Ambetter Health Insurance offers plans in some parts of the United States. In each state it serves, there are several plan options for policyholders to choose from, including an affordable “catastrophic” health insurance plan or coverage with a lower deductible. Better still, some of these plans offer coverage for adult dental and vision services at an affordable cost.
When you enroll in an Ambetter health insurance plan, you’ll also have access to user benefits that can make your life easier. This includes telehealth services with a $0 copay and a 24/7 nurse advice line to answer questions and provide support at any time of day. Policyholders with prescriptions can also enroll in a mail-order pharmacy program to receive their medication right at their front door.
That doesn’t mean that Ambetter is perfect. This insurance provider doesn’t offer a mobile app, so there is no way to easily access your health insurance information and manage your plan on the go. Ambetter isn’t known for its customer service either.
It’s important to weigh the pros and cons when choosing a health insurance plan. Start with our Ambetter health insurance review to help determine whether you should consider this insurance provider.
- Affordable plans for relatively healthy people
- Telehealth services
- Some plans offer vision and adult dental insurance coverage
- Perks program to help save on healthy living
- Low monthly premiums
- Only available in some states
- Poor customer service reputation
Ambetter Ratings at a Glance
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Like many insurance companies, Ambetter health insurance has pros and cons that you need to weigh out to decide whether it’s the best option for you. It shines when it comes to the variety of plan options available and the low monthly premiums. The perks program and benefits, including telehealth services and a mail-order pharmacy program also increase the appeal of using this health insurer. Ambetter receives 3.5 out of 5 stars in terms of being a good health insurance company.
Ambetter Health Insurance Pros and Cons
Ambetter Health insurance has pros and cons as outlined below.
Pros
- Low rates
- The option for dental and vision insurance
Cons
- Limited availability in different states
- A customer service reputation that could be better
Ambetter offers three tiers of Marketplace health insurance plans — Gold, Silver and Bronze tier plans.
- Ambetter Secure Care is the Gold-tiered plan, and as such, this is the plan that has the highest monthly premium payments.
- Ambetter Balanced Care is the plan that Ambetter says is the best value. This Silver-tiered plan offers modest monthly premium payments with lower out-of-pocket costs. It’s the perfect “in the middle” plan.
- Ambetter Essential Care has the lowest monthly premium payment. As the Bronze-tiered option, this is a good option for people who don’t expect to need medical care often. This plan comes with the highest out-of-pocket costs to make up for the low monthly premium.
- Vision
- Adult Dental
Generally speaking, Ambetter’s coverage options are fairly standard. But, unlike some of its competitors, it offers the option to select a health plan with vision and adult dental coverage. Choosing a plan like this is a great way to get full coverage all from one insurance provider.
Ambetter offers multiple ways to get in contact with its customer service team. If you’re trying to reach out online, you’ll select your state to find the right contact information. The customer service team can be reached by phone or you can fill out an online form to ask a question or request assistance.
It seems that the quality of service you receive depends on the state that you live in. On average, Ambetter does not have the best reputation for customer service. Some of the complaints policyholders have made include long wait times when calling for assistance, incorrect billing and issues with health insurers.
Since health insurance premiums are based on factors like your age, health and where you live, it’s impossible to tell you exactly how much you will pay if you choose a plan from Ambetter. Even so, you can use this example to compare the pricing of Ambetter’s plans.
These quotes are for a 30-year-old woman living in Orlando, Florida, based on an annual income of $36,000.
| Plan | Monthly Premium | Deductible | Out-of-Pocket Maximum |
| Bronze Ambetter Essential Care 1 - EPO | $57 per month | $8,300 per year | $8,300 per year |
| Bronze Ambetter Essential Care 1 + Vision + Adult Dental - EPO | $70 per month | $8,300 per year | $8,300 per year |
| Ambetter Essential Care 2 HSA - EPO | $65 per month | $6,900 per year | $6,900 per year |
| Ambetter Balanced Care 29 - EPO | $168 per month | $5,450 per year | $8,400 per year |
| Ambetter Balanced Care 12 + Vision + Adult Dental - EPO | $188 per month | $6,500 per year | $8,400 per year |
| Ambetter Balanced Care 25 HSA - EPO | $204 per month | $4,800 per year | $4,800 per year |
| Ambetter Secure Care 5 - EPO | $210 per month | $1,450 per year | $6,300 per year |
The Bronze plans in particular have very low monthly premiums when compared to other health insurers. However, it’s important to keep in mind that these quotes are based on a salary of $38,000. For those with higher salaries, the monthly premiums from this health insurance company will likely be higher.
Ambetter Mobile App
Ambetter does not currently offer a mobile app. While many providers have been slow to adopt mobile apps, others responded quickly to user demand for easy account management via dedicated application. For this reason, we rate companies based on their mobile app offerings as well as other factors.
In addition to affordable monthly premiums, Ambetter offers a good deal of benefits for its policyholders. The fact that vision and adult dental coverage is available on some plans can save policyholders a lot of time and money because it eliminates the need for other insurance.
For extra support, Ambetter’s care managers can work with policyholders and their doctors to develop care plans and coordinate services. Pregnant individuals can also use the Start Smart For Your Baby® program to receive resources and support through pregnancy and in the beginning stages of an infant’s life.
There are many benefits that provide convenience, as well. Ambetter allows policyholders to enroll in a mail-order pharmacy program and receive telehealth services 24/7 at no extra cost. A 24/7 nurse advice line is also available for health questions and guidance.
