What is another name for AmeriHealth?

Editorial team Published on

AmeriHealth's Medicaid and government-funded managed care division was previously known as AmeriHealth Mercy before changing its name to AmeriHealth Caritas in 2013.

Depending on the specific service or affiliate, AmeriHealth also operates through related entities:

  • AmeriHealth Caritas: The subsidiary handling Medicaid, Medicare, and CHIP plans across multiple states (formerly AmeriHealth Mercy).
  • Independence Blue Cross: AmeriHealth is an affiliate/division closely tied to Independence Blue Cross in the mid-Atlantic region.
  • AmeriHealth Administrators: The national third-party administrator (TPA) wing for self-funded employer plans.

What kind of insurance is AmeriHealth?

AmeriHealth is a regional health insurance provider that offers commercial health plans, individual and family coverage, and managed care solutions.

Types of Insurance Plans Offered

  • Health Maintenance Organization (HMO): Requires you to use a specific network of doctors and get referrals to see specialists. Costs are generally lower.
  • Preferred Provider Organization (PPO): Offers more freedom to see out-of-network doctors without a referral, though monthly premiums are usually higher.
  • Exclusive Provider Organization (EPO): Covers only in-network care like an HMO, but does not require specialist referrals.
  • Point of Service (POS): Combines features of HMO and PPO plans, allowing some out-of-network coverage coordinated by a primary care physician.

Key Programs and Coverage Areas

  • Commercial & Individual: Offers private health plans for individuals, families, and businesses (mainly in New Jersey, select Pennsylvania employer groups, and expanding areas like Atlanta, Georgia).
  • AmeriHealth Caritas: A major division focusing on government-sponsored programs like Medicaid and Medicare/dual-eligible plans across multiple states.
  • Affordable Care Act (ACA) Tiers: Individual plans on and off the marketplace follow standard metal tiers (Bronze, Silver, and Gold) covering essential health benefits.

You can review specific options and details directly on the AmeriHealth Official Website.

Is AmeriHealth a Cigna plan?

AmeriHealth is a separate health insurance company, but certain AmeriHealth plans use the Cigna Healthcare PPO Network for out-of-area or national coverage.

📊 Understanding the Relationship

  • Independent Company: AmeriHealth operates its own regional health plans (primarily in New Jersey, Pennsylvania, and Delaware) and administrative services.
  • Network Collaboration: AmeriHealth partners with Cigna to let members use Cigna's national doctor and hospital network when traveling or receiving care outside of AmeriHealth's local regional service area.
  • ID Card Indicator: You can check your physical or digital AmeriHealth Member Login card; if it features the Cigna logo, it means your specific AmeriHealth plan includes access to the Cigna PPO network for national coverage.

Is AmeriHealth a part of Medicaid?

Yes, through its division AmeriHealth Caritas, AmeriHealth operates managed care plans that provide government-funded Medicaid coverage in select states.

How AmeriHealth Works With Medicaid

  • Managed Care Organization (MCO): AmeriHealth acts as a private company hired by state governments to manage and deliver Medicaid health benefits.
  • State Specific: Availability depends on where you live. AmeriHealth offers Medicaid plans in multiple states—such as AmeriHealth Caritas Ohio and AmeriHealth Caritas Pennsylvania—rather than nationwide.
  • Other Plans: AmeriHealth also offers commercial insurance, Medicare, and Health Insurance Marketplace plans, which are separate from standard Medicaid.

Are AmeriHealth and BCBS the same?

AmeriHealth and Blue Cross Blue Shield (BCBS) are not the same company, but they have close corporate connections through Independence Blue Cross.

The Relationship

  • Ownership: AmeriHealth is a wholly or majority-owned subsidiary and affiliate of Independence Blue Cross (IBX), which is a major Blue Cross Blue Shield plan based in Philadelphia.
  • Separate Products: While AmeriHealth is tied to Independence Blue Cross, AmeriHealth plans themselves are branded separately and are distinct from standard Blue Cross Blue Shield products.
  • Joint Ventures: Certain branches, like AmeriHealth Caritas, have also included ownership stakes from other regional BCBS plans, such as Blue Cross Blue Shield of Michigan.

