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, etc.
Ambetter Insurance Vs. Blue Cross Blue Shield:
Here is a brief comparison between Ambetter Insurance and Blue Cross Blue Shield:
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 offers limited coverage to only 20 states. 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 its 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; instead they have divided their plans into three metal tiers –
The bronze metal plan is also called the Ambetter Essential Care, the cheapest policy the company can offer. Although it has the highest deductible, it is best for people with excellent health who don’t have many 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|
Ambetter Balanced Care or Silver Tier plan has lower deductibles and out-of-pocket money. However, the monthly premiums are quite expensive for this plan.
The 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|
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.
|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:
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.
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, 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, your out-of-pocket costs will be less than a bronze plan but higher than a gold one.
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.
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 coverage that is not included in the Original Medicare Plan A and B.
On the contrary, Blue Cross Blue Shield offers Medicare plans through selected healthcare providers to their members. 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 with no health insurance or who 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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