On top of all of that, Ambetter offers a perks program to provide discounts on local gym membership, meal delivery services and more.
Ambetter’s website is straightforward and easy to navigate. The site makes it easy to get health insurance quotes, so you can review the plans that are available to you. There are also several resources on the website that can help you understand how to balance out-of-pocket costs and monthly premiums to find the best plan for you.
The absence of a mobile app can be frustrating for users who want to be able to easily access their health insurance information on the go and in doctor’s offices. The amount of customer service complaints against Ambetter can also take away from an otherwise positive user experience.
Ambetter Health Insurance vs. Competitors
Though Ambetter isn’t available in every state, it’s competitive in the locations that it serves. Ambetter’s low monthly premiums and variety of plan options are only made better by the fact that some plans offer vision and adult dental coverage. The number of benefits offered by these health insurance plans also makes it quite an attractive option, especially in a time when it’s not unusual to use telehealth services.
- Best For:Nationwide coveragesecurely through Blue Cross Blue Shield Health Insurance's website
- Best For:No enrollment period health insurancesecurely through Sidecar Health Access Plan's website
Plans referred to above are excepted benefit fixed indemnity insurance products marketed and administered by Sidecar Health Insurance Solutions, LLC and underwritten by Sirius America Insurance Company or United States Fire Insurance Company, depending on the state. As an excepted benefit plan, it does not provide comprehensive/major medical expenses coverage, minimum essential coverage, or essential health benefits. You cannot receive a subsidy (premium tax credit and/or cost-sharing reduction) under the ACA in connection with your purchase of such an excepted benefit fixed indemnity insurance plan. Also, the termination or loss of this policy does not entitle you to a special enrollment period to purchase a health benefit plan that qualifies as minimum essential coverage outside of an open enrollment period. Coverage and plan options may vary or may not be available in all states.
Get Started with Ambetter Health Insurance
To see if Ambetter is available in your area, you can visit the website to browse the list of states it serves. You can also get a free health insurance quote to compare all of the options that are available to you. Once you’ve found your plan, all you need to do is purchase and keep up on your payments to enjoy your health insurance coverage.
Frequently Asked Questions
When can I enroll in health insurance?
The best time to enroll is during the Open Enrollment period between November 1 and December 15. If you lose your health insurance coverage outside of the Open Enrollment period, you may be eligible to enroll at that time as well.
Will my Ambetter health insurance plan automatically renew?
Yes. Ambetter sends renewal information out to policyholders each year in the fall. It’s important to review the renewal information and reach out to Ambetter if you need to make changes to your health insurance plan.
Is Ambetter accepted in Texas?
Yes, Ambetter insurance is accepted in the state of Texas. It is recommended to double-check their coverage map to find a local provider in your area.
User Reviews
Kalen Menke
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Arelis
Their 2023 premiums are extremely expensive even with subsidy. Deductibles and Maximum out of pocket amounts are very high.
Sam
Niki Hughes
Bad company, stole money from my credit card. Horrible, incompetent, and non-English speaking customer service. No one knows what they are doing. One rep was outside & the wind was blowing so hard I asked where he was and he said, the Philippines.
Rosario
the credibility of this website is suspect when this junk insurance company is rated that high. 1 star in any category is too high
Gin
Ambetter is the worst coverage I have ever had. Very much like dealing with an overbearing parent that wants to dictate your every breath. They went months of paying for my medication for anxiety then suddenly stopped. Poor customer care.
Seth j
Completely incompetent service. They have been fighting me for months on a claim that was supposed to be covered
Mark T Alden
Worst insurance ever. Will not cover an epidural shot for back problem after 2 specialist have requested an approval. $1080 per month premium for just myself, and now it looks like I will have to pay for this shot myself as if I had no insurance. Awful!
Hal
I don't believe the ratings in this article for one second. Just search ambetter reviews and see the real customer ratings. Ambetter is the worst insurance company ever.
Florelvia Delgado
No se les ocurra comprar este seguro. A mi quedaron en devolverme un dinero que me quitaron de mi cuenta en diciembre y ya vamos para Mayo y nunca me lo repusieron. Siempre me decian que en 7 días y me quede esperando y nunca me lo devolvieron .
Laura Gray
I have been on the phone for two days to get approval for two necessary. Customer service is the absolute worse. I spoke with a boss who told me everything would be taken care of-yet it has not. The girl who called me today had no idea who I was. Terrible
Noelia Kendrick
Worst experience ever with Ambetter Silver Plan. Having trouble finding specialist that will accept the insurance. And now my pcp won’t accept this plan. I had two brain surgeries last year and now I’m not able to see my Drs.
Eric M Nelson
Martin was my advisor. Very polite and respectful. He helped me with the care I needed. Much appreiciated!!. Thank you for the time and consideration..
Linda
I have Ambetter Essential Care and have not been able to find a primary care MD who accepts this coverage. I was assigned a gastroenterologist as a primary care MD in error and after 2 phone calls to Ambetter, I have only received non participating info
Genxiang li
Worst ever. I have the ambetter value plan and the website says that I can see any PCP in network. Almost all PCP's listed on their website in my city are pediatricians. The remaining few have either left the facility, or will not accept the plan.
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About Ashley Hart
Ashley Hart is a personal finance writer passionate about helping people feel empowered to take control of their finances. She has more than eight years of writing experience, focused on insurance.