Ambetter Health Expands Geographic Footprint and Enhances Member Benefits in 2025

Rhea-AI Summary

Ambetter Health, a subsidiary of Centene (NYSE: CNC), announced its expansion for 2025, adding 60 new counties across 10 states, including Iowa. The company will be available in 29 states across the U.S. Ambetter Health remains the number one marketplace health insurance based on enrollment and market share, serving over 4.4 million members in 2024.

For 2025, Ambetter Health is enhancing its offerings with:

• My Health Pays® program in select states
• Walgreens discounts in Florida, Georgia, Illinois, and Mississippi
• Improved plan designs for members with diabetes in Florida and Tennessee
• New Ambetter Health Solutions product for ICHRA in six states
• Rebranding of Bronze|Silver|Gold network to Premier Network

The open enrollment period for the Health Insurance Marketplace runs from Nov. 1, 2024, through January 2025, with varying end dates by state.

Positive

• Expansion into 60 new counties across 10 states, including Iowa
• Remains number one marketplace health insurance with 4.4 million members
• Introduction of new benefits and programs like My Health Pays® and Walgreens discounts
• Enhanced plans for members with diabetes in select states
• Launch of Ambetter Health Solutions for ICHRA in six states

Negative

• None.

Insights

Healthcare Industry Analyst

Ambetter Health's expansion into 60 new counties across 10 states, including Iowa, signifies a strategic growth initiative for Centene This move strengthens their position as the leading marketplace health insurer, potentially increasing their market share and revenue streams. The expansion, coupled with enhanced benefits like the My Health Pays program and Walgreens discounts, could drive member acquisition and retention.

The introduction of specialized plans for diabetic members in Florida and Tennessee is a targeted approach to address a significant health demographic. By offering $0 copays on preferred insulin and select medications, Ambetter is positioning itself competitively in the chronic disease management space, which could lead to increased enrollment and improved health outcomes.

The new Ambetter Health Solutions product for ICHRA demonstrates adaptability to evolving employer-sponsored health insurance trends. This move could capture a growing market segment as more employers shift towards defined contribution models for health benefits.

Overall, these initiatives suggest a multi-faceted strategy to enhance Centene's market position, potentially driving long-term growth and profitability in the highly competitive health insurance marketplace.

Financial Analyst

Centene's strategic expansion of Ambetter Health into new markets and the enhancement of its product offerings present a positive outlook for potential revenue growth. The addition of 60 new counties across 10 states significantly increases Ambetter's addressable market, which could translate to higher premium revenues in the coming years.

The introduction of specialized plans for diabetics and the new Ambetter Health Solutions for ICHRA demonstrate product diversification, which may lead to improved market penetration and potentially higher profit margins. These tailored offerings could attract a more diverse customer base and potentially reduce churn rates.

With over 4.4 million members and maintaining the top position in marketplace health insurance, Ambetter Health contributes significantly to Centene's overall financial performance. The expanded geographic footprint and enhanced benefits could drive membership growth, potentially leading to increased economies of scale and improved operational efficiency.

Investors should monitor key metrics such as membership growth rates, medical loss ratios and operating margins in the coming quarters to assess the financial impact of these expansions and product enhancements on Centene's bottom line.

Remains the number one marketplace health insurance based on enrollment and market share, expanding into 60 new counties across the U.S.

Offers enhanced plans for members with diabetes in select states

ST. LOUIS, Oct. 2, 2024 /PRNewswire/ -- Ambetter Health, the marketplace health insurance offered by subsidiaries of Centene Corporation (NYSE: CNC), a leading healthcare enterprise committed to helping people live healthier lives, announced today it will expand its geographic footprint, adding 60 new counties across 10 states in 2025, which includes expansion into Iowa. Ambetter Health will be available in 29 states across the U.S.

Experience the interactive Multimedia News Release here: https://www2.multivu.com/ambetter_health/9251051-en-ambetter-health-expands-geographic-footprint-enhances-member-benefits-2025 

In 2024, Ambetter Health remained the number one marketplace health insurance based on enrollment and market share, providing insurance to more than 4.4 million members.

"Our continued geographic and product expansion provides us with a unique opportunity to deliver comprehensive, affordable health insurance solutions to more members for the 2025 plan year," said Chief Executive Officer of Ambetter Health, Kevin Counihan. "This ensures even greater access to high quality health care in the communities we serve across the country."

In addition to providing coverage for all essential health benefits, including preventive and wellness services, maternity and newborn care, pediatric services, mental health services, hospitalizations, prescription drug coverage, and dental and vision in select states, Ambetter Health's 2025 offerings include: 

• My Health Pays
  In select states, members have access to the My Health Pays® program, where they can earn points for practicing healthy eating habits and staying active. Through the program, members can complete health-related activities and challenges and can earn up to $500 in rewards* in 2025. These rewards can be used for health-related expenses such as copays and deductibles. My Health Pays® also allows members to set and reach health goals at their own pace by providing seasonal suggestions for activities and guidance to help stay on track.
  
