Quick answer
Ambetter is the Marketplace brand of Centene Corporation, one of the largest sellers of ACA individual-market plans, though its enrollment fell sharply during 2026 as enhanced premium tax credits expired. For 2027, Ambetter is leaving Delaware and New Hampshire entirely, while its Florida business moves to another Centene subsidiary so Ambetter-branded coverage stays available there. Rate changes for 2027 vary widely by state, so check your own state’s filing instead of assuming a single national number.
Key takeaways
- Ambetter sold plans in 29 states for 2026, but its Marketplace enrollment fell from 5.9 million in mid-2025 to about 3.5 million in mid-2026, a drop of roughly 41%.
- Ambetter is discontinuing Marketplace coverage in Delaware and New Hampshire for 2027; about 11,600 people, roughly a fifth of New Hampshire’s Marketplace, are enrolled in Ambetter plans there.
- In Florida, Ambetter’s Sunshine State Health Plan subsidiary is leaving the individual market, but Centene is moving those members to another of its subsidiaries so Ambetter coverage continues under a different corporate entity.
- Filed 2027 rate changes range from about 9% in states like Illinois and North Carolina to more than 35% in Pennsylvania, where Ambetter’s increase was the highest among that state’s 14 insurers.
- Centene, Ambetter’s parent, posted $1.1 billion in net income in the second quarter of 2026, a turnaround from a loss a year earlier, even as its Marketplace membership shrank.
On this page
What Ambetter is and where it sells plans
Ambetter Health is the individual and family Marketplace brand of Centene Corporation (NYSE: CNC), a St. Louis-based managed-care company that also runs Medicaid and Medicare Part D plans under other names. Ambetter went into the 2026 open enrollment period selling in 29 states and more than 1,700 counties, with about 5.8 million Marketplace members as it headed into open enrollment. Actual enrollment fell hard over the course of the year: Centene reported 3.5 million Marketplace members as of the second quarter of 2026, down from 5.9 million in the second quarter of 2025, a roughly 41% drop the company attributes to the expiration of enhanced premium tax credits at the start of 2026. My Health Pays, Ambetter’s long-running rewards program, lets members earn up to $500 a year for things like annual wellness visits, qualifying screenings and online health challenges, and the rewards can go toward premiums, copays, deductibles or coinsurance, and in some states toward bills like rent or utilities.
Where Ambetter is leaving for 2027
Ambetter is discontinuing Marketplace coverage entirely in Delaware and New Hampshire for 2027. In New Hampshire, about 11,600 people are enrolled in Ambetter plans, close to a fifth of that state’s Marketplace; the exit was announced in June 2026 for a December 2026 end date, and affected members need to pick a different insurer during open enrollment. See what to do if your insurance company leaves the Marketplace for the general process. Florida is a partial case: Ambetter’s Sunshine State Health Plan subsidiary is withdrawing from Florida’s individual market, but Centene is shifting those members to a different Centene subsidiary, so Ambetter-branded coverage should still be available there. In North Carolina, Ambetter isn’t leaving, but its service area shrank from all counties in 2025 to 63% of counties in 2026, so availability depends on where you live.
What a 2027 Ambetter plan might cost
Rate changes for 2027 are set state by state and insurer by insurer, so there’s no single “Ambetter is up X%” figure. Here’s a sample of what state insurance regulators have published so far.
| State | Ambetter’s 2027 rate change | Status |
|---|---|---|
| Pennsylvania | +35.1% | Approved (highest of PA’s 14 insurers) |
| New Jersey | +20.8% | Proposed |
| South Carolina | +22.1% | Proposed |
| Missouri | +10.3% | Proposed |
| Illinois | +9.2% | Proposed |
| North Carolina | +8.5% | Proposed |
| Alabama | +11.4% | Approved |
Because prices swing this much by state, compare your specific ZIP code and plan rather than relying on a national average. For context, see how much coverage costs in Missouri or Pennsylvania, read how health insurance rates are determined, and check how to lower your Marketplace premium once you’ve picked a plan.
