In 2025, choosing the right affordable health insurance plan is more important than ever. With health care costs continuing to rise, many individuals and families are turning to Marketplace plans under the Affordable Care Act (ACA). Two of the most recognized and widely used insurers offering these plans are Ambetter and CareSource. While both companies aim to provide accessible and affordable healthcare, they differ in their plan structures, service areas, member experience, and added benefits.
This in-depth guide compares Ambetter vs. CareSource so you can choose the best plan for your health needs and budget.
About Ambetter Health
Ambetter is a health insurance product offered by Centene Corporation, one of the largest Medicaid and Marketplace plan providers in the U.S. Ambetter operates under different brand names in various states, such as Sunshine Health in Florida or Buckeye Health in Ohio, but all fall under the Ambetter umbrella.
Where Ambetter is Available
Ambetter serves over 29 states including Texas, Florida, Georgia, Ohio, Illinois, Pennsylvania, and more.
Ambetter Plan Types (Metal Tiers)
Ambetter offers standard Bronze, Silver, and Gold plans, categorized based on monthly premiums and out-of-pocket costs:
- Bronze (Essential Care): Lower monthly premiums, higher deductibles
- Silver (Balanced Care): Moderate premiums and cost-sharing
- Gold (Secure Care): Higher premiums, lower deductibles and copays
Ambetter Special Plan Options
Ambetter offers flexible and targeted options based on your preferences:
- Value Plans – Lower costs with a limited network; requires referrals
- Select Plans – Balanced premiums with a narrower network
- Virtual Access Plans – Prioritizes 24/7 virtual care with no-cost virtual primary care visits
Ambetter Key Benefits
- 24/7 Virtual Telehealth for urgent and primary care
- My Health Pays® Rewards for healthy activities (redeemable for utilities, rent, or groceries)
- $0 copay for select generic drugs and preventive services
- Optional Dental & Vision Packages
- Chronic condition management programs (e.g., for diabetes, asthma)
About CareSource
CareSource is a nonprofit, mission-driven health plan provider with a focus on affordability and whole-person care. CareSource serves Medicaid and Marketplace enrollees across select states and places strong emphasis on addressing social determinants of health.
Where CareSource is Available
CareSource offers Marketplace plans in Ohio, Indiana, Georgia, West Virginia, Kentucky, and some expansion markets in 2025.
CareSource Plan Types (Metal Tiers)
Like Ambetter, CareSource offers ACA-compliant Bronze, Silver, and Gold plans:
- Bronze: Best for low-cost premiums but high deductibles
- Silver: Offers cost-sharing reductions for lower-income individuals
- Gold: Designed for frequent healthcare users who prefer lower deductibles
CareSource Key Benefits
- CareSource24® Nurse Line – 24/7 advice from registered nurses
- Prescription drug coverage with home delivery and mail-order options
- Optional dental and vision plans for adults
- Over-the-counter (OTC) benefits on some plans
- Life Services® program offering job placement support, housing help, and food access
- Whole-person health focus, integrating behavioral health with physical health
Ambetter vs. CareSource: Feature-by-Feature Comparison
| Feature | Ambetter Health | CareSource |
| Company Type | For-profit subsidiary of Centene | Nonprofit managed care organization |
| Availability (States) | 29 states | 5 states (OH, IN, GA, KY, WV) |
| Plan Tiers Offered | Bronze, Silver, Gold | Bronze, Silver, Gold |
| Virtual Care Access | 24/7 Virtual Access Plans | 24/7 Nurse Hotline |
| Provider Network | Large PPO/EPO networks (varies by state/plan type) | Regional networks; some areas more limited |
| Special Programs | My Health Pays® rewards, chronic care coordination | Life Services® for social support, job and housing assistance |
| Drug Coverage | $0 copays on some generics, select brand-name discounts | Home delivery, medication therapy management |
| Dental/Vision | Optional adult dental & vision | Optional adult dental & vision |
| Behavioral Health | Included; may offer virtual therapy via third parties | Integrated behavioral health with case management |
| Preventive Care | Covered at 100% | Covered at 100% |
| Customer Reviews | Mixed – often cited for billing and network transparency issues | Mixed – strong social mission, but delays in service noted |
Cost Comparison (2025 Estimates)
| Plan Type | Ambetter (Avg Monthly Premium) | CareSource (Avg Monthly Premium) |
| Bronze | $20–$90 (after subsidies) | $15–$85 (after subsidies) |
| Silver | $50–$200 (after subsidies) | $40–$180 (after subsidies) |
| Gold | $150–$300 | $140–$280 |
| Deductibles | $2,000–$9,000 | $2,500–$8,500 |
| Out-of-Pocket Max | $9,450 (individual cap in 2025) | $9,450 (individual cap in 2025) |
Note: Exact pricing depends on state, age, household size, and income. Most low-income applicants will qualify for subsidies, significantly reducing these numbers.
Which Should You Choose?
Choose Ambetter if you:
- Want a large national presence with various plan tiers and virtual care options
- Prefer a rewards program that provides incentives for healthy behavior
- Value telehealth and online access to healthcare providers
- Need more plan variety (Select, Value, Virtual Access)
Choose CareSource if you:
- Want nonprofit-backed care with a focus on community resources
- Live in one of the five states CareSource serves and want local support
- Are interested in job placement, housing help, or wellness coaching
- Prefer stronger behavioral health integration
Final Verdict: Ambetter vs. CareSource for 2025
Both Ambetter and CareSource offer reliable, affordable health insurance options for individuals and families who qualify for ACA Marketplace plans. If you value network flexibility and virtual-first care, Ambetter may be a better fit. If you’re looking for wraparound support, community programs, and nonprofit values, CareSource is an excellent choice.
To make the best decision:
- Use Healthcare.gov or your state’s marketplace to compare plans side by side
- Review provider networks and covered medications
- Evaluate your personal health needs and budget
- Call both companies and ask questions about your region