Which health insurance company is the best option for you and your family? Compare Humana and Ambetter side by side.
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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.
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.
|Medicare Star Rating||3 stars (out of 5)|
|NAIC Complaint Index||0.40% for individual health||1.12% for individual health insurance|
|Market Share Percentage||20%|
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|
|Ambetter Mobile App|
|Ambetter does not currently have a mobile app.|
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/.
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
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.
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.
Humana offers insurance in all 50 states but coverages vary by state.
Humana Insurance offers Medicare plans and group plans for employers. Currently, it is not offering individual & family plans (2020).
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 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.
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.
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.
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 Contact Info|
|Address||300 E. Randolph St. Chicago, IL 60601|
|Phone||1 (800) 654-7385|
|Ambetter Contact Info|
|Address||Ambetter from Coordinated Care, 1145 Broadway, Suite 300, Tacoma, WA 98402|
|Phone||1 (877) 687-1197|
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