Ambetter
4.4
Overall Score
David Happe Waconia, MN
Worst health insurance we have EVER had. I cancelled it after 90 days. Here's the deal : Expensive premiums through the ObamaCare Florida exchange. Almost NONE of the doctors listed on their web site will actually take the insurance, and the ones that will are the worst rated/reviewed doctors in the State. If you go to a doctor out of state? Not covered. They assigned me (a 45 year old male) a primary doctor... I didn't pick it. Guess what? They assigned me a PEDIATRICIAN 45 minutes away from my home. If you don't go to the assigned doctor? YOU GUESSED IT... denied claim as you didn't use your "primary" physician. In short, this insurance is a 100% SCAM intended to fleece people out of money to subsidize other people. It's literally the WORST. Oh and if you are travelling? No coverage. ANYWHERE in the United States. Use an out of network emergency room while you are vacationing? NO COVERAGE. It's the worst. RUN AWAY from this scam.
9 years ago
You know Seattle, WA
Ambetter Coordinated Health is the worst company that I have dealt with in this digital of the new millennium.
1) Billing: You can't pay t:hem. You can pay by credit card and walk away and they will pre-authorize your payment to your bank making the funds unavailable then after 10 business days they don't take the money and then suspend your service for non payment.
-To combat this I sentdthe the receipt in their messaging system telling them to make sure they follow through with the transaction. know one should have to do this.
-They didn't have proof of any transaction that you have made. The customer service agent doesn't have access to verify that you even made or attempted to make a payment. However after I complained in March they now show transactions and the receipt. Even with that the payments that they show that I have made in the last six months are inaccurate or incomplete.
2) Customer Service: they cannot see or access any real information. Don't leave a survey it is not their fault. But they should tell you the truth about their limited access instead of speaking strongly and frustrated with the customer in repeating wait 3-5 business days.
-They can't tell you what happen to a payment that wasn't processed to be resubmitted and they can't see any receipts.
-When they make a mistake in not completing the transaction it takes forever for them to clear up the suspension they have against you from using your insurance. Even though it's their fault in not processing the payments. The agents will state it will take 3-5 business days . When you come back with the statement "but your record shows you have had the payment processed and out of my account for 7 business days" there is no answer and the agent gets angry and repeats 3-5 business days and there is no one in billing that they can transfer you to to get real business taken care of rather than speaking to a frustrated agent that knows their information is inaccurate.
3) The phone system know more about processed payments than the website or the agent does but still unreliable.
4)I have never had such a hard time paying for services in my life. I don't know the other end yet. Being that we have had the services for 5 months and I gave them the last payment 3 business days ago because I am going to another company They still haven't paid for my services from 45 days ago. It's pending because of the payment they did not take out of my bank after the funds were there and pending for 10 business days. We are full paid until the end of the month but we are still suspended.
5) On their side it seems they only want to take payments from checking accounts and not credit cards. I guess because they know there is flaw in their system. But I don't want to give out that info because it's easier to dispute/ trace a transaction with a credit card and it's easier to cancel a card. But to cancel a checking account because of potential fraudulent activity is a greater impact on the consumer. So I don't like to give out my checking account info.
Watch out. I have spent more time trying to pay this company. With all of my other bills it takes 30 minutes total monthly. With this company I have spent hours a month checking to see if they payment is still pending and if they eve took the payment and resubmitting the payment after the preauth falls off and the funds become available again and being suspended most of the time because of this circle
9 years ago
Hena Parveen Bothell, WA
I never write reviews for anything, but I HAVE to for this company. It has to be one of the poorest health care insurance service I have ever had. Their reps are not helpful, and I talked to one who was downright rude! They had a miscommunication with the health exchange and did not cover me for a month (which I am willing to pay the fine for later) but now they are claiming I was covered and I should pay the premium! Even my welcome package says my effective date of coverage but they said they changed my effective date about 2 months after my coverage began! Ridiculous! I will never use this company again! They are unprofessional and won't accept their system error.
