Amerigroup

What Amerigroup does

Amerigroup Corporation is a United States managed care organization (MCO) that delivers government-sponsored health insurance to Medicaid and Medicare-eligible populations. The company is a wholly-owned subsidiary of WellPoint, Inc. (now Elevance Health, NYSE: ELV), headquartered in Indianapolis, Indiana, with operational mailing presence in Virginia Beach, Virginia; it was founded in 1994 and employs 10,000+ people. Amerigroup served millions of members across at least seven states spanning the Southeast, Southwest, Midwest, Mid-Atlantic, and Mountain West regions, with the Amerigroup brand retained in Georgia while Medicaid and Medicare operations in AZ, DC, IA, NJ, TN, TX, and WA have transitioned to a unified Wellpoint identity beginning in 2024.

Amerigroup monetizes capitated per-member-per-month contracts with state Medicaid agencies and the Centers for Medicare & Medicaid Services (CMS) — a recurring subscription revenue model in which the plan bears utilization risk in exchange for fixed monthly payments. Its core product portfolio consists of state-sponsored Medicaid plans for low-income individuals and families, plus Medicare Advantage and Part D plans largely delivered under the Wellpoint brand. The primary digital channel is the Sydney Health mobile application, offered on iOS and Android, which provides plan-management, provider search, ID-card access, live-agent chat, and community-resource lookup. A web-based Member Secure Application complements the app, while the provider-facing Availity-integrated portal handles authorizations, claims submission, and reporting across the multi-state network.

Distribution is exclusively government-channel: members are acquired via state Medicaid enrollment processes, healthcare-provider referrals, and digital self-service through Sydney Health, with phone-based support at 800-600-4441. The company maintains HIPAA-compliant privacy and PHI-handling controls. Customer concentration is structurally concentrated on a small number of state Medicaid contracts and the CMS Medicare program. Recent strategic activity has centered on the Amerigroup-to-Wellpoint rebranding, the Sydney Health platform consolidation, and exposure to the Iowa Senate File 2464 HMO-tax proposal that would materially shift ~$173M of new tax burden to Amerigroup Iowa and two co-MCOs.

Name

Amerigroup

Legal name

Amerigroup Corporation

Website

http://www.amerigroup.com/

Company type

Private

Founded year

1994

Operating status

Operating

Headcount range

5,001–10,000 employees

Short description

Amerigroup Corporation is a US managed care organization and Elevance Health subsidiary that delivers Medicaid and Medicare health plans to low-income and senior members across multiple states, operating under the Amerigroup brand in Georgia and the Wellpoint brand elsewhere, and monetizing state capitated contracts.

Ownership category

akta.pro rank

Product category

Managed Health Care Insurance

NAICS

Direct Health and Medical Insurance Carriers (524114), Direct Life, Health, and Medical Insurance Carriers (52411)

SIC

Hospital & Medical Service Plans (6324), Accident & Health Insurance (6321)

akta.pro primary industry

TANF/CHIP Managed Care Plans (HLAEAEAA)

akta.pro secondary industries

Managed Care Entity Administration for Medicaid (MCO/PHP/PIHP/PAHP) (HLAEAEAJ), MA HMO Plans (HLAEACAA), MA Prescription Drug Plans (MA-PD) (HLAEACAF)

Keywords

• Managed care plans
• Medicaid health insurance
• Medicare Advantage plans
• Government health programs
• Health plan administration

Headquarters

HQ city

Virginia Beach

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2C

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure, Others

Revenue model

1. Medicaid Health Insurance: Amerigroup operates as a managed care organization (MCO) receiving capitated payments from state governments to provide health coverage to Medicaid-eligible individuals. Revenue is generated through per-member-per-month payments from state Medicaid programs.
2. Medicare Plans: Medicare Advantage and Medicare Part D prescription drug plans offered under the Wellpoint brand in select states. Revenue comes from CMS (Centers for Medicare & Medicaid Services) contracts based on enrollment.

