Ambetter – Illinois Health Plans 2023
For a complete list of Ambetter in-network providers, please visit here
Coverage Area: Cook County, DuPage County, Will, Kane, And Kankakee Counties, Lake County
Ambetter – Illinois Health Plans
Ambetter Health is changing their plan names for 2023. Members may see a new plan name, but they still have the same great coverage and benefits they’ve come to expect from Ambetter Health. Please refer to the 2023 Plan Name Reference Guide to view the Ambetter Health name changes.
Ambetter is one of 5 carriers in Illinois for 2023, and one of 3 who is covering Cook & DuPage counties. They are currently only offering Silver & Gold plans, which can only be enrolled on the exchange. They also offer plans bundled with optional vision & dental plans.
Ambetter is a good choice for anyone who qualifies for Cost Sharing reductions, as well as for people who are more concerned about their prescription drug coverage (more copays then similar Blue Cross plans) vs gaining access to a wide provider & hospital network.
*NEW NorthShore Hospitals include:**
Highland Park Hospital
Hospital List – Cook and DuPage Counties
Amita Hospital System
Edward Elmhust Hospitals
Northwest Community Hospital**
Sinai Health System
Louis A. Weiss Memorial Hospital
Saint Bernard Hospital
Swedish Covenant Hospital
**(Members can use the Primary Care Providers (PCP) and Specialty Providers at this location for their medical care.)
2023 Plan Comparison – Our Top 3 Recommended Ambetter Plans
|Plans||Everyday Gold + Vision + Adult Dental||CMS Standard Silver||Elite Bronze – HMO|
|PLAN SUMMARIES||Plan Summary||Plan Summary||Plan Summary|
|MAX OUT OF POCKET|
|PRIMARY CARE||$35 Copay||$40 Copay||$45 Copay|
|SPECIALIST||$55 Copay||$80 Copay||$115 Copay|
|GENERIC DRUGS||$5 Copay / $15 Copay||$20 Copay/ $20 Copay||$5 Copay / $35 Copay|
|PREFERRED BRAND DRUGS||$60 Copay||$40 Copay||$195|
|NON PREFERRED BRAND DRUGS||50% Coinsurance||$80 copay||$250|
|SPECIALTY DRUGS||50% Coinsurance||$350 Copay||50% coinsurance subject to Rx deductible|
Reasons to Choose Ambetter
- My Health Pays: Members can earn up to $500 in rewards annually, which can reduce monthly premiums by up to $41 per month.
- Teladoc Program with a $0 copay: At home, in the office or even on vacation. Get medical advice, a diagnosis or a prescription for non-emergency health issues when you need it
- Affordable Health Plans: Ambetter is projected to have one of the lowest cost Silver plans available on the Marketplace for 2023 Open Enrollment.
- Start Smart for your Baby: A program created to provide advice and resources for pregnant members and new parents
- Health Management Programs
- 24/7 Nurse Advice Line
- Care Management