Ambetter of Illinois, or Ambetter Insured by Celtic, is a health insurance marketplace product of the Centene Corporation. It is a Fortune 500 company with more than 30 years of experience in the Managed Care Industry. They serve to better the health of their members and their beneficiaries, focusing on compassionate and coordinated care.
They believe that “quality healthcare is best delivered locally.” Ambetter of Illinois is insured by Celtic Insurance Company, a Qualified Health Plan provider in the Illinois Health Insurance Marketplace.
Rewards Program
Ambetter Insured by Celtic offers the My Health Pays® program for its members, where they can earn points upon completing healthy activities. These activities include –
- Eat Right
- Move More
- Be Well
- Save Smart
Members can earn up to a $500 reward through this program by redeeming their points. You can use this reward to pay health-related costs like monthly premiums, deductibles, coinsurance, and bills like utilities and transportation.
Best Ambetter Insured by Celtic Care Management Program
Ambetter Insured by Celtic offers Care Management services for members with complex medical or behavioral health needs. This program is member-centered and family-focused. They have licensed nurses and social workers to deliver these services to Ambetter members. They will help you better understand and manage your health condition and locate community resources.
Health Management Programs
Ambetter Insured by Celtic offers disease management services if you have any chronic health condition. Their Health Management Programs help you live healthier and provide educational tools and support. Moreover, they provide behavioral health services like depression management programs. Ambetter Health Management Programs include the following health conditions:
- Asthma
- Coronary Artery Diseases (adult only)
- Depression
- Diabetes
- Hypertension and High Cholesterol
- Low Back Pain
- Tobacco Cessation
Telehealth
Ambetter Insure by Celtic offers 24/7 telehealth access to in-network healthcare providers. Members can get medical advice or prescription over the phone or via video conference with a $0 copay. Moreover, members can upload images to support doctor consultations and share their visit summaries with their PCP.
Network Coverage
Ambetter Insured by Celtic has served in the Illinois Health Insurance Marketplace since 2015. They offer health insurance plans in the following counties –
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Health Insurance Plans
Ambetter Insured by Celtic offers a wide range of health insurance plans to the people of Illinois. Below is a list of available insurance plans:
| Ambetter Balanced Care 11 | Ambetter Balanced Care 2 | Ambetter Balanced Care 1 | Ambetter Balanced Care 12 Standardized | Ambetter Secure Care 1 with 3 Free PCP Visits | |
| Deductible | $0 | $6,500 | $5,500 | $3,500 | $1,000 |
| Max Out of Pocket | $2,700 | $6,500 | $6,500 | $7,350 | $6,350 |
| Network | HMO | HMO | HMO | HMO | HMO |
| Metal Level | Silver | Silver | Silver | Silver | Gold |
| Primary Care | $8 | $30 | $30 | $30 | 20% Coinsurance after deductible |
| Specialist | $15 | $60 | $60 | $65 | 20% Coinsurance after deductible |
| Generic Drugs | $8 | $15 | $10 | $15 | $10 |
| Brand Drugs | $30 | $50 | $50 | $50 | $25 Copay after deductible |
| Non-Preferred Brand Drugs | 50% | No Charge after Deductible | 20% Coinsurance after deductible | $100 | $75 Copay after deductible |
| Specialty Drugs | 50% | No Charge after Deductible | 20% Coinsurance after deductible | 40% Coinsurance after deductible | 30% Coinsurance after deductible |
Ambetter Insured By Celtic offers prepared comprehensive health insurance plans focusing on the people of Illinois. They are both affordable and have several benefits. Before choosing any insurance plan, customers should contact the local agents to learn more about the plans. For more information, you can also visit https://www.ambetterofillinois.com/.
Frequently Asked Questions
Q. Is Ambetter a PPO or HMO?
Ambetter does not offer any PPO or Preferred Provider Organization plans. They only provide the following:
- Health Maintenance Organizations (HMOs)
- Exclusive Provider Organizations (EPOs)
Q. What are the essential health benefits of Ambetter?
Ambetter offers the following essential health benefits:
- Hospitalization
- Various therapy services
- Prescription drugs
- Laboratory services
- Mental health and Substance abuse services
- Pediatric services
- Maternity and Newborn care
- Preventive and Wellness services
- Outpatient or Ambulatory services
- Emergency services
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