9 years ago
Janet C Gatesville, TX
since I got this insurance back in Jan2016 I have nothing but issues!!! First off my doctor is within their network but yet they seemingly make it super hard for them! they say it needs to be filed under eye doctors & then when they do they get told no its medical.....no winning! then they "forget" to credit my payments in a timely manner & threaten to drop me! i paid my bill at the beginning of the month & still nothing but a nasty letter & now they have tripled my month bill!!! i try to get into my account online it doesnt let me sign in & then i call & for 1 question it takes about 45 minutes to get an answers--most times the person doesnt speak english or does so poorly or just plain RUDE.......had o know they were this bad i never would have taken this crappy service!!!
9 years ago
Leah Dugan Chicago, IL
DO NOT EVER PICK THIS INSURER! You will regret it.
Dealing with this company has caused me time, money, frustration, and my son going without coverage for 3 months. I paid for coverage on time, every month, from Jan - May of this year. I kept receiving letters stating that I owed them money from the previous month. I would call, tell them I had paid already, and after 15-30 minutes on the phone with a rep, was told, each time, the situation was getting fixed. I did this three months in a row. In an attempt to fix the situation, I paid the extra money they insisted I owed (which I had already paid) because my son was overdue for a well visit. At the beginning of this month (May) I received a letter stating that my son's coverage was cancelled in FEBRUARY. This was BEFORE all of my phone calls. No one I spoke with at anytime over the phone told us we had been dropped, they simply took our payment and let us believe we were covered. I have since called the Market Place and they have escalated my case and we hope to get it resolved. In the meantime, my son is STILL WITHOUT COVERAGE and I have paid MORE than what I owed for literally nothing. This is the worst customer service experience I have ever had in my life. And I will be filing a complaint with the BBB.
9 years ago
Veronica Miller Spokane, WA
I don't even know where to begin. This company goes beyond negligent, incompetent, and dishonest. This company is intentionally stealing money from taxpayers, clients, and providers. What they do is calculated. I have been paying faithfully every month my premiums over the phone with my debit card, have confirmation numbers, and the whole nine yards. Just found out today that I have not even been covered since January. They intentionally put you in what they call "suspension" for some alledged mispayment. All the while they are taking your money they have no intension of paying the provider. At the same time they are taking your payments, they are collecting huge monthly premiums from the federal government and ripping off tax payers. They know what they are doing. I had one of their reps get honest with me today. He said this happens all the time and that he has chosen to pay the federal fines and have nothing to do with Ambetter or Obama Care. This coming from a guy that works for them. Go figure. When is there going to be a class action suit? Dishonest companies like Ambetter couldn't do a "better" job of sending our nation into bankruptcy than if that was their intention to do so in the first place. Do you think maybe it is? Every complaint posted in these miserable reviews I have experienced. Believe me this goes beyond incompetence. This is intentional.
9 years ago
Annie Lovato Seattle, WA
Ambetter customer service is the worst I have ever experienced. After signing on for a new plan at the start of 2016, I noticed my payments were not being taken out of my account. I called to inquire and was told that my auto pay through my bank was not set up. So, I went through the process for a 2nd time and was assured that it was set up correctly. Stil, no payment was taken out so I called again and was told the same thing and went through the same process, again. Still no payment so I called a third time and was told that the reason no payments were being made was because I had a credit on my account. Unsure of where this credit would come from I inquired about that. They were clueless. So, I took at as fact because they are supposed to know what they are doing. I then call back a couple months later because I am still not getting charged and they tell me that all I owe is $19.03 and they say my autopay through my bank is STILL not set up so I go through that process again. Here it is the end if April and I receive a letter in the mail telling me my account is suspended because of non-payment and at the same time I receive another letter in the mail with an enclosed check of $121.03 telling me I have overpaid and they are paying me back. WHAT!?? So after several oblivious customer service reps later and being asked if I am related to Demi Lovato, which I did not appreciate I FINALLY get a supervisor who then spends another 40 minutes trying to figure this mess out. It gets figured out and then I am hit with the amount of ALL of the months I had tried to pay all at once which was a large chunk of change. I was told to NOT cash the check and that once I paid 4 months worth of payments my account would be back to active. I am LIVID that this is how things went down. I basically begged them to let me pay my monthly bill each month, was given the run around, had my insurance taken away from me and a check mailed to me, then was hit with all four months of payments that I had tried to make in the first place all at once. HORRIBLE COMPANY!!!! If you can get your insurance anywhere else DO IT!!!