Key Differences

  • Networks: AmeriHealth and local BCBS plans (like Horizon BCBS in New Jersey) operate with distinct provider networks, hospital participation lists, and geographic rules.
  • Plan Availability: AmeriHealth operates specific regional health plans and administrative services, whereas BCBS is a massive national association of independent, locally operated companies.

Your AmeriHealth New Jersey Advantage Health Plan

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Is AmeriHealth Administrators part of BCBS?

AmeriHealth Administrators is a wholly owned subsidiary of Independence Blue Cross's parent organization, Independence Health Group, but it operates as a separate third-party administrator and does not offer official Blue Cross Blue Shield (BCBS) branded products or services.

Relationship Details

  • Parent Company: It belongs to Independence Health Group, which operates the primary Blue Cross Blue Shield plan in the Greater Philadelphia area.
  • Operations: AmeriHealth Administrators functions as a national third-party administrator (TPA) for self-funded employer plans and other carriers rather than issuing standard BCBS health insurance policies.
  • Network Disclosures: Specific programs or services managed through AmeriHealth Administrators are often classed as independent from Blue Cross Blue Shield Global Solutions and other regional BCBS association benefits.

Is AmeriHealth part of Medicare?

AmeriHealth is a private insurance company that offers AmeriHealth Medicare Advantage Plans (Part C), but it is not a part of the official federal government Medicare program itself.

💡 How AmeriHealth Connects to Medicare

  • Private Insurer: AmeriHealth contracts with Medicare to provide private alternative plans.
  • Medicare Advantage (Part C): These plans bundle Parts A, B, and usually Part D into one package.
  • Original Medicare: You must still be enrolled in Original Medicare (Parts A and B) to join an AmeriHealth Medicare plan.

What company owns AmeriHealth?

AmeriHealth is owned by Independence Health Group (the parent company of Independence Blue Cross), which operates some of its divisions like AmeriHealth Caritas as a joint partnership with Blue Cross Blue Shield of Michigan.

📊 Ownership Breakdown

  • AmeriHealth (Commercial/Regional):
    • Wholly owned subsidiary of Independence Health Group / Independence Blue Cross.
  • AmeriHealth Caritas (Medicaid/Medicare):
    • Majority-owned by Independence Health Group (approx. 60%).
    • Co-owned/minority interest held by Blue Cross Blue Shield of Michigan (approx. 40%).

Is AmeriHealth good insurance?

AmeriHealth is a competitive health insurance provider, but whether it is "good" depends heavily on your location and your specific healthcare needs.

Pros of AmeriHealth

  • Regional Network Strength: Strong HMO and POS network options, particularly for families and individuals in Central and South New Jersey (such as Mercer, Burlington, Camden, Atlantic, and Cape May counties) and parts of Pennsylvania.
  • Competitive Pricing: Often provides lower premium rates and smaller annual rate increases compared to major regional competitors like Horizon Blue Cross Blue Shield.
  • Comprehensive Benefits: Standard plans include essential health benefits, telemedicine access, gym discounts, and chronic condition case management.
  • Specialized Care: AmeriHealth Caritas is widely recognized as a major leader in managed care for Medicaid and low-income or chronically ill populations.

Cons and Customer Complaints

  • Mixed Customer Satisfaction: Customer reviews on platforms like WalletHub and Trustpilot are sharply divided.
  • Claim and Coverage Friction: Negative feedback frequently centers on difficult claim denials, delayed approvals for specialized treatments or therapy, and challenges with prescription drug coverage.
  • Geographic Limitations: Coverage is primarily restricted to New Jersey and Pennsylvania, making it a poor fit for frequent travelers or college students living out of state.

What is Cigna health now called?

Cigna's Medicare business is now called HealthSpring.

Key Details of the Change

  • The Buyer: Health Care Service Corporation (HCSC) bought Cigna’s Medicare Advantage, Medicare Part D, supplemental benefits, and CareAllies businesses.
  • The New Name: HCSC rebranded these Medicare products under the HealthSpring name.
  • Main Cigna: The broader commercial Cigna Healthcare company still exists and operates under the Cigna name; only the Medicare-related division changed.