Humana vs. Ambetter Insurance

Which health insurance company is the best option for you and your family? Compare Humana and Ambetter side by side.

Compare Health Insurance Rates in Your Area

Humana vs. Ambetter: What You Need to Know

In 2001, Humana partnered with Navigy to create an online web portal called availity.com, which enables physicians and health providers to conduct business with the two companies. Four years later Human partnered with Virgin Group, offering financial incentives to those with healthier lifestyles. In 2006, Humana launched RightSource, a nationwide pharmacy business. In March 2008, Fortune Magazine named Humana one of the top five “most admired healthcare companies in the U.S.

Humana (HUM) is the third-largest health insurance provider in the US. Their headquarters are in Louisville, Kentucky. Humana has over 13 million customers in the U.S and is 73rd in Fortune 500 rankings. Humana no longer offers individual medical insurance. However, you can shop rates on their website with partner carriers. Or, you can compare quotes with SmartFinancial.

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 Humana Overview and Ambetter Overview.

What is Humana and Ambetter Insurance Rating?

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

ComparisonHumanaAmbetter
Year Founded19611984
Medicare Star Rating3 stars (out of 5)
BBB RatingA+A+
NAIC Complaint Index0.40% for individual health1.12% for individual health insurance
Market Share Percentage20%
Financial StrengthExcellent
A.M. Best Ratingbb

Pros & Cons of Humana or Ambetter

Pros

Humana
  • Humana Health Insurance is a trusted and reliable source for Medicare Supplements and Medicare Advantage.
  • Humana offers commercial health insurance options.
Ambetter
  • Ambetter provides coverage to individuals who don’t qualify for traditional plans.
  • Very high market share.

Cons

Humana
  • Humana Health Insurance no longer offers individual and family health plans.
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.

Humana and Ambetter Mobile Apps Options

The MyHumana app allows users to find doctors, hospitals, and pharmacies, view claims, and pay your bill. They also offer an app called Humana Pharmacy which helps you to manage your prescriptions.

Humana Mobile App
iOS     3.1561 users
Android     3.93,372 users
Ambetter Mobile App
Ambetter does not currently have a mobile app.

Humana and Ambetter Enrollment Process

Humana

You can begin the enrollment process here or you can have an agent assist you for several free health insurance quotes here.

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 Humana and Ambetter Insurance

Humana

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.

Paper claims and encounters submission addresses for Humana medical claims:

Humana Claims: P.O. Box 14601, Lexington, KY 40512-4601

HumanaDental® claims: P.O. Box 14611, Lexington, KY 40512-4611

Humana encounters: P.O. Box 14605, Lexington, KY 40512-4605

Claim overpayments: Humana, P.O. Box 931655, Atlanta, GA 31193-1655

HumanaOne® claim submissions: HumanaOne, P.O. Box 14635, Lexington, KY 40512-4633

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 Humana Insurance

Humana

Is Humana a good healthcare insurance company?

Humana is one of the better-known health insurance companies in the U.S. IT is financially strong and was rated A- by A.M Best, a respected insurance rating organization. Humana has been awarded by several organizations, like the Dorland Health Award for exceptional service. It also won the J.D Power and Associates Award for Highest Member Satisfaction for group health insurance in several states.

What states offer Humana Insurance?

Humana offers insurance in all 50 states but coverages vary by state.

Is Humana Insurance only for seniors?

Humana Insurance offers Medicare plans and group plans for employers. Currently, it is not offering individual & family plans (2020).

What are the different types of Humana plans?

For Medicare plans, Humana offers Medicare coverage options outside Medicare Parts A and B, long-term care, dental care, vision care, some transportation services, prescription coverage, DME coverage, overage for deductibles for Medicare Part A and Part B and more. It offers Medicare Advantage and Medicare Supplement plans.

Check out our full list of common questions about Humana.

Ambetter

What states accept Ambetter health insurance?

Ambetter offers coverage for individuals in Arizona, Arkansas, Florida, Georgia, Illinois, Indiana, Kansas, Mississippi, Missouri, New Hampshire, Nevada, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas and Washington.

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.

Check out our full list of common questions about Ambetter.

Humana and Ambetter Insurance Contact Info

Humana Contact Info
Address300 E. Randolph St. Chicago, IL 60601
Phone1 (800) 654-7385
Websitehttps://www.humana.com/
Facebookhttps://www.facebook.com/Humana/
Youtubehttps://www.youtube.com/humana
Twitterhttps://twitter.com/Humana
Linkedinhttps://www.linkedin.com/company/humana/
Ambetter Contact Info
AddressAmbetter from Coordinated Care, 1145 Broadway, Suite 300, Tacoma, WA 98402
Phone1 (877) 687-1197
Websitehttps://www.ambetterhealth.com/
Facebookhttps://www.facebook.com/AmbetterHealthcare/
Youtubehttps://www.youtube.com/channel/UC1fien5XXb1voeybJcWr6kQ
Twitterhttps://twitter.com/Centene
Linkedinhttps://www.linkedin.com/company/centene-corporation/

Compare Insurance Rates for Free.

Enter your zip code, answer a few questions, and compare rates in less than 3 minutes.