9 years ago
Emily Ardolf
It took me 6 months to see a doctor and only after I went to the local news. This is because in Waco no one will take this insurance if you're a new patient. When I switched insurance, my dr office claimed that meant I was a new patient. After multiple calls from the local news, my dr office finally saw me. However, I can't now update my PCP to whom it is and when I search in their system not a single provider comes up in my zip code. However, magically they found me a PCP to assign me. This insurance has been a nightmare to use and I'm looking into private insurance which may cost me a significant amount long-term, but result in better coverage.
9 years ago
Lori Tampa, FL
This company is the worst insurance I have ever had. Online and with a telephone rep it looked like my primary was associated to them. He was not. I found this out AFTER I signed up and paid. When I went to make a vision appointment I found out the majority of options available were dropping the plan that had Ambetter attached to it. I was literally told there wasn't a vision option for me within 300 miles that would be covered with my plan. What? They drafted my account for a monthly payment too early and by 'accident', without my permission. Their customer care reps are clueless. I've paid for this plan for 4 months at nearly $300.00 a month and haven't used it because nobody takes this insurance! I'm dropping it. Such a mistake.
9 years ago
Andy Resende Savannah, GA
I HAD to get health insurance in the end of last year because of the Affordable Care Act. I chose Ambetter because it had a primary doctor that was covered under Ambetter.
I came to find out as soon as I tried to make an appointment with him that he is no longer with Ambetter and Ambetter refuses to take his name out of their site.
Along with this doctor, I learned that there is almost ZERO coverage with Ambetter in the Savannah area... and I am talking about: dentist, allergist, orthopedic, dermatologist, you name it! No one takes this insurance in Savannah!
I am now stuck with this insurance paying for something I can't use... If I cancel it, I will be penalized for not having insurance, but at least my fine will be less than what I have to fork out every month for no use... but that's the avenue I am going for because I contacted the Healthcare Marketplace and they said there's nothing they can do about that either...
9 years ago
Tinh Savannah, GA
None of the Drs. or health facilities accept Ambetter in the Savannah, GA area, yet, when we sign up online at the HealthMarket place, it shows that several family doctors and specialty groups accept it. Of course, when you show up with the Ambetter card, NO ONE accepts it in this city!!!! You will pretty much pay for health coverage that isn't accepted here. Pay for nothing!!!!
Representative at Ambetter was able to pull up one doctor in their system that accepts it, but it turns out, that doctor no longer is here in Savannah! That goes to show how slow their system is. It's not current or updated at all! This wasted too much of my time. It's April now and I still not have any health care I paid for!
9 years ago
Matthew Heller Coral Gables, FL
I have a catastrophic plan with Ambetter. I knew what I was getting into, but paying over $1300 a year just so I can go to a doctor for three health maintenance visits (no labs or prescriptions covered mind you) is too much. I have also found inaccurate information on their web portal (i.e. website says I owe an extra month's premium while agent on the phone guarantees I'm paid up--glad I didn't blindly pay online). All calls made to Ambetter take several minutes to reach an agent, which is the only option since repeatedly entering my Member ID#, SSN, DOB, or zip code in the automated menu are always met with a recorded "Sorry, there is no record for that information." The company is frustrating and a time suck, but tell me something about the US system of health care that isn't.
