Ambetter
Ambetter Health is Centene Corporation's ACA Marketplace health insurance brand, offering Qualified Health Plans (HMO, EPO, PPO, POS) to over 5.5 million individuals and families across 29 states through federal and state-based exchanges, bundled with telehealth, rewards, and care management.
- Company typePrivate
- Founded2012
- HeadquartersSt Louis, United States
- Headcount101–250
- GTM typeB2C
- OfferingServices
What Ambetter does
Ambetter Health is the ACA Marketplace health insurance brand of Centene Corporation (NYSE: CNC), offering Qualified Health Plans (HMO, EPO, PPO, and POS) to individuals and families through the federal Health Insurance Marketplace and state-based exchanges across 29 states. The brand serves primarily under-insured and uninsured populations, with many members receiving federal premium tax credits based on income. Plans include essential health benefits, preventive care, mental health services, prescription coverage, and optional dental and vision add-ons. Beyond core underwriting, the platform bundles telehealth (Virtual 24/7 Care), a wellness rewards program (My Health Pays, up to $500 in rewards), chronic condition management for diabetes, asthma, and COPD, a 24-hour nurse advice line, care management coordination, and an ICHRA-compatible employer offering (Ambetter Health Solutions).
The technology stack comprises a digital insurance platform with online enrollment tools, a consumer mobile app, provider-finder functionality, and machine-readable JSON APIs for product, formulary, and provider network data. Distribution runs through state-specific websites, a multi-language licensed agent call center, and broker channels, with the brand operating through 28 wholly-owned Centene state subsidiaries (e.g., Celtic Insurance Company, Buckeye Health Plan, Home State Health). As of December 31, 2025, Ambetter serves over 5.5 million members, and the brand is run as a national platform with state-level licensing and local provider network contracting.
Revenue is generated through monthly subscription premiums from individual members and ICHRA-participating employers, with revenue risk correlated to ACA enrollment policy, federal premium tax credit availability, and the medical loss ratio dynamics of the Marketplace segment.
Ambetter firmographics
Firmographics- Name
- Ambetter
- Legal name
- Ambetter Health (brand name used by Centene Corporation subsidiaries)
- Website
- https://ambetterhealth.com
- Company type
- Private
- Founded year
- 2012
- Operating status
- Operating
- Headcount range
- 101–250 employees
- Short description
- Ambetter Health is Centene Corporation's ACA Marketplace health insurance brand, offering Qualified Health Plans (HMO, EPO, PPO, POS) to over 5.5 million individuals and families across 29 states through federal and state-based exchanges, bundled with telehealth, rewards, and care management.
- Ownership category
- akta.pro rank
Ambetter industry classification
Industry- Product category
- Health Insurance
- NAICS
- Direct Health and Medical Insurance Carriers (524114), Insurance Carriers (5241)
- SIC
- Accident & Health Insurance (6321)
- akta.pro primary industry
- ACA Marketplace (On-Exchange) Individual Plans (FSAIAEAA)
Keywords
Where Ambetter is headquartered
LocationHeadquarters
- HQ city
- St Louis
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
Ambetter business model
Business model- GTM type
- B2C
- Offering type
- Services
- Cost components
- Personnel, Operations, Marketing or Sales, Technology or R&D, Infrastructure, Others
Revenue model
- Health Insurance Premiums: Ambetter Health generates revenue through monthly premium payments from members enrolled in its Qualified Health Plans offered on the ACA Health Insurance Marketplace. Many members receive premium tax credits based on income, which subsidize their coverage.
- ICHRA Plan Offerings: Ambetter Health also offers individual health insurance plans compatible with Individual Coverage Health Reimbursement Arrangements (ICHRAs), allowing employers to provide health benefits allowances that employees can use to purchase individual coverage.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Monthly | ACA Marketplace Health Insurance Plans |
Go-to-market motion2 records
Distribution channels4 records
Marketing channels5 records
Ambetter product offering
Product offeringCore offering
Ambetter Health is the ACA Marketplace health insurance brand of Centene Corporation, offering Qualified Health Plans (HMO, EPO, PPO, and POS) to individuals and families across 29 states through the federal Health Insurance Marketplace and state-based exchanges. The plans cover essential health benefits including preventive care, mental health services, and prescription drugs, and are paired with member programs such as Virtual 24/7 Care telehealth, My Health Pays Rewards, care management, and a mobile app. Ambetter also sells ICHRA-compatible individual plans and a separate dental and vision offering, distributed through licensed agents, direct online enrollment, and employer channels.
