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Anthem vs. Ambetter Insurance
Which health insurance company is the best option for you and your family? Compare Anthem and Ambetter 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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Anthem vs. Ambetter: What You Need to Know
In 2004, WellPoint Health Networks Inc and Anthem, Inc. merged and became the nation’s leading health benefits company. In December 2014 WellPoint Inc. changed its corporate name to Anthem, Inc. The Anthem companies offer health care plans and related services like dental, vision, behavioral health, life insurance and disability insurance benefits as well as long-term care insurance and flexible spending accounts. Anthem has about 40 million members and is ranked 33rd on the Fortune 500.
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.
To learn more about each company, you can check out the Anthem Overview and Ambetter Overview.
What is Anthem and Ambetter Insurance Rating?
Which health insurance company is better? We've made it easy to compare companies side by side. See how Anthem and Ambetter ranked among the industry ratings.
| Comparison | Anthem | Ambetter |
|---|---|---|
| Year Founded | 2004 | 1984 |
| BBB Rating | A+ | A+ |
| NAIC Complaint Index | 0.30% for individual health insurance | 1.12% for individual health insurance |
| Market Share Percentage | 6.3% | 20% |
| Financial Strength | Excellent | Excellent |
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Pros & Cons of Anthem or Ambetter
Pros
Anthem
- Anthem Inc. is one of the largest providers of health insurance plans in the country, serving approximately 40 million members
- Anthem Inc. is a financially secure health insurance carrier.
Ambetter
- Ambetter provides coverage to individuals who don’t qualify for traditional plans.
- Very high market share.
Cons
Anthem
- Anthem received some bad press in 2014, for refusing to cover the hospitalization of a man with stage 4 cancers. Anthem ended up paying for coverage after public outcry.
- In 2017, Anthem was fined for untimely responses to complaints.
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.
Anthem and Ambetter Mobile Apps Options
The Anthem Medicaid app is only available to policyholders in 5 states. Indiana, Kentucky, Nevada, Wisconsin, and Virginia. The app allows users to find doctors, hospitals, and pharmacies, view claims, pay your bill, and manage your prescriptions.
| Anthem Mobile App | ||
|---|---|---|
| iOS | 2.2 | 42 users |
| Android | 2.9 | 101 users |
| Ambetter Mobile App | ||
|---|---|---|
| Ambetter does not currently have a mobile app. | ||
Anthem and Ambetter Enrollment Process
Anthem
Anthem 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/.
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/.
How to File a Claim with Anthem and Ambetter Insurance
Anthem
Make sure you use the claim form from your benefit plan because each type is different. You’ll need to get procedures codes from your doctor’s office. File the paperwork within the time limit. Include pre-approval if it’s needed.
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.
Common Questions About Ambetter and Anthem Insurance
Anthem
Are the Anthem Insurance reviews positive or negative?
The complaint ratio on individual health plans are lower than complaint ratios on group health plans. Both fall below the average number of complaints compared with other carriers.
Is Anthem medical insurance good?
Anthem is a trusted medical insurance provider which serves millions of Americans. Complaint ratios, however, tend to be a bit higher than average on group insurance plans.
How does Anthem deductible work?
Like most health care plans, Anthem has an annual flat-dollar deductible you must meet before your plan begins to pay your medical expenses.
Is Anthem Blue Cross the same as Blue Shield?
Anthem offers health insurance as a Blue Cross Blue Shield affiliate.
Ambetter
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?
AYour member ID # is on the front of your insurance card.
Does Ambetter cover surgery?
Ambetter covers necessary surgery but not cosmetic surgery or other elective types of surgery and procedures, including infertility treatment.
Who underwrites Ambetter insurance?
Several different subsidiaries of Centene Corporation underwrite Ambetter Insurance. For instance, Ambetter of Tennessee is underwritten by Celtic Insurance Company.
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Anthem and Ambetter Insurance Contact Info
| Anthem Contact Info | |
|---|---|
| Address | 220 Virginia Avenue Indianapolis, IN 46204 |
| Phone | 1 (800) 331-1476 |
| Website | https://www.anthem.com/ |
| https://www.facebook.com/AnthemBlueCrossBlueShield/ | |
| Youtube | https://www.youtube.com/channel/UCInrJqNqrSpvHwNErijbVyg |
| https://twitter.com/AnthemInc | |
| https://www.linkedin.com/company/antheminc/ | |
| 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/ | |
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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