Ambetter focuses primarily on the Affordable Care Act (ACA), though they also do Medicare Advantage within several states. With regards to their ACA business, Ambetter offers plans on exchange only. They’re in multiple states across the country, and their footprint continues to grow. Compared to other carriers, they’re one of the few companies that has not lost a lot of money on the individual market. The reason why they’ve been relatively successful is because of their small networks. Having been active in the Medicaid market, Ambetter became accustomed to small networks, which translated into their qualified health plans.
Prior to Obamacare, big companies like Blue Cross Blue Shield, Cigna, and United Healthcare established massive PPO networks. Unfortunately, big networks did not work well in the ACA market. Since ACA became law in 2010 and then began to roll out in 2014, big companies have been scaling back and shrinking their networks. In doing so, they’re regaining more control over the costs and managing their exposure.
For example in Texas, most networks available were PPOs, meaning people could use any provider they wanted; they simply had to check if the provider was in network or out of network. Now, however, the only plans available on or off marketplace are HMO plans. With HMO plans, companies can use smaller networks to control the costs. Ultimately, only the companies that adhere to the small networks are the ones doing moderately well in this ACA-governed market. This is why Ambetter is doing well.
Though referred to as Ambetter, the company actually has different names in different states. For instance, in Mississippi, Ambetter is issued by Magnolia Health. The parent company is Centene Corporation. Regardless of which state offers Ambetter plans, they plan on staying in the marketplace through the 2017-2018 plan year and beyond. They’ll continue to grow as they have each and every year. So if Ambetter is available in your market area, then it’s definitely an option worth considering.
Since insurance is oftentimes overwhelmingly confusing, we want to shed light on this industry by answering YOUR questions. So if you have any questions or concerns, comment below and your question may be the topic of our next video!
For immediate assistance, call us toll-free at (844) 410-1320!