Product overview
Ambetter Health is a health insurance brand offered by Centene Corporation through the Affordable Care Act (ACA) Health Insurance Marketplace and state-based exchanges across 29 states. The core product consists of health insurance plans (HMO, EPO, PPO, and POS types) providing essential health benefits, preventive care, mental health services, and prescription coverage. The product portfolio includes a rewards program (My Health Pays), telehealth services (Virtual 24/7 Care), health management programs for chronic conditions (diabetes, asthma, COPD), care management, a 24/7 nurse line, dental and vision insurance, maternity programs (Start Smart for Baby), member perks, and a mobile app. Ambetter also offers ICHRA (Individual Coverage Health Reimbursement Arrangement) plans for employers and provides the Ambetter Health Solutions sub-brand with additional employer-focused products in select states.
Differentiator
Problem solved
Functional benefit
Brands
- My Health Pays Rewards: A wellness rewards program that allows members to earn up to $500 for completing healthy activities such as eating right, moving more, saving smart, and living well. Rewards can be used for pharmacy cost share at Hy-Vee, Walmart, and mail order pharmacy.
- Virtual 24/7 Care
- Ambetter Perks
- Start Smart for Baby
- Ambetter Health Solutions
Products and services
- Ambetter Health Plans Health insurance plans sold to individuals and families on the ACA Health Insurance Marketplace across 29 states, including HMO, EPO, PPO, and POS product types covering essential health benefits, preventive care, mental health services, and prescription coverage.
- Ambetter Health ICHRA Plans
Quantifiable outcome
- Over 5.5 million members served in the individual ACA Marketplace as of 12/31/2025
- +1 more outcomes
Companies that use Ambetter
Customer profileNamed customers1 record
Segments2 records
Ideal customer profiles2 records
Ambetter technology and API
TechnologyTechnology focussed No
API detail
- Has API
- Yes
- API docs
- API detail
Core technology
AI maturity
App detail
Integration4 records
Feature4 records
Ambetter partnerships and signals
Strategic signalPartnerships
Four partnerships are on record, tiered minor and core.
- KABOOM!minorAmbetter Health partnered with the nonprofit KABOOM! and the City of Hialeah to complete a new kid-designed playground at Southeast Park on January 30, 2026, with over 100 company volunteers assembling equipment, adding landscaping, and creating seating areas in a single day. This was the second collaboration between the three organizations following a 2019 playground build at Bucky Dent Park. The project aims to promote health, social connection, and safe outdoor recreation for local children.
- City of HialeahminorThe City of Hialeah collaborated with Ambetter Health and KABOOM! to build a new playground at Southeast Park, completed on January 30, 2026, as part of efforts to provide local children with opportunities for play, social connection, and safe outdoor recreation.
- Tampa Bay BuccaneersminorAmbetter Health and the Tampa Bay Buccaneers launched a joint public service announcement titled 'Stay Healthy, Stay in the Game' encouraging Floridians to prioritize preventive care and routine screenings before year-end. The PSA featured Buccaneers players Jamel Dean, Devin Culp, and Graham Barton discussing the importance of knowing health metrics like blood pressure and cholesterol. The initiative targets under-insured and uninsured populations served through the federal Health Insurance Marketplace.
- Geisinger Health SystemcoreAmbetter Health expanded into nine additional counties in Pennsylvania for the 2026 plan year through a partnership with Geisinger Health System, offering comprehensive benefits, online enrollment, wellness rewards, and telehealth services to Pennie marketplace consumers.
Scale indicators3 records
Recent moves6 records
Expansion highlights5 records
Ambetter competitors and assessment
Company assessmentDirect peers
- Oscar Health: Tech-forward ACA Marketplace individual health insurer selling plans on Healthcare.gov across more than 20 states, directly overlapping Ambetter's on-exchange core product, target customer (individual under-65 buyers), and digital-first distribution model.
- Molina Healthcare: Government-sponsored health insurer with a significant ACA Marketplace footprint alongside Medicaid and Medicare, structurally analogous to Ambetter/Centene with similar dual-eligible and low-income customer focus and state-by-state subsidiary model.
