AmeriHealth Insurance Review & Complaints: Health Insurance (2023)

AmeriHealth is a family of companies offering health insurance plans in specific regions, as well as Medicare, plans in several states across the country. They also have a branch offering worker’s compensation coverage.

We can help in finding the right health insurance for you, you can use our free insurance quote comparison tool above by entering your ZIP code.

What is AmeriHealth?

AmeriHealth was founded in 1995 as Delaware Valley HMO and originally served a small portion of Pennsylvania. They expanded over the next few years into New Jersey. Today they operate as a subsidiary of Independence Blue Cross.

The company offers individual and group health insurance coverage with both HMO and PPO plans. The family of companies also includes AmeriHealth Caritas— including AmeriHealth Caritas Louisiana and AmeriHealth Caritas Pennsylvania— for Medicare- and Medicaid-managed care and AmeriHealth Casualty which writes workers compensation insurance for businesses. Caritas programs are available in several states, although not nationwide.

The company’s headquarters are located in Cranbury, New Jersey, although they have offices across the coverage area. Health insurance plans are sold through brokers and independent agents.

What products does AmeriHealth offer?

AmeriHealth New Jersey and AmeriHealth Pennsylvania offer a selection of health insurance plans for individuals, as well as group health plans. Managed care for Medicare and Medicaid and worker’s compensation are sold through separate companies.

AmeriHealth Health Insurance

In order to find information on the health plans offered by AmeriHealth, we had to visit the broker page, as the member’s page is aimed at those who already have health coverage.

AmeriHealth offers many high-quality plans, with EPO and HMO options at the bronze, silver, and gold levels. There is also a Catastrophic Simple Saver plan that is available to provide a high deductible, low-cost health care coverage option for those who do not expect to require a lot of regular care for chronic medical condition management and wish to limit out of pocket medical costs in the case of a serious illness.

At the Bronze level, there are three EPO choices: AmeriHealth Advantage, Tier 1 Advantage, and the Local Value/Regional Preferred network choice, which is also offered with an HSA. Copays with these plans are $25 for primary/$50 specialists, and $50/$75, respectively. The Catastrophic Simple Saver plan has a $30 copay for primary and preventative care visits, while urgent care and all others are subject to the deductible.

The Silver Level is the most comprehensive, with six plans to choose from. These include several EPO networks, three with an HSA, and one HMO option. Copays start at $15/35 for the EPO Advantage plan, with a variety of other copay and coinsurance options across the other plans. The one HMO option has a $50 primary and $75 specialist copay.

The Gold plan options include three EPOs and one HMO. Copays for these plans are as low as $10 for primary and preventative care and $20 for specialists. The HMO option has $15/$30 copays for primary/specialist. The Gold plans feature the lowest deductibles, as low as $1,000 individual.

Due to the large selection of plan options available, choosing the right plan based on a combination of cost and benefits is best done with the assistance of a broker. The range of plans appears to provide an option to meet most budgets and needs.

AmeriHealth Dental and Vision

AmeriHealth offers two dental plans. One is pediatric dental-only, and the other is pediatric dental with the addition of adult preventative care.

There are three vision plans offered. The three levels of adult vision care cover eye exams at 100% and offer different levels of coverage for other services and for eyeglasses and contacts.

AmeriHealth Caritas

AmeriHealth Caritas writes Medicare and Medicaid managed plans that include Medicare Advantage.

Plans vary from state to state as well as based on eligibility. Among the options are specific plans for those with special needs as well as for those qualified for both Medicare and Medicaid.

AmeriHealth Casualty

The AmeriHealth Casualty program offers a range of services for businesses including medical management, loss prevention, and worker’s compensation.

Are AmeriHealth rates affordable?

AmeriHealth has an easy to read chart for health insurance rates, listing costs for each of the various plans based on age. The chart starts with one rate for ages 0-20 and then goes by age yearly from there.

We were unable to find specific family rates, however, there is a system for calculating it; the chart instructs the reader to add up the rate for each person up to three children. After three, no additional premium is charged for adding more children to the health care plan.

Although rates are readily available, the wide variety of plans and difference by age, family composition, and even location makes it difficult to provide any sort of comparison to other insurance companies. It is nice to see that anyone can calculate their rate without having to make contact with an agent or enter personal information.

How are claims handled?

Since AmeriHealth is a healthcare company, there is little to review in terms of benefits management or the claim payment policy. In most cases, health care providers will bill directly for services and the insured will then receive a bill for any coinsurance that is due, or any amount not covered.

How are the ratings and consumer reviews for the company?

AmeriHealth has a dismal rating of F on the Better Business Bureau (BBB) which is very unusual to see. Although the complaint volume is actually low – only 14 in the past three years – the BBB has given the lowest available rating due to the failure of AmeriHealth to respond to any of those 14 complaints.

AmeriHealth has 87 ratings on Consumer Affairs, the vast majority of which are negative. Many of the complaints regard failure to pay claims and a lot of run-around from customer service. There are a few scattered positive reviews, but of 87 star ratings, 81 are only one star.

While the overall number of complaints is low, it can be discouraging to see a company that fails to respond to complaints, particularly those filed with the BBB, which are usually dealt with swiftly.

What’s the bottom line?

AmeriHealth has a good selection of health plan options available to those in New Jersey and Pennsylvania. The failure to respond to complaints with the BBB, however, gives us pause regarding this company’s reputation. They may be worth further investigation, but we would like to see them handle their current complaint volume before we can recommend them.

Compare rates today. Enter your ZIP code into our free tool below to get started.