Best Ambetter Insured by Celtic Benefits in 2021

Ambetter of Illinois or Ambetter Insured by Celtic is a health insurance marketplace product of the Centene Corporation. It is a Fortune 500 company that has more than 30 years of experience in the Managed Care Industry. They serve to better the health of its members and their beneficiaries with a focus on compassionate and coordinated care.

They believe in “quality healthcare is best delivered locally”. Ambetter of Illinois is insured by Celtic Insurance Company which is 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 completion of healthy activities. These activities include –

  • Eat Right
  • Move More
  • Be Well
  • Save Smart

Through this program, members can earn up to a $500 reward by redeeming their points. You can use this reward to pay health-related costs like monthly premiums, deductibles, coinsurance, and monthly 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

If you have any chronic health condition, Ambetter Insured by Celtic offers you disease management services. Their Health Management Programs help you to live a better, healthier lifestyle and provide you with 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


Ambetter Insure by Celtic offers 24/7 telehealth access to in-network healthcare providers. Members can get medical advice or prescription over phone or video conference with a $0 copay. Moreover, members can upload images to support doctor consultation and can share their visit summary with their PCP.

Network Coverage

Ambetter Insured by Celtic has been serving in the Illinois Health Insurance Marketplace since 2015. They offer health insurance plans in the following counties –

  • Cook
  • Dupage
  • Grundy
  • Henry
  • Kane
  • Kankakee
  • Kendall
  • Lake
  • Madison
  • McHenry
  • Mercer
  • Monroe
  • Rock Island
  • St. Clair
  • Will

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
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 comprehensive health insurance plans that are prepared 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 know more about the plans. For more information, you can also visit

Frequently Asked Questions

Q. Is Ambetter a PPO or HMO?

Ambetter does not offer any PPO or Preferred Provider Organization plans. They only offer:

  • Health Maintenance Organization (HMOs)
  • Exclusive Provider Organization (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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