Plan features and financial standing
Beyond My Health Pays, Ambetter added condition-specific “Premier” plans for 2026 aimed at members managing diabetes or asthma and COPD, with $0 copays on selected medications, supplies and specialist visits, plus 24/7 virtual care for common illnesses. Centene also sells ICHRA-compatible off-exchange plans through “Ambetter Health Solutions” for people whose employer reimburses premiums instead of offering a group plan. Ambetter doesn’t publish one nationwide description of its plan networks, and whether a specific plan works like an HMO, an EPO or something else can depend on your state, so check whether your doctors are in-network before you enroll rather than assume.
Complaints, quality ratings and a lawsuit to know about
Quality can differ a lot from one state’s Ambetter plan to the next, so look at the specific plan. HealthCare.gov shows a star rating for each plan while you shop, NCQA’s Report Cards site rates health plans by state, and the NAIC’s Consumer Insurance Search shows complaint history for the company that issues the plan in your state. One legal matter worth knowing about: a wrongful-death lawsuit filed in Arizona in May 2025 alleges that Centene’s Health Net subsidiary kept an inaccurate list of mental-health providers, sometimes called a ghost network, under an Ambetter plan, and that an enrollee could not get real access to therapy before his death; his mother is suing for wrongful death, negligence and fraud. Centene didn’t comment on the case to the reporter, and as of the report the case was still active. The allegations are unproven.
Pros and cons
Pros
- One of the widest state footprints among ACA insurers, so Ambetter is an option in many places other insurers have pulled back from.
- My Health Pays rewards can offset premiums and cost-sharing by up to $500 a year for routine preventive care.
- Condition-specific Premier plans offer $0 copays on select diabetes and asthma or COPD medications and supplies.
Cons
- Marketplace membership dropped roughly 41% in a single year, and Ambetter is exiting two states entirely for 2027.
- Networks differ by state and plan, so you’ll need to check that your doctors are covered.
- A pending, unproven lawsuit in Arizona alleges inaccurate mental-health provider listings under an Ambetter plan.
Other insurer guides: Blue Cross Blue Shield, Cigna, Kaiser Permanente, Molina, Oscar and UnitedHealthcare. See also the best health insurance companies.
See 2027 Ambetter plans and prices in your area: compare quotes by ZIP code.
Frequently asked questions
Is Ambetter leaving my state for 2027?
Ambetter is discontinuing Marketplace coverage entirely in Delaware and New Hampshire for 2027. It’s also pulling back county by county in some states, like North Carolina, so check your own state’s insurer list during open enrollment even if Ambetter isn’t fully exiting.
Why did Ambetter’s membership drop so much in 2026?
Centene attributes the roughly 41% drop in Marketplace membership between the second quarters of 2025 and 2026 to the expiration of enhanced premium tax credits at the start of 2026, which raised what many members pay after subsidies.
Is Ambetter the same company as Centene?
Yes. Ambetter is the Marketplace brand name Centene Corporation uses for its individual and family ACA plans; Centene sells Medicaid and Medicare plans under other brand names.
How much will an Ambetter plan cost me in 2027?
It depends on your state, county, age and plan; filed changes for 2027 range from under 10% in some states to more than 35% in Pennsylvania. Compare actual plans in your ZIP code rather than relying on a state average.
Sources
- PRNewswire: Ambetter Health Kicks Off Marketplace Open Enrollment
- Becker’s Payer Issues: Centene boosts guidance amid $1.1B Q2 profit as ACA membership drops
- Becker’s Payer Issues: 6 insurers exiting ACA markets
- New Hampshire Public Radio: Ambetter Health to exit New Hampshire’s ACA marketplace
- Healthcare Dive: Centene “ghost network” wrongful-death lawsuit
- HealthCare.gov: Quality ratings
This article is general information, not insurance, tax or legal advice. Rate changes and plan availability vary by state, county and insurer, and the lawsuit described involves unproven allegations. Last reviewed September 2026.