9 years ago
Sabrina Diz Key Biscayne, FL
i signed up through the Marketplace on 11/2015 and on 02/11 I called to get my info packet and sign up a doctor. I had just gone through a death in the family and was a little late in doing everything, but still on time. The rep I spoke to fabricated a whole story, stated that my policy was cancelled due to non-payment, and when I asked her for more details, she said I hadn't paid the "Initiation Fee" or the "Start up Fee"...I was floored. I called Marketplace and started a new policy with Coventry Health - but Marketplace told me that their Health companies don't have any of those fees. So I called back Ambetter and the new rep told me my policy wasn't cancelled and that those other charges did not exist!!! Now I was in a pickle stuck with two insurance companies. I've been trying to get Ambetter to cancel my policy for 2 months now AND get a refund. They refuse to refund me because they say I had coverage!!! The following are my conversation notes:
FEB 11: AMBETTER REP SAID AMBETTER IS CXLED, GOT NEW INSURANCE CO WITH COVENANT, CALLED AMBETTER WAS TOLD NOT CXLED, ASKED FOR CANCELLATION AND REFUND $126.54
MAR 01: CALLED AMBETTER AND REP SAID SHE WOULD SEND THIS TO THE RIGHT DEPARTMENT, TO CALL BACK IN ONE WEEK
MAR 22: REP SHOWS THAT THE POLICY IS BEING CXLED; DOES NOT SEE A REFUND BEING PROCESSED - 1/1 TO 2/29 HAD COVERAGE; EXPLAINED TO REP I DID NOT HAVE A DOCTOR NOR PAPERWORK - 2 PACKETS WENT OUT IN NOVEMBER AND ANOTHER IN FEBRUARY; NOTATIONS IN SYSTEM - "PROBABLE LIABILITY MUST BE PROVEN IN ORDER TO GET REIMBURSEMENT, CONTACT MARKETPLACE REGARDING COVERAGE". CANCELLATION# FL20166193994950
***DO NOT TRUST THIS COMPANY OR THEIR REPS!!!!
9 years ago
Mark Hamlin Auburn, WA
This is company is the worst. Today is 3/8/16 and I have been dealing with them since 12/5/15 to pay a claim that they should have paid in November 2015. It was a routine preventative maintenance procedure that is supposed to be covered in full with no deductible. That part they seem to agree with every time I speak to them as well as the letters I receive from them. They just can't seem to handle the part where they are supposed to send a check to the doctor's office.
I called in again today and asked to speak to a supervisor in the grievance department to find out why the claims have not been paid. I am told they don't know how to transfer me to the grievance department but will give me their supervisor. While supposedly talking to a supervisor I get the same line as before. The only difference was that she said that it is not possible at all for me to talk to someone in the grievance department. They will send the information to the grievance department and I have to wait. So I ask for that supervisor's boss and get Jasmin who for all I know is just another person in the cubicle next door who's only job is to answer the phone and give pre canned responses like everyone else that I have talked to.
What a monumental waste of time dealing with customer service at Ambetter is! Nothing gets done. The doctor's office still want's their money and my credit score is at risk because the doctor's office is going to send the bill to collections. Ambetter gets my money every month on a timely basis and I get nothing in return. Ambetter is the worst insurance company but unfortunately I'm stuck with them until the next enrollment process. I'm starting to think that it would probably be better for me to just cancel my policy, pay the doctors with cash and accept the tax penalty for not having insurance.
