Ambetter is the biggest name on the ACA Marketplace that most people have never heard of. It is not a company. It is a brand Centene puts on plans sold by its state subsidiaries, which is why the sign says Ambetter from Superior HealthPlan in Texas and Ambetter from Buckeye Health Plan in Ohio.
That structure matters when you go looking for a price, because Ambetter does not publish one. Its own enrollment page says only that costs vary by location, age, household size and plan level. So the numbers below come from CMS’s 2026 Marketplace rate and plan files, which list every plan’s premium, deductible and out-of-pocket cap by county. Those files were last imported to CMS systems by August 4, 2026.
What Is Ambetter Health Insurance
Ambetter Health is Centene Corporation’s individual health insurance brand for the ACA Marketplace. Centene’s 2025 Form 10-K calls itself the largest Marketplace carrier, “serving 5.5 million members across 29 states as of December 31, 2025, under the brand name Ambetter Health.” The same filing says Ambetter is offered in 29 states again in 2026.
Ambetter’s own consumer page still shows that 5.5 million figure, footnoted “as of 12/31/2025.” It is now well out of date. Centene’s second-quarter 2026 results, released July 28, 2026, put Marketplace membership at 3,494,700 as of June 30, 2026, down from 5,862,800 a year earlier. That is a loss of roughly 2.4 million members in twelve months, and it is the single most important fact about Ambetter right now.
The cause is not a mystery. The enhanced premium tax credits created in 2021 expired on January 1, 2026. Centene’s 10-K states it plainly: “The enhanced eligibility extended by the IRA expired at the end of 2025. While enhanced eligibility has expired, APTCs are still in force and provide meaningful subsidies to eligible members.” Subsidies did not disappear. They shrank, and the 400% federal poverty level income cap came back. Our guide to the ACA subsidy expiration walks the mechanics, and ACA subsidy income limits covers who still qualifies.
How Ambetter Plans Work
Ambetter sells bronze, silver and gold plans, with platinum in a few states. In CMS’s 2026 file, its 378 on-exchange individual plans in federal-platform states break down as 137 gold, 124 silver and 117 expanded bronze.
The network design is mixed. Of those 378 plans, 182 are HMOs, 145 are EPOs, 41 are PPOs and 10 are POS plans. HMOs and EPOs both lock you to a network with essentially no out-of-network coverage outside emergencies, which is why the HMO vs PPO distinction and in-network vs out-of-network rules matter more here than the metal level does.
Referrals are mostly not required: 353 of the 378 plans are flagged as not requiring a specialist referral, 25 as requiring one. And 117 of the 378 are HSA-eligible, which is worth knowing if you want the tax shelter alongside the coverage.
One caveat on geography. CMS’s Exchange public use files cover only states on the federal HealthCare.gov platform, 30 states in the 2026 file. Ambetter appears in 20 of them. The other nine states in Ambetter’s 29-state footprint run their own exchanges (California, New York, New Jersey, Pennsylvania, Washington, Nevada and others), and their plans are not in this dataset. So the price ranges below describe Ambetter’s federal-platform business, not every plan it sells.
How Much Is Ambetter Insurance in 2026
Every figure here is the 2026 plan year, for a 40-year-old non-smoker, before any premium tax credit. Ranges come from 4,097 age-40 rate rows across Ambetter’s 378 plans in CMS’s 2026 Rate PUF.
| 2026 Ambetter figure | Low | Median | High |
|---|---|---|---|
| Monthly premium, age 40, all metal levels | $357 | $659 | $1,341 |
| Monthly premium, expanded bronze | $357 | $535 | $1,094 |
| Monthly premium, silver | $385 | $702 | $1,335 |
| Monthly premium, gold | $409 | $711 | $1,341 |
| Individual deductible, standard on-exchange plans | $0 | $5,950 | $8,450 |
| Individual out-of-pocket maximum | $6,500 | $8,525 | $10,500 |
| Silver deductible (standard variant) | $0 | $6,000 | $8,000 |
| Gold deductible | $0 | $1,450 | $2,000 |
For scale, the median age-40 premium across all 4,044 individual plans in the same CMS file is $691.56, with a national floor of $277.59 and a ceiling of $3,051.03. Ambetter’s median of $658.62 sits modestly below the national median. It is not the cheapest carrier in most markets and it is not the most expensive.
Three things that table hides.
The silver deductible number is misleading if your income is low. Those figures are the standard silver variant. If your household income is between roughly 100% and 250% of the federal poverty level and you pick a silver plan, cost-sharing reductions rewrite the deductible and out-of-pocket cap downward, sometimes dramatically, and you only get them on silver.
