolina.
- Medicare ratings have dropped over the past few years, possibly due to rapid expansion and acquisition.
Ambetter and WellCare Mobile Apps Options
The MyWellCare app allows you to keep track of your benefits, look for providers, and use it as a digital ID Card.
| Ambetter Mobile App | ||
|---|---|---|
| Ambetter does not currently have a mobile app. | ||
| WellCare Mobile App | ||
|---|---|---|
| iOS | 1.7 | 53 users |
| Android | 2.3 | 209 users |
Ambetter and WellCare 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/.
WellCare
You can get several free health insurance quotes here. For Wellcare enrollment forms visit here.
How to File a Claim with Ambetter and WellCare 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.
WellCare
Your doctor or care provider should submit a claim to the insurer. You should be covered except for copay. Your insurer will send you an explanation of benefits. If you owe anything, your doctor will send you a bill. If you visit an out-of-network provider, you will not be covered unless it was an emergency. Call 855-672-2755 with any additional questions.
Common Questions About WellCare and Ambetter Insurance
Ambetter
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.
Does Ambetter require pre-authorization for services?
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.
WellCare
What is WellCare insurance?
WellCare provides managed care services through Medicaid, Medicare Advantage and Medicare Prescription Drug plans.
Is WellCare good insurance?
WellCare received 3.57 stars out of 5 by Medicare’s rating system. It has an A+ rating with the Better Business Bureau (BBB).
Who takes WellCare insurance?
Wellcare has a network of providers. To find a WellCare provider or to see if your doctor accepts Wellcare, visit here.
Are Wellcare and Centene the same?
Centene acquired Wellcare in January 2020.
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Ambetter and WellCare 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/ | |
| WellCare Contact Info | |
|---|---|
| Address | P.O. Box 31370 |
| Phone | 1 (800) 960-2530 |
| Website | https://www.wellcare.com/ |
| https://www.facebook.com/WellCareHealthPlans/ | |
| Youtube | https://www.youtube.com/channel/UCpI5y9aJ895uevK-EAG67eA |
| https://twitter.com/PlansWellcare | |
| https://www.linkedin.com/company/wellcare/ | |
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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