Ambetter – Illinois Health Plans

Ambetter - Illinois Health Planshappyfamily
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2020 Ambetter Provider Finder
2020 Ambetter Hospital List

Coverage Area: Cook County, DuPage County

Ambetter – Illinois Health Plans

Our Rating: Ambetter - Illinois Health Plans

Ambetter is one of 5 carriers in Illinois for 2020, 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.

Hospital List – Chicago Area

HospitalAddressPhone Number
Kindred Chicago Lakeshore6130 North Sheridan RoadChicago, IL 60677(773) 381-1222
Mt Sinai Hospital2750 W 15th PlaceChicago, IL 60608(773) 542-2000
Thorek Memorial Hospital850 West Irving ParkChicago, IL 60613(773) 525-6780
Louis A Weiss Memorial Hospital4646 North Marine DriveChicago, IL 60640(773) 878-8700
Kindred Hospital Chicago North2544 W Montrose AvenueChicago, IL 60618(773) 267-2622
Kindred Chicago Central Hospital4058 W Melrose StreetChicago, IL 60677(773) 736-7000
Saint Bernard Hospital326 W 64th StreetChicago, IL 60621(773) 962-3900
Swedish Covenant Hospital5145 North California AvenueChicago, IL 60625(773) 878-8200
Holy Cross Hospital2701 W 68th StreetChicago, IL 60629(773) 884-1602

2020 Plan Comparison

Note: Silver plans on the exchange may qualify for Cost Sharing Reduction, meaning you may see different deductibles and copayments based on if you qualify based on your income level.

PlansAmbetter Balanced Care 11 (2020)Ambetter Balanced Care 2 (2020)Ambetter Balanced Care 1 (2020)Ambetter Balanced Care 12 Standardized (2020)
Ambetter Secure Care 1 (2020) with 3 Free PCP Visits
MAX OUT OF POCKET$2,700$6,500$6,500$7,350$6,350
METAL LEVELSilverSilverSilverSilverGold
PRIMARY CARE$8$30$30$30
20% Coinsurance after deductible
20% Coinsurance after deductible
GENERIC DRUGS$8$15$10$15$10
BRAND DRUGS$30$50$50$50
$25 Copay after deductible
NON PREFERRED BRAND DRUGS50%No Charge after Deductible20% Coinsurance after deductible$100
$75 Copay after deductible
SPECIALTY DRUGS50%No Charge after Deductible20% Coinsurance after deductible40% Coinsurance after deductible
30% Coinsurance after deductible