Oscar vs. Ambetter Insurance

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

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Oscar vs. Ambetter: What You Need to Know

In 2012, Oscar Ceo Mario Schlosser and his wife were preparing to have a baby and saw how difficult it was to navigate through the healthcare system. Schlosser’s friend, Josh Kushner, had also had a similar frustration in treating an injury. They founded Oscar Health on a hope to help consumers feel less powerless in managing their health. What makes Oscar different is the Concierge Team that guides members and handles customer service questions and coordination of clinical care.

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 Oscar Overview and Ambetter Overview.

What is Oscar and Ambetter Insurance Rating?

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

ComparisonOscarAmbetter
Year Founded20121984
BBB RatingA+A+
NAIC Complaint Index1.12%1.12% for individual health insurance
Market Share Percentage20%
Financial StrengthExcellent
A.M. Best Ratingbb

Pros & Cons of Oscar or Ambetter

Pros

Oscar
  • Affordable marketplace plans with different tiers of coverage.
  • Health plan concierges who offer guidance and answer questions.
  • Very low complaint ratio, which means they offer great customer service.
Ambetter
  • Ambetter provides coverage to individuals who don’t qualify for traditional plans.
  • Very high market share.

Cons

Oscar
  • Oscar Health Insurance is only available in New York, California, Texas, New Jersey, Ohio, Tennessee, Arizona, Florida, and Michigan.
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.

Oscar and Ambetter Mobile Apps Options

The Oscar app allows you to access your health information anytime you need it. It allows you to search for doctors & drugs and even have virtual visits with a doctor.

Oscar Mobile App
iOS     4.82.5K users
Android     3.3433 users
Ambetter Mobile App
Ambetter does not currently have a mobile app.

Oscar and Ambetter Enrollment Process

Oscar

Oscar Health Insurance offers plans through the health insurance marketplace. You can begin searching plans here or you can get several free health insurance quotes with SmartFinancial.

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 with SmartFinancial. 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 Oscar and Ambetter Insurance

Oscar

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.

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 Oscar Insurance

Oscar

How to cancel Oscar health insurance

To cancel Oscar health insurance, you can call Oscar health directly at 1-855-672-2788 or cancel using your account at healthcare.gov or your state’s health exchange marketplace.

How much can I save by switching to Oscar insurance?

Oscar Insurance has several options for health insurance, based on the different tiers that marketplace insurers use. Prices for plan vary from person to person but the average monthly cost for a 30-year-old is $162.09 pm the secure plan. The deductible, however, is $7,900. If you need emergency surgery, you’d have to pay the $7,900 before expenses get covered.

Is Oscar a good health insurance provider?

Oscar Insurance is a reliable company with positive ratings in customer service. Users find the online app and doctor-on-call service helpful.

How to get Oscar insurance quote

You can get health insurance quotes here.

Check out our full list of common questions about Oscar.

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.

Oscar and Ambetter Insurance Contact Info

Oscar Contact Info
Address75 Varick St. 5th Fl, New York, NY 10013
Phone1 (844) 392-7589
Websitehttps://www.hioscar.com/
Facebookhttps://www.facebook.com/OscarHealth/
Youtubehttps://www.youtube.com/user/OscarHealthInsurance
Twitterhttps://twitter.com/OscarHealth
Linkedinhttps://www.linkedin.com/company/oscar-health/
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/

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