What is Ambetter's in-network service?
Ambetter contracts with providers for the full range of covered benefits. These providers are called in-network providers. Throughout the year, the providers available in-network may change. It is important that you review the provider directory for the latest information on whether or not the provider you are planning to see is in-network.*
How can I take full advantage of my Ambetter coverage?
To take full advantage of your Ambetter coverage, it is important to only use in-network providers. For more information, please review your Evidence of Coverage (EOC) or contact Member Services. * When receiving care at an in-network Ambetter hospital, some hospital based providers may not be in-network.
What is Ambetter telehealth and how does it work?
Ambetter Telehealth * provides members with 24/7 medical help from doctors via video and phone. Whenever you need help, you can have a video call with a provider. You can ask health questions or get a diagnosis for non-emergency health issues. Plus, there’s no copay when you use in-network telehealth providers.
When will I receive my renewal information for Ambetter?
If you are an Ambetter member, you will receive renewal information in the fall, with details for next year’s Ambetter coverage. Review your renewal information closely. If you don’t need to make any plan changes, we will automatically renew your coverage.
What is an in network provider?
An in-network provider is a doctor or facility that's part of your Ambetter health insurance plan. They have a contract with your health insurance company for their services at a set cost. When you visit an in-network provider, the cost is less than visiting an out-of-network provider.
Does Ambetter offer health insurance?
Ambetter offers affordable health insurance plans in 20 states. Our plans have valuable benefits so our members can take charge of their health. Learn more about our plans and benefits below.
Does Ambetter provide medical care?
Benefits content with slides. Benefits section contains member benefits information. *Ambetter does not provide medical care.
Is pediatric vision covered by Ambetter?
Pediatric vision is an essential health benefit available in all Ambetter plans. Adult vision and dental insurance plans are available in some states. Shop Ambetter plans to learn more.
Does Ambetter Telehealth have a co-pay?
24/7 medical help from doctors via video and phone, with $0 co-pay.#N#Ambetter Telehealth * gives you access to doctors for non-emergency health issues or questions. Request a prescription or ask for medical advice by video or phone, 24/7. Plus, there’s no co-pay when you use in-network telehealth providers.
Ambetter Health Insurance Overall Rating
Like many insurance companies, Ambetter health insurance has pros and cons that you need to weigh out to decide whether it’s the best option for you. It shines when it comes to the variety of plan options available and the low monthly premiums.
Ambetter Health Insurance Coverage Options
Ambetter offers three tiers of Marketplace insurance plans — Gold, Silver and Bronze tier plans.
Ambetter Health Insurance Customer Service
Ambetter offers multiple ways to get in contact with its customer service team. If you’re trying to reach out online, you’ll select your state to find the right contact information. The customer service team can be reached by phone or you can fill out an online form to ask a question or request assistance.
Ambetter Health Insurance Customer Pricing
Since health insurance premiums are based on factors like your age, health and where you live, it’s impossible to tell you exactly how much you will pay if you choose a plan from Ambetter. Even so, you can use this example to compare the pricing of Ambetter’s plans.
Mobile App
Ambetter does not currently offer a mobile app. While many providers have been slow to adopt mobile apps, others responded quickly to user demand for easy account management via dedicated application. For this reason, we rate companies based on their mobile app offerings as well as other factors.
User Benefits
In addition to affordable monthly premiums, Ambetter offers a good deal of benefits for its policyholders. The fact that vision and adult dental coverage is available on some plans can save policyholders a lot of time and money because it eliminates the need for other insurance.
Ambetter User Experience
Ambetter’s website is straightforward and easy to navigate. The site makes it easy to get health insurance quotes, so you can review the plans that are available to you. There are also several resources on the website that can help you understand how to balance out-of-pocket costs and monthly premiums to find the best plan for you.
What is a network provider?
A network is a group of health care providers. It includes doctors, specialists, dentists, hospitals, surgical centers and other facilities. These health care providers have a contract with us. As part of the contract, they provide services to our members at a certain rate. This rate is usually much lower than what they would charge ...
What is Medicare based rate?
Medicare-based rates, which are determined and maintained by the government. “Reasonable,”, “usual and customary” and “prevailing” charges , which are obtained from a database of provider charges. Other types of rate schedules. To find the method and percent, check your plan documents.
Is coinsurance higher than network deductible?
This is higher than your network deductible (sometimes, you have no deductible at all for care in the network). You must meet the out-of-network deductible before your plan pays any out-of-network benefits. With most plans, your coinsurance is also higher for out-of-network care.
Does Aetna pay for out of network care?
But it pays less of the bill than it would if you got care from a network doctor. Also, some plans cover out-of-network care only in an emergency.
Is Aetna higher than the amount it recognizes?
It is usually higher than the amount your Aetna plan “recognizes” or “allows.”. We do not base our payments on what the out-of-network doctor bills you. We do not know in advance what the doctor will charge. An out-of-network doctor can bill you for anything over the amount that Aetna recognizes or allows.
Is coinsurance higher for out of network?
With most plans, your coinsurance is also higher for out-of-network care . Coinsurance is the part of the covered service you pay after you reach your deductible (for example, the plan pays 80 percent of the covered amount and you pay 20 percent coinsurance).
