Ambetter Insurance Vs Blue Cross Blue Shield: Which is Best in 2021?

You are here to get the effective information on Ambetter Insurance Vs Blue Cross Blue Shield for making a decision on your health insurance. We tried to collect all of the important information regarding these two healh insurance companies. Just keep reading…

Ambetter is a part of Centene Corporation, a multi-line managed care organization. It is a multi-national Fortune 500 company with over 30 years of experience in the managed care industry. Ambetter health insurance plans provide high-quality healthcare services to its members. Ambetter Insurance offers mental and behavioral health services, maternity care, prescription drug coverage, vision and dental coverage, and much more.

Ambetter Insurance Vs Blue Cross Blue Shield:

Here is a brief comparison between Ambetter Insurance and Blue Cross Blue Shield:

Provider Network

Blue Cross Blue Shield is an association of several independent health insurance companies. They provide a certain royalty fee to BCBS to use its trademark and sell health care services. BCBS provides network coverage to 41 states of the USA. On the other hand, Ambetter Insurance provides limited coverage to only 20 states. These are – Arizona, Florida, Illinois, Kansas, Mississippi, New Hampshire, Nevada, Ohio, South Carolina, North Carolina, Texas, Arkansas, Georgia, Indiana, Michigan, Missouri, New Mexico, Pennsylvania, Tennessee, and Washington.

Types of Plans offered by Ambetter Insurance

Ambetter Insurance offers limited plans for their members. These are –

  • Health Maintenance Organisation (HMO)
  • Personal Preferred Organisation (PPO)
  • Exclusive Provider Organisation (EPO)

Ambetter is a part of the Health Insurance Marketplace (HIM). It is designed for people with no health insurance or who don’t qualify for any typical plan. Ambetter does not offer HSA plans, rather they have divided their plans into three metal tiers –

Bronze Plan

The bronze metal plan is also called the Ambetter Essential Care, the cheapest policies the company can offer. Although it has the highest deductible, it is best for people with great health and who don’t have much scheduled medical expenses.

Product Deductible Out-of-pocket maximums Monthly cost for a 40-year-old
Ambetter Essential Care 1 $6,800 $6,800 $329.47
Ambetter Essential Care 1 + Vision $6,800 $6,800 $333.27
Ambetter Essential Care 1 + Vision + Dental $6,800 $6,800 $342.15

Silver Plan

Ambetter Balanced Care or Silver Tier plan have lower deductibles and out-of-pocket money. However, the monthly premiums are quite expensive for this plan.

Product Deductible Out-of-pocket maximums

Monthly cost for a 40-year-old

Ambetter Balanced Care 2 $6,500 $6,500 $460.80
Ambetter Balanced Care 1 $5,500 $6,500 $468.18
Ambetter Balanced Care 10 $5,000 $6,700 $487.53
Ambetter Balanced Care 3 $3,000 $6,500 $491.68

Gold Plan

The Gold Metal tier or the Ambetter Secure Care has the most expensive premiums. But it has more affordable deductibles and out-of-pocket maximums. Hence, it allows you to take advantage of the coinsurance benefits. This plan is the best for those with higher medical expenses.

Product

Deductible

Out-of-pocket maximums

Ambetter Secure Care 3 $6,500 $6,500

When you choose Ambetter, you will get the following Essential Health Benefits (EHBs):

  • Emergency care
  • Outpatient care
  • Preventive and Wellness care
  • Maternity care
  • Pediatric care
  • Mental health and Substance abuse care
  • Prescription Drugs, etc.

Blue Cross Blue Shield offers the following plans for its members –

  • Health Maintenance Organization (HMO)
  • Health Maintenance Organization Point-of-Sale (HMO POS)
  • Local and Regional Preferred Provider Organization (PPO)
  • Private Fee for Service (PFFS)
  • Medical Savings Account (MSA)
  • Special Needs Plan (SNPs)

BCBS also offers HAS plans that are divided into the following metal tiers:

Bronze Plan

The bronze plans of the Blue Cross Blue Shield cover 60 percent of your healthcare expenses. That means you have to bear only 40 percent of the overall cost. Bronze plans come with lower monthly payments but have higher out-of-pocket costs.

Silver Plan

The silver plans cover around 70 percent of your overall healthcare expenses. However, there is a twist in this plan. If you are eligible for a cost-sharing reduction subsidy, then the silver plan will cover about 73%, 87%, or 94% of your expenditures. Their monthly payments are lower than a gold plan but higher than a bronze plan. If you do not qualify for the cost-sharing reduction, then your out-of-pocket costs will be less than a bronze plan but higher than a gold plan.

Gold Plan

The gold plans have higher monthly payments, but lower out-of-pocket costs. They cover around 80 percent of your healthcare expenses. This means you have to pay only 20 percent of the total expenditure.

Medicare Plans

Both Ambetter Insurance and Blue Cross Blue Shield offer medicare plans for their members. If you are an Ambetter member, they will give you access to coverage with Allwell. It is a Medicare Advantage plan offered by the Superior HealthPlan and Sunshine Health. You will get the coverage that is not included in the Original Medicare Plan A and B.

On the contrary, Blue Cross Blue Shield offers Medicare plans to their member through selected healthcare providers. These include Medicare Advantage (Part C), Medical Supplement or Medigap plans, and Prescription Drug Plans (Part D).

Both companies offer a wide range of plans for their customers with individual benefit levels. If you want to buy any of the plans, contact your nearest provider and choose the plan that best meets your needs.

Frequently Asked Questions

Is Ambetter good health insurance?

Ambetter may be a good option for those who have no health insurance or do not qualify for any typical plan. They are affordable compared to some health insurance companies. However, Ambetter only serves in 20 states and the complaint ratio is somewhat high in some of the states.

Does Blue Cross Blue Shield cover outside the US?

Many people go abroad for work or living purposes for an extended period of time. Blue Cross Blue Shield offers the GeoBlue plans for them.

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