9 years ago
Jay Hoffman Round Rock, TX
I am 53 years old. Ambetter by Celtic is the absolute worst health insurance company I have ever experienced. They have challenged nearly every aspect of my care. My doctor's directions are irrelevant to them. They will not approve medicines that I have had success with for years. I have lost work due to illness waiting for them to ultimately deny filling my allergy medicine. Steer clear of this company. They should not be allowed to do business in Texas. In the next few days, I will file a complaint with the Texas Department of Insurance. I hope you will do the same if you are a victim of theirs. You will see this post in every social media avenue and online review site that I can find. Please share this to help your neighbors. #ambetter #ambettersucks #celticinsurance
9 years ago
Giselle Chang Hialeah, FL
This co. is horrible, my husband and I choose it thru the market place, after 2 months they cancelled his policy, however they been billing and receiving the payments, Market place been sending them reinstatements requests, we been doing conference calls, spoke with everybody there, no body knows what they are doing. there is not a supervisor who can give you a solution, every person we spoke with do an escalate supposedly to solve the problem, but nothing happen, meantime, insurance is no covering medicines, doctors appointment, been waiting for the reinstatement of his policy more than 30 days. this co. is a joke. but the take your money anyway that the only thing they do. no body do their job. there.
9 years ago
Aga Acworth, GA
Ambetter is THE worst company I have ever had to contact. Firstly, their automated payment system message is incoherent, and then cuts out. Then they make you wait on the phone for 40 minutes, then cut you off. I tried to register online, and it didn't recognize me as a member. No button to press for help. Then I call again, and try the phone payment... It just cut me off. I tried to get a human, and was then told after 2 hours dealing with this garbage that their offices were closed. Heaven knows what they would be like IF you needed to make a claim. Go with ANYONE else, but these people. It is literally, your life in their hands.
9 years ago
Gerard Jacksonville, FL
This company is ridiculous.
They have a listing on their website to show which providers accept Ambetter.
Literally 20 doctors later (all listed in their up-to-date list) I finally found 1 that accepts Ambetter.
Yes, I literally called 20 different offices that supposedly accept Ambetter(according to Ambetter) and only 1 said they did.
Scheduled an appointment as I was having some issues and they called me up a day before my appointment that they no longer accept Ambetter and I would have to pay everything out of pocket.
Since I am already paying for my insurance I really don't want to pay 100% of my health care needs as well.
About 3/4 of the doctors officers gave the same reason why they don't accept Ambetter: Ambetter does not pay them.
1 of the doctors listed is actually an acquaintance of ours and he told us from the beginning that he does not accept Ambetter and is unsure why his office is listed as healthcare providers that accept Ambetter.
When I called up Ambetter asking what nearest walk in clinic was available to see if I could get prescription medication for my breathing problems, they referred me to an office that's about a 4 hour drive away. Seriously Ambetter?
9 years ago
Mariya Seattle, WA
Please don't choose this insurance people!
I have never in my life encountered such a horrible company!
We had it for just a couple month and had trouble finding any doctor to take it.Their list of network is outdated, doctors that their website says take Ambetter told me they do not anymore and never will again and now I know why.One time I went to a doctor I got sent a 150$ bill even though it was a regular visit that I should only pay 1$ copay for. My husband is a diabetic.We ordered his medicine once and next order they refused to cover his syringes.A month ago we got fed up and requested to be disenrolled and receive a refund for the month we won't be using their services, since we paid ahead of time.They said we were disenrolled and will be issued a refund within 48 hours.We never did.Called again.The next person said it's not in the system but now it will be.You qualify for an expedient refund.Will get your refund in 48 hours.Nothing!Next person on the phone said we need to call Health benefit exchange to disenroll.That was new!Ok, we called them.Got confirmation for disenrollment. Same story. ..Nothing!Received a mail from Ambetter saying we have voluntarily disenrolled.But no refund still.Called again today.They say we are not disenrolled so no refund.I'm holding their letter in my hand that says we are and they say that we are Not disenrolled. Basically the point is they don't want to give us money back.
I have seen some mistakes done dealing with companies of all sorts, miscommunication, red tape, human error.But they were all resolved after a couple of calls. This however is Catch 22.
Not only they are the worst health insurance I have ever had but they also are playing tricks with those who want to exercise their right to take their money and walk away from a bad business.I'm not the kind of person to go out there and write a bad review based on my emotions but I would not want any other human being to get into this mess.Ambetter is a nightmare!
