Ambetter for Texas Obamacare Comparison and Reviews
Ambetter has been making ground in the Texas market for individuals and families over the past few years and we expect this to continue for some time for two reasons.
Network and pricing!
In a sea of HMOs, Ambetter's EPO is a welcome breath of flexibility on the network side.
We'll look at all of this but first, our credentials:
This is what we'll cover:
- Introduction to Ambetter for Texas Obamacare
- The Ambetter EPO and HMO networks
- Ambetter's pricing in the Texas market
- How to quote and enroll in Obamcare Ambetter in Texas
Let's get started!
Introduction to Ambetter for Texas Obamacare
First, Ambetter is fully committed to the individual family market in Texas.
Just a head's up...Obamacare is short-hand for ALL individual and family plans on the market whether on-exchange or direct with the carriers.
They participate in the Exchange which means you may qualify for subsidies that can bring down the plan costs significantly based on income.
This is probably the biggest question we get these days since income can be confusing. A big review on how to get the most subsidy or the income chart for Texas ambetter obamacare.
Any subsidy will apply towards Ambetter's plans on the Exchange which you can quote below.
Keep in mind that the plan benefits are subsidized so that a Gold plan will be pretty similar to another Gold plan within Ambetter or even between different carriers by +/- 2%.
Here are the "benchmark" plans which each carrier including Ambetter have.
This then leaves two real aspects to compare since the benefits are standardized:
- Networks: who you can see and how care is managed
- Pricing: how much you'll pay per month for the policy
Let's go to Ambetter's big difference in the Texas market.
The Ambetter EPO and HMO networks
Ambetter actually has two different suites of plans available in Texas:
- EPO - works like a PPO but there's no benefit out of the network other than a true emergency
- HMO - based on local network you must stay in; care is more managed (referrals, primary care doctors, etc)
HMO's are pretty standard these days and the market keeps moving that way since the underlying cost of health care just keeps spiraling:
The EPO though is a different deal all together.
The two carriers that are really giving BCBS a run for its money are Oscar and Ambetter.
Lo and behold, they both offer EPOs!
The EPO is as close as we can get to the PPOs that many people are familiar with from employer coverage where you have maximum flexibility.
So we're seeing two markets really in Texas Obamacare:
- People who are most cost sensitive choose HMO
- People who want max flexibility and control looking at EPOs or BCBS's POS
So, network is really a big driver in today's world:
For people who want control and a wider network, Ambetter's EPO is a leader on that front.
As an example, it's a way to get the Scott & White networks (check updated provider links in the quote below).
We're happy to check your doctors or walk through how the different networks really work. We have a big comparison of Texas Obamacare networks below.
Use the online provider links in the quote below or ask your doctors "what Exchange networks do you participate with?".
We're happy to chase this down for you at help@texaplans.com .
TTheir answer may address the question as to whether Ambetter is the right direction.
That then leaves pricing!
Ambetter's pricing in the Texas market
AAmbetter's right in the middle for the HMO model and comparable to Oscar's EPO which tend to both be cheaper than BCBS's POS option.
Here's a sample quote for a 54 year old in Travis county at the silver level (most popular by far) with no subsidy:
Keep in mind that subsidies can bring all these prices down significantly!
We see the Ambetter HMO plan right in the middle of the field. Really, this is a question where your doctors participate.
If they work with the cheaper options, than those probably make sense since the benefits are standardized.
Keep in mind that carrier pricing strength can really differ area to area and with different ages/family make-ups.
Ambetter will be better priced in other areas so it's really important to run your quote below.
Speaking of which!
HHow to quote and enroll in Obamacare Ambetter in Texas
You can run your Texas individual and family quote including Ambetter here:
A few notes to get the best quote.
- Best estimate for this year's income; AGI on the 1040 tax form next April
- HHousehold is everyone that files on that 1040 tax form even if not enrolling
This figures into the subsidy calculation and we're happy to walk through your income at help@texasplans.com or 800-320-6269. Pick a time to chat here/a>.
TThis is where we see so many people make mistakes when they try to do it themselves.
There's zero cost for our assistance so let us know how we can help!
Ambetter should continue to be a strong competitor especially for the EPO side of things where people have more control and broader networks on the individual family plan.
With subsidies bringing down these costs, it becomes a viable option against Oscar and BCBS' POS network plans.
We're happy to compare these for you.