Pricing tiers

Go-to-market motion2 records

Distribution channels3 records

Marketing channels4 records

Core offering

Amerigroup operates as a Managed Care Organization (MCO) providing state-sponsored Medicaid and Medicare health insurance plans to eligible low-income individuals, families, children, seniors, and persons with disabilities. The company contracts with state Medicaid agencies and CMS to deliver health coverage through provider networks, receiving capitated per-member-per-month payments in exchange for managing comprehensive benefits including doctor visits, hospital stays, pregnancy care, lab and X-ray services, prescriptions, and vision and dental coverage depending on state and age.

Product overview

Amerigroup is a health insurance company that provides Medicaid and Medicare plans primarily for individuals who qualify for state-sponsored programs. The company operates as a Managed Care Organization (MCO) serving millions of members across multiple states. The core product portfolio consists of Medicaid Health Plans (offered as Amerigroup in Georgia and as Wellpoint in other states) and Medicare Plans (offered as Wellpoint in most states). The Sydney Health mobile app serves as the primary digital companion for members, providing access to plan details, provider search, ID card management, and live agent chat. Amerigroup also maintains provider portals integrating with third-party platforms like Availity for claims and authorization workflows. The company is undergoing a rebranding to Wellpoint in most markets while maintaining the Amerigroup brand in Georgia for Medicaid services.

Differentiator

Problem solved

Functional benefit

Products and services

• Amerigroup Medicaid Health Plans State-sponsored Medicaid health insurance providing free or low-cost coverage for children, adults, and families who qualify based on income eligibility. Covers doctor visits, hospital stays, pregnancy care, labs, X-rays, and additional benefits depending on state and age. Currently offered under the Amerigroup brand in Georgia.
• Wellpoint Medicaid Health Plans Medicaid health plans offered under the Wellpoint sub-brand in DC, IA, NJ, TN, TX, and WA, representing the rebranded continuation of Amerigroup's Medicaid offerings in these states. Coverage, providers, and benefits remain consistent with prior Amerigroup plans.
• Amerigroup Medicare Plans Medicare Advantage and Medicare Part D prescription drug plans providing health coverage for eligible seniors and individuals with disabilities, contracted through CMS. Plans offered under the Wellpoint brand in Arizona, Iowa, New Jersey, Tennessee, Texas, and Washington.
• Wellpoint Medicare Plans Medicare Advantage and Medicare Part D plans offered under the Wellpoint brand in AZ, IA, NJ, TN, TX, and WA, continuing the same level of coverage and provider access as Amerigroup Medicare plans.
• Sydney Health Mobile App Free mobile application for Amerigroup members to access health insurance benefits, check plan details, find doctors and pharmacies, chat live with agents, access member ID cards, and search community resources. Features Android Fingerprint login and is available on iOS and Android.
• Provider Portal Online portal for healthcare providers to access resources, tools, and the Availity integration platform for requesting authorizations, submitting claims, and accessing reports. Serves providers in Georgia and affiliated markets including Louisiana, New York, and Florida.
• Member Secure Web Portal Secure online portal where members can log in to view account information, manage their health plan, access plan documents, and utilize member self-service features.

Segments1 record

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration1 record

Feature1 record

Partnerships

Eight partnerships are on record, tiered core and minor.

