Which health insurance company is the best option for you and your family? Compare UnitedHealthcare and Ambetter side by side.
UnitedHealth Group was founded in 1977 by Richard Burke and went public in 1984. It was Dr. Paul Ellwood, who coined the term “health maintenance organization,” and who helped Burke start-up UnitedHealth. In 1979, the company created the first network senior health plan.
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 UnitedHealthcare Overview and Ambetter Overview.
Which health insurance company is better? We've made it easy to compare companies side by side. See how UnitedHealthcare and Ambetter ranked among the industry ratings.
|Medicare Star Rating||4.5 stars (out of 5)|
|NAIC Complaint Index||1.12% for individual health insurance|
|Market Share Percentage||0.2|
The Health4Me app from UnitedHealthcare allows you to look for doctors and review your coverage and benefits.
|UnitedHealthcare Mobile App|
|Ambetter Mobile App|
|Ambetter does not currently have a mobile app.|
UnitedHealth Group offers plans through the health insurance marketplace. You can begin searching for plans with SmartFinancial's Healthcare Insurance page.
Each state has its own marketplace. If you’re not sure where to begin, visit https://www.healthcare.gov/.
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/.
UnitedHealth Group pays network providers directly but if you are billed by a provider, you can contact UnitedHealth Group at 1 (800) 328-5979. If you are filing a claim for an out-of-network provider for an emergency or because you were referred to the provider by UnitedHealth Group you must submit the following information
The above information should be sent to: UnitedHealthcare P.O. Box 740800 Atlanta, GA 30374-0800
If filing a claim for Outpatient Prescription Drug Benefits, your claims should be submitted to: Optum Rx P.O. Box 29077 Hot Springs, AR 71903
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.
Medicare Advantage is Medicare Part C, which replaces original Medicare Parts A and B and is administered through a private insurer. Medicare Advantage plans offer some benefits that Original Medicare does not. UnitedHealth also offers special Medicare Advantage plans for patients with Alzheimer’s or chronic dementia.
Yes, in 1998, the company rebranded and changed the name UnitedHealthcare insurance to the UnitedHealth Group.
If you don’t have health insurance through an employer, you can buy private insurance for yourself and/or your family with UnitedHealth insurance. For health insurance rates visit here and fill out a brief form.
UnitedHealth Group benefit plans are offered by employers. To see if your company offers a plan through UnitedHealth, speak to someone in your human resources department.
Check out our full list of common questions about UnitedHealthcare.
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.
Out-of-network services and providers require prior authorization unless it’s an emergency service. You need a referral from a Primary Care Physician to see a specialist unless you’re seeing certain in-network doctors like an obstetrician, gynecologist or psychiatrist.
Check out our full list of common questions about Ambetter.
|UnitedHealthcare Contact Info|
|Address||P.O. Box 1459, Minneapolis, MN 55440-1459|
|Phone||1 (800) 328-5979|
|Ambetter Contact Info|
|Address||Ambetter from Coordinated Care, 1145 Broadway, Suite 300, Tacoma, WA 98402|
|Phone||1 (877) 687-1197|
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