  
• Walgreens Discounts*
  In Florida, Georgia, Illinois and Mississippi, Ambetter Health and Walgreens are improving the affordability of health and wellness products for members. In 2025, members in those states will receive a 20% discount on Walgreens-branded over-the-counter health and wellness products including, but not limited to: allergy, blood pressure and diagnostics, children's medications, cough/cold relief, dental, diabetes, diet aids and supplements, digestive health and nausea, first aid, foot care, hand sanitizer, healthcare appliances, hearing aid batteries, home healthcare solutions, humidifiers, pain relief, reader glasses, sanitary, sleep aids, smoking cessation, sun care, vaporizers, vitamins and supplements.
  
  
• Plan Design Changes for Members with Diabetes
  Starting in 2025, some Ambetter Health Premier plans (formerly the Ambetter Health Bronze|Silver|Gold network) in Florida and Tennessee will provide members managing diabetes with additional healthcare options and savings. Members of these plans will have lower out of pocket costs for certain medications, supplies and clinical support. Members in these plans may have access to $0 copays for preferred insulin and select medications used to manage diabetes, high blood pressure, high cholesterol, and mental health. These plans also include $0 copays on certain diabetic supplies and labs such as lancets, glucose test strips, ketone and urine test strips, insulin syringes, pen needles as well as routine A1c labs.
  
  
• Ambetter Health Solutions
  Starting in 2025, Ambetter Health is introducing a new product, Ambetter Health Solutions, which is designed for individuals purchasing Marketplace coverage through an ICHRA (Individual Coverage Health Reimbursement Arrangement). This product will be available in South Carolina, Indiana, Mississippi, Ohio, Georgia, and Missouri, and will provide access to high quality providers with an additional benefit of acupuncture coverage. ICHRA allows employers of all sizes to directly reimburse employees for individual health insurance premiums and qualifying medical expenses tax free, while allowing employees greater choice to shop and enroll in whatever available plan works best for them and receive reimbursements for coverage. Employers can learn more at: https://www.ambetterhealth.com/employers.html.
  
  
• Premier Network
  Beginning Jan. 1, 2025, the Ambetter Health Bronze|Silver|Gold network will become known as the Premier Network. Members can continue to rely on the same provider network with the doctors and hospitals they know and trust.

The open enrollment period for the Health Insurance Marketplace runs Nov. 1, 2024, through January 2025. End dates will vary by state. For more information about Ambetter Health and its health coverage options, please visit www.ambetterhealth.com.

About Ambetter Health
Ambetter Health is a health insurance offering that is available on the Health Insurance Marketplace, or exchange, established by the Affordable Care Act. It is one of the healthcare programs provided by Centene Corporation, a leading healthcare enterprise committed to helping people live healthier lives. Ambetter Health is made available through local health plans and covers a wide variety of healthcare services, including preventive and wellness services, maternity and newborn care, pediatric services, mental health and substance misuse services, prescription drug coverage and more. Statistical claims and the #1 Marketplace Insurance statement are in reference to national on-exchange marketplace membership and based on national Ambetter data in conjunction with findings from 2024 Rate Review data from CMS, 2024 State-Level Public Use File from CMS, state insurance regulatory filings, and public financial filings. This is a solicitation for insurance. For more information on health benefits and health insurance plans in your state, please visit the state specific link on AmbetterHealth.com.

*Discount valid only for in-store purchases of eligible Walgreens brand health and wellness products by current members eligible for the Ambetter Health discount program. Discount cannot be used online. For a full list of Walgreens brand health and wellness products, please visit Walgreens.com/SmartSavings. Offer not available on the following items: alcohol, charitable donations, dairy, home medical equipment and durable medical equipment products, items or services submitted to insurance for reimbursement or where otherwise limited by law, liquor departments, lottery tickets, magazines, money orders/transfers, newspapers, pharmacy items and services, phone/prepaid/gift cards, photo orders, prescriptions, Prescriptions Savings Club membership fee, pseudoephedrine or ephedrine products, stamps, tobacco and transportation passes. Walgreens reserves the right to discontinue the offer at its discretion.

View original content:https://www.prnewswire.com/news-releases/ambetter-health-expands-geographic-footprint-and-enhances-member-benefits-in-2025-302264954.html

SOURCE Ambetter Health

FAQ

What is Ambetter Health's expansion plan for 2025?

Ambetter Health is expanding into 60 new counties across 10 states, including Iowa, bringing its total coverage to 29 states across the U.S. in 2025.

How many members does Ambetter Health (CNC) serve?

As of 2024, Ambetter Health serves over 4.4 million members, maintaining its position as the number one marketplace health insurance based on enrollment and market share.

What new benefits is Ambetter Health offering in 2025?

Ambetter Health is introducing My Health Pays® program, Walgreens discounts in select states, enhanced plans for members with diabetes, and a new Ambetter Health Solutions product for ICHRA in six states.

When is the open enrollment period for Ambetter Health plans in 2025?

The open enrollment period for Ambetter Health plans runs from November 1, 2024, through January 2025, with end dates varying by state.

What changes are being made to Ambetter Health's network naming in 2025?

Beginning January 1, 2025, Ambetter Health's Bronze|Silver|Gold network will be rebranded as the Premier Network, maintaining the same provider network.