• AvailitycoreTechnology or IntegrationAvaility Portal provides health care professionals free access to real-time information and instant responses. Through Availity, providers can request authorizations, submit claims, and access reports. This is a critical integration partner for provider-facing operations.
• Louisiana – Healthy BlueminorChannel Partner/ Reseller/ DistributorAffiliated Medicaid plan in Louisiana operating under the Healthy Blue brand. Part of the broader network of Amerigroup-related health plans.
• New York – Anthem Blue Cross and Blue ShieldminorChannel Partner/ Reseller/ DistributorAffiliated health plan in New York operating under the Anthem Blue Cross and Blue Shield brand. Part of the Elevance Health (formerly Anthem) portfolio.
• New York – Highmark Blue Cross Blue Shield of Western New YorkminorChannel Partner/ Reseller/ DistributorAffiliated health plan in New York operating under the Highmark Blue Cross Blue Shield brand in Western New York.
• Florida – Simply Healthcare Plans, Inc.minorChannel Partner/ Reseller/ DistributorAffiliated Medicaid plan in Florida operating under the Simply Healthcare Plans brand.
• Florida – Clear Health AllianceminorChannel Partner/ Reseller/ DistributorAffiliated Medicaid plan in Florida operating under the Clear Health Alliance brand.
• Iowa Total CareOthersCo-MCO with Amerigroup Iowa in the Iowa Medicaid program. Both organizations would bear 85% of a proposed $173 million HMO tax increase under Iowa Senate File 2464.
• Molina Healthcare of IowaOthersCo-MCO with Amerigroup Iowa in the Iowa Medicaid program. Both organizations would bear 85% of a proposed $173 million HMO tax increase under Iowa Senate File 2464.

Scale indicators1 record

Recent moves6 records

Expansion highlights4 records

Broad incumbents

• Humana: Major Medicare Advantage leader with growing Medicaid presence via CenterWell, competing with Amerigroup/Wellpoint in dual-eligible markets such as AZ, IA, NJ, TN, TX, and WA.
• Cigna Group (Evernorth): Operates Medicaid and Medicare plans as part of a broader portfolio anchored by Evernorth health services. Competes in select Medicaid markets and shares dual-eligible opportunities with Amerigroup.
• CVS Health (Aetna): Operates Medicaid managed care through Aetna, with integrated PBM (Caremark) and retail health assets. Competes with Amerigroup in state Medicaid procurements and dual-eligible markets.
• UnitedHealth Group (Optum/UnitedHealthcare): The largest US health insurer, offering Medicaid managed care (e.g., UnitedHealthcare Community & State) as part of a much broader portfolio including commercial, Medicare, and Optum services. A scale competitor in Medicaid procurements despite its diversified base.
• Elevance Health (Anthem/Wellpoint): Amerigroup's parent company and the largest Blue Cross Blue Shield licensee, with Medicaid (Amerigroup/Wellpoint), Medicare, and commercial plans nationwide. Provides strategic context and consolidated competitive positioning for Amerigroup.

Regional players

• Health Care Service Corporation (HCSC): Largest customer-owned health insurer in the US, with a strong regional focus in TX, IL, MT, NM, and OK. Increasingly competing for Medicaid contracts and entering Medicare Advantage, partially overlapping with Amerigroup's geographic footprint.
• Blue Shield of California: A nonprofit health plan with Medi-Cal (Medicaid) managed care operations in California. Operates the same MCO capitated model for publicly-funded populations but is geographically focused on CA, where Amerigroup does not currently operate.

Direct peers

• CareSource: A nonprofit Medicaid MCO serving Medicaid and dual-eligible members across multiple states including OH, GA, IN, KY, and WV. Operates a similar government-sponsored managed care model with a focus on low-income and vulnerable populations.
• Centene Corporation: The largest pure-play Medicaid managed care company in the US, serving Medicaid, Medicare, and Marketplace members across all 50 states. Operates the same MCO model with capitated state contracts, making it Amerigroup's closest direct competitor in government-sponsored healthcare.
• Molina Healthcare: A leading Medicaid-focused MCO serving low-income individuals and families through state contracts, often co-MCO with Amerigroup in markets like Iowa. Operates a similar dual-eligible strategy and faces identical state procurement dynamics.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/Amerigroup
• Facebookfacebook.com/AmerigroupCorporation
• LinkedInlinkedin.com/company/amerigroup-corporation

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles2 records

Funding overview

Funding rounds1 record

Investors1 record

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments1 record

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Amerigroup