9 years ago
Jess Atlanta, GA
Ambetter overcharged my bank account over $500, and with overdraft fees from my other bills coming out, my account is overdrawn. They first told me it would take 30 days to get my money back. After calling the billing department numerous times and waiting on hold for about 2 hours total, now they are saying 3-5 days. That was Friday, today is Wednesday, and i still don't have my money. I requested a refund confirmation email so that I can give proof to my bank so that they will refund my overdraft fees. I was told it would take 3-5 days for the email too. And i still have not received an email. In the time it took the manager to notate my request, he could have sent me the email himself. I am HIGHLY dissatisfied with the way AMBETTER'S HUGE MISTAKE is being handled corrected. It has negatively impacted all of my finances and bill payments, so I hope anyone reading this will rethink using Ambetter. More like AmTERRIBLE.
9 years ago
mary Shannon
OMG, this company is the biggest headache you'll ever encounter, all the complaints listed here I have experienced! !! Every single one !!! Lucky I did find a Dr that felt sorry for me & treated me ! His staff called this NOBETTER ! I paid on 1st every month, was suspended every month, after 3 to 4 hours I'd be reinstated! I feel for anyone that gets on this plan !!! I was told to Call Obama! ! Once told they were to busy bn 1st excepting payments, they didn't have time to deal w complaints, call back middle of month !!!!!!! Grrrrrrrrr, I switched paying triple premiums, but peace of mind so worth it !!!!!!
9 years ago
kevin Helotes, TX
Ambetter should change it's name to AMWORST! Last year i experienced a mass in my nose that was possibly cancerous. It took two months to finally see an ENT because there were none in my area that accepted the insurance, even though their provider list shows several.
This year we signed up with them again but with a better plan hoping for better results. Two and a half months ago my wife was referred to a specialist by her PCP but again the ENT does not take Ambetter. Almost 3 months later Ambetter has not been able to find her an ENT that accepts the insurance.
I told Ambetter last year that it is deceptive to provide a list of providers that is inaccurate when they are aware of his fact. But this year they have the exact same list of providers. STAY AWAY FROM THIS COMPANY. We are canceling them and starting with AETNA in March.
9 years ago
Lucy Atlanta, GA
Terrible customer service. They tell Yoi one thing then do another. The billing department is the worst I have ever seen. They send the wrong bill for 3 months. I called and questioned it twice. I was told it was was correct so I paid the amount they were asking which was lower than my monthly premium. When they finally get their act together, they bill me for their mistake and tell me I am late on my payments. I can't say anything good about this company. I thought I was done with them. We did NOT select them for our insurance for 2016 yet they have sent us our cards and say we have paid through February. We have not paid them this year. The people here are incompetent and their computer systems do my work. On top of the billing issues, they raised our premium 3 months into the year. Are they even allowed to do that!? Stay away!! The price is too good to be true. Pay a little more for a better company. The lower price is definitely not worth the stress and hassle.
9 years ago
Gilbert Arriaga TX
Worst decision I've ever made in my life. There is not a single Dr within 100 miles of me that takes this health insurance. Before I paid they gave me 3 primary care providers one of which I had to choose for them to cover my medical expenses. After I paid I called the 3 Dr's they gave me and NONE of them existed at the numbers provided and when I tracked one down I found out they don't take this health insurance at all. It took this company more than a week to activate my coverage and they refused to cover the $100's of dollars of medications I had to pay for in the interim. Because no primary Dr's within 100 miles of me take this health insurance I am also being denied coverage for the specialists I need to see. In other words they took my money and gave me NOTHING in return and cosy my health to suffer in a way I can not begin to explain. I am laying here with a herniated disc, a torn disc, 7 bulging disc and spinal cord compression and because I paid Ambetter to be my health insurance company I can not see a Dr or get any treatment at all. I would not wish this on anyone. Please don't make the same mistake I did.