Emerging players
- Bright Health Group: Smaller ACA Marketplace-focused carrier that has narrowed its geographic footprint; competes with Ambetter on individual on-exchange plans and shared the same risk-bearing, technology-enabled model targeting individual buyers.
- Clover Health: Medicare Advantage-focused insurer with technology-driven member engagement; an adjacent peer to Ambetter in government-sponsored individual coverage, sharing the digital-first philosophy but with a different primary program (Medicare vs. ACA Marketplace).
Broad incumbents
- UnitedHealthcare: Largest U.S. health insurer offering individual ACA Marketplace plans in many of the same states as Ambetter, with much broader commercial, Medicare, and Medicaid portfolios; competes head-to-head with Ambetter in on-exchange geographies.
- Elevance Health (Anthem): Major Blue Cross Blue Shield licensee with large ACA Marketplace presence via Anthem Blue Cross plans across multiple states; competes directly with Ambetter in individual exchange markets and operates broader employer and government lines.
- Cigna Group: Large diversified health insurer with ACA Marketplace offerings (post-HealthSpring/Evernorth portfolio); competes with Ambetter on individual coverage while serving much larger employer and stop-loss segments.
- Kaiser Permanente: Integrated nonprofit payer-provider offering individual Marketplace plans in selected states, competing with Ambetter in the same on-exchange geographies but with a fundamentally different integrated care delivery model.
- CVS Health (Aetna): Vertically integrated payer-retailer offering ACA Marketplace individual plans through Aetna in select states; competes with Ambetter on individual coverage while leveraging pharmacy, PBM (Caremark), and MinuteClinic assets.
Regional players
- Blue Cross Blue Shield Association (state plans): Individual state Blue Cross Blue Shield plans (e.g., Florida Blue, Blue Shield California, BCBS NC) compete with Ambetter on a state-by-state basis in ACA Marketplace, often as the legacy market leader in their respective geographies.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks6 records
Key highlights7 records
Customer concentration
Ambetter social profiles
Digital presenceAmbetter compliance and trust
Trust signalCompliance1 record
Ambetter financial estimates
Financial estimateRevenue estimate
Valuation estimate
Ambetter leadership team
Management profileNumber of profiles
Ambetter subsidiaries and ownership
Company hierarchySubsidiaries29 records
Ambetter funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Ambetter M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Ambetter
What does Ambetter do?
Ambetter Health is the ACA Marketplace health insurance brand of Centene Corporation, offering Qualified Health Plans (HMO, EPO, PPO, and POS) to individuals and families across 29 states through the federal Health Insurance Marketplace and state-based exchanges. The plans cover essential health benefits including preventive care, mental health services, and prescription drugs, and are paired with member programs such as Virtual 24/7 Care telehealth, My Health Pays Rewards, care management, and a mobile app. Ambetter also sells ICHRA-compatible individual plans and a separate dental and vision offering, distributed through licensed agents, direct online enrollment, and employer channels.
Is Ambetter a public or private company?
Ambetter is a private company. It is classified as corporate owned and is currently operating.
When was Ambetter founded?
Ambetter was founded in 2012. It employs 101 to 250 people.
Where is Ambetter based?
Ambetter is headquartered in St Louis, United States, in the North America region.
How does Ambetter make money?
Two revenue lines are on record. Health Insurance Premiums are the primary driver. The others are ICHRA Plan Offerings.
Who are Ambetter's main competitors?
Direct peers on record are Oscar Health and Molina Healthcare. Emerging players are Bright Health Group and Clover Health. Broad incumbents are UnitedHealthcare, Elevance Health (Anthem), Cigna Group, Kaiser Permanente and CVS Health (Aetna). Blue Cross Blue Shield Association (state plans) is listed as a regional player.
Does Ambetter have an API?
Yes. Machine-readable files in JSON format providing access to Ambetter product, formulary, and provider network information. These files can be downloaded by third parties to review data. The endpoint is available at api.centene.com/ambetter/reference/cms-data-index.json. Developer documentation is at api.centene.com/ambetter/reference/cms-data-index.json.
What industry is Ambetter in?
Ambetter's product category is Health Insurance. Its primary akta.pro industry code is FSAIAEAA, ACA Marketplace (On-Exchange) Individual Plans. Its NAICS code is 524114 and its SIC code is 6321.