Gold is often the better math now. Ambetter’s median gold premium ($711) is only about $9 a month above its median silver premium ($702), and the median gold deductible is $1,450 against $6,000 for silver. That inversion is common in 2026 and is worth checking in your own county before you default to silver.
The subsidy, not the sticker, decides what you pay. Premium tax credits are calculated off the second-lowest-cost silver plan in your rating area. Nationally, KFF found the average net premium Marketplace enrollees actually pay rose 58% between 2025 and 2026, from $113 to $178 a month, while average Marketplace deductibles rose 37% to a record $3,786. Both moves trace back to the enhanced credits lapsing, not to Ambetter.
Is Ambetter Good Insurance?
CMS rates Marketplace plans on a 1-to-5 star scale through its Quality Rating System, the marketplace cousin of Medicare Advantage star ratings. Almost nobody uses it in Ambetter reviews, which is odd, because it is the only independent quality measure that exists for these plans.
In the plan year 2026 nationwide file, Ambetter has 18 rated products (a product is one issuer in one state with one plan type, not one plan). Its average is about 3.0 stars: 14 products at 3 stars, two at 4, and two at 2. The national average across all 298 rated products is about 3.4 stars, and the distribution nationally is 122 products at 4 stars, 114 at 3, 39 at 2, 21 at 5 and 2 at 1.
So the honest answer is that Ambetter is average to slightly below average on measured quality, with no 5-star product anywhere in the file. It scores better than Oscar or Molina do on the same measure, and worse than the market as a whole. It buys its position with breadth: 29 states and a lot of counties where the alternatives are thin. KFF found that 165 counties had just one Marketplace insurer in 2026, up from 93 in 2025, and one in three counties has fewer insurers than the year before.
Who Ambetter Is Good For and Who Should Skip It
A good fit if you are subsidy-eligible and want a low bronze premium. Ambetter’s bronze floor of $357 a month at age 40 is among the cheaper entry points, and with a tax credit applied it can land near zero in some counties.
A good fit if your county has few carriers. In much of the rural South and Midwest, Ambetter is one of two or three options. Being present is worth something.
A good fit if you want gold-level coverage cheaply. The near-parity between Ambetter’s median silver and gold premiums in 2026 makes gold unusually attractive if you expect to use care.
Think twice if you have a specialist you will not give up. Most Ambetter plans are HMO or EPO, meaning out-of-network care is generally not covered at all. Verify your doctors against the specific plan, not just “Ambetter.”
Think twice if you travel or split time between states. Service areas are county-level and the network does not follow you.
Think twice if quality ratings drive your decision. At about 3 stars, Ambetter is not where the ratings point. If a 4-star or 5-star product exists in your county, compare it.
Ambetter vs. Oscar vs. Molina
| 2026 plan year | Ambetter (Centene) | Oscar | Molina |
|---|---|---|---|
| States on the Marketplace | 29 | 20 | 14 |
| Median age-40 premium, federal platform | $659 | $606 | $616 |
| Premium floor | $357 | $300 | $428 |
| CMS quality rating, average | about 3.0 stars | about 2.7 stars | about 2.5 stars |
| Membership trend | 5.86M to 3.49M (Q2 2025 to Q2 2026) | 2.03M to 2.96M | 690K to 283K |
| Plan types | HMO, EPO, PPO, POS | HMO and EPO mostly | HMO only |
Ambetter is the widest footprint and the middle price. Oscar is cheaper on median and grew while everyone else shrank. Molina is the smallest of the three on the exchange and rates lowest. All three sit below the national quality average, which is a real trade-off you should make on purpose rather than by accident.
The Bottom Line
Ambetter’s price is a county-level question and nothing on Ambetter’s own site will answer it. What the CMS data does tell you is the shape of the answer: roughly $360 to $1,340 a month at age 40 before subsidies in 2026, a median near $660, deductibles that cluster around $6,000 on standard silver and around $1,450 on gold, and quality ratings that hover at average.
Three moves before you enroll. Compare gold against silver in your own county, because the premium gap is unusually small this year. Check whether cost-sharing reductions apply to you, because they change the silver math completely. And confirm your doctors are in the specific plan’s network, since most Ambetter plans give you no out-of-network fallback and you would be relying on an insurance denial appeal if something went wrong.
One timing note. Everything above is 2026 plan year data. HealthCare.gov says Open Enrollment for 2027 coverage starts November 1, 2026, with December 15 the deadline for January 1 coverage and January 15, 2027 the final day. Rates will change. Before then, if you are between jobs see health insurance for the unemployed, and if you work for yourself compare against self-employed health insurance costs and when open enrollment runs.