9 years ago
Jere Houston, TX
I have had nothing but bad experience with this company. When I called to get help with going to see a dr which shingles this month not a single dr would help me would of had to wait for 3 days before being seen. I even called on a Saturday to see if there was any dr or urgent care I could go to and I was on the phone over 2 hours with a rep that was no help at all. Then I called to cancel this plan by the 15th and was told that it was done even was transferred to health care gov and again told was done. Then last week get an email thanking me for being a member I called again and was guaranteed it was cancelled and not to worry. So guess what no it wasn't and they pulled out the funds from my account and was told it takes 7 to 10 business days to get the funds back. This is BS they sure are good at taking your money but worthless when it comes to helping you out when you need to use the plan. Never been so discussed with a health insurance plan.
9 years ago
Peter J Hall San Antonio, TX
The real problem with this company is less than 20% of the doctors in my city will accept the insurance. The ones who do take it complain about Ambetter not paying them, having to spend hours trying to collect from them and in one case taking litigation against them.
This is the same for blood work and imaging, the places Ambetter tells you accept their insurance do not. I personally believe that all of these places did at one time but got tired of not being paid so they stopped accepting patients with their insurance, one office staff member actually confirmed this to me.
Emergency room visits, that is laughable, you can only go to the hospitals that they cover. I live in San Antonio TX, with 15+ hospital brands. ONLY one accepts the insurance. Absurd.
Bottom line, if you live in a smaller city think twice about using them, odds are that you will not find a doctor that accepts their insurance, if you live in a big city and are pretty healthy you *might* have some luck. Caviet Emptor...
10 years ago
Miguel Gonzalez
My biggest complaint is that I have with ambetter is that for over a year and yet I am unable to find a dental provider that covers this insurance. It was a pain finding our current providers, the directory claims many available doctors, dental, and optical but 8 out of 10 do not accept Ambetter. By the way our zip code 78664 which in no way is a small remote city.
10 years ago
Jean Curran Alpharetta, GA
• Copayments are fixed dollar amounts (for example, $15) you pay for covered health care, usually when you receive the service
• Coinsurance is your share of the costs of a covered service, calculated as a percent of the allowed amount for the service. For example, if the
plan's allowed amount for an overnight hospital stay is $1,000, your coinsurance payment of 20% would be $200. This may change if you haven't
met your deductible.
• The amount the plan pays for covered services is based on the allowed amount. If an out-of-network provider charges more than the allowed
amount you may have to pay the difference. For example, if an out-of-network hospital charges $1,500 for an overnight stay and the allowed
amount is $1,000, you may have to pay the $500 difference. (This is called balance billing).
• This plan may encourage you to use in-network providers by charging you lower deductibles, copayments, and coinsurance amounts.
10 years ago
Review Source
Roxana Perez ,
I used Ambetter three years ago and I have no complaints. The prices were affordable and the network was easy to navigate. I had no issues connecting with the right professionals or to access any medication.
5 years ago
P. Palmer El Paso, TX
We just started using ambetter this year and have been very happy with our healthcare coverage. The only negative is that not as many providers take it in our area so it has taken us awhile to find new healthcare providers that we trust.
7 years ago
Larry Sobol
Horrible insurance. Terrible customer service. Hang up on customers. Need to remove from Healthcare.gov. People sick and afraid to go to the dr because they deny everything without.
7 months ago
jeremy shaw
Can I make it zero stars? They dropped my newborn daughter off the insurance because someone Put her name as "baby girl". Sat on the phone for hours trying to figure out to get this changed, no one can do it. Its been 3 months now we are getting full billing from her appointments. I cannot change insurance because its not "open enrollment". The escalation team said they would fix the problem in 3-5 business., its been over a month. You call and get a new person to help and no-one can fix. My daughter is currently uninsured
1 year ago
Carmen M. LeMay
Ambetter, what a joke, should be called Am Scammer, I went to a hospital in my network, claim was denied because INS said it was not in network, so I verified the address with rep on the phone, and it was in my network, so INS rep said, my lab work was sent to an out of network lab. I called hospital and was told they do not send out lab work, it is done in house. I disputed the claim, and my dispute was again denied. this health INS is a scam, don't waist you money or time with this worthless INS
1 year ago
Belinda Priest
I chose this insurance because they said my doctor was in network. When I went for my appointment I was informed by the office they did not accept my insurance. While waiting to be called back I called Ambetter and was told by Ambetter that yes my doctor was an in-network provider. I think they just list everyone as in-network even if they aren't just to get you to sign up for the insurance.
