HCSC vs. Ambetter Insurance

HCSC vs. Ambetter: What You Need to Know

Today HCSC serves over 15 million members with a variety of group and individual health care plans, services, and life insurance products. As a pioneer in many states, HSBC was the first to do many things. In Illinois, HCSC was the first to provide coverage for bone marrow transplants, heart transplants and to provide group health insurance to rural and small communities as well as the first CareVan as a mobile immunization program. In Texas, they were the first to provide coverage for cancer treatment, catastrophic diseases like polio, leukemia and diptheria, and they provided healthcare starting at birth. They also provided coverage to migrant farmworkers in Texas. In New Mexico, HCSC was the first to offer PPO coverage, point-of-service coverage, electronics claims exchange with providers, customer service for large group accounts, and in-hospital medical coverage on a per-visit basis. In Oklahoma, HCSC was the first to create a mobile health screening unit and free screenings for vision, hearing, glaucoma, blood, and blood pressure.

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.

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

What is HCSC and Ambetter Insurance Rating?

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

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HCSC and Ambetter Mobile Apps Options

Each state has its own HCSC / Blue Cross Blue Shield app on iTunes and GooglePlay. The app allows users to find doctors, hospitals, and pharmacies, view claims, pay the bill, and manage prescriptions.

HCSC and Ambetter Enrollment Process

HCSC

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

Each state has its own marketplace. If you’re not sure where to begin, visit Healthcare.gov. Remember that HCSC only operates in 5 states: Illinois, Montana, New Mexico, Oklahoma, and Texas.

Ambetter

Ambetter is available through the health insurance marketplace or you can get several free quotes. 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 HCSC and Ambetter Insurance

HCSC

To submit electronic claims, you or your billing agent need to use a third-party claims clearinghouse vendor, like Availity. For paper claims, you need to complete the right claim forms.

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 HCSC Insurance

HCSC

Ambetter

HCSC and Ambetter Insurance Contact Info