I am lucky my doctor will work with me and treat me as a cash pay customer.
1 year ago
Southern Coffee Moments
This is one of the worst insurance companies I have ever had. I would look somewhere else for better service. This is not the place for any living person. I cannot get my prescription that I need unless I pay for it. When it supposed to be free. So I am going back to what I had before. If it's not broke, don't fix it. Leave well enough alone. The company is headed for a downfall!! Do Better or SHUT Down!!!
1 year ago
macoe davis
I wish I could give less stars, haha! Poor communication skills. Stole money from us because they drafted from our account more than once in a month and won't send a check back. Have to call them too many times to get a solution to a problem...oh wait, did I say solution? I meant NO SOLUTION to a problem. The "reference" numbers are a joke. Don't bother writing them down. All for show. If you don't want an unpaid internship where you call your insurance everyday to sit on a phone with an automatic answering machine, DON'T SIGN UP FOR AMBETTER!!! Definitely switching carriers.
1 year ago
jeffrey hill Matawan, NJ
I wish I could leave zero stars. BEWARE OF THIS COMPANY. DO NOT DO ANY SORT OF BUSINESS WITH THIS COMPANY. I have been in a battle for over a month for a refund. Hours I’ve spent on the phone trying to get my money back. I signed up and payed twice for the first month - accidentally bc of simultaneously signing up and paying with autopay. I keep getting sent to different people who are the opposite of helpful. This company has robbed me of $551.24 and will not return my money. Stay as far away from this company as possible. BUYER BEWARE
1 year ago
Eric Perry
Been insured for just over a year so I call for my 1095 form for my taxes and got the run around,so I got transfered three times and the final transfer was a no help recording.I will cancel first thing in the morning and very unhappy by the lame service I received ,the last person I talked to was speaking over me and was of NO Help....Will not be back
1 year ago
aria manolakaki Odessa, TX
When shopping for insurance, my specialist doctor was listed in network with ambetter and specialty drugs were covered after I purchased their insurance and went to my specialist They told me at his office that they do not work with ambetter. They only cover generic medications no specialty drugs are covered.
Getting a customer service agent on the phone is horrible it is impossible to communicate they do not speak or understand English
1 year ago
Enya Bradner Redmond, WA
The worst health insurance. I was called by a facility to set up primary care, but the earliest appt for “new patients” was 3-4 months down the road. Had an health situation and needed to go to a clinic for immediate attention. Got turned away from THREE clinics because they wouldn’t see me with Ambetter insurance. All the clinics Ambetter contracted with were 20-200miles away and NONE were open on weekends. Apparently with Ambetter, you need to only get sick on the weekdays and be able to drive hours for “immediate” care. The worst money I’ve ever spent.
1 year ago
Laura “Vanilla” Jamison
Yes, I am leaving a 2nd review because this is beyond ridiculous. NO ONE can tell me WHY I have to contact THEM to verify MY information and now they are claiming on their site that my insurance has lapsed even though they aren't letting me know why and they did send me my membership cards and I know they will tell me to contact them AGAIN when I should NOT have to go through all of that JUST FOR A SIMPLE ANSWER. Screw this company, you have lost a customer, I don't even want to pay y'all a cent if this is how you treat your customers!!!
1 year ago Edited January 24, 2024
Ekta Kamboj Lakewood, WA
I would rate them 0 star if that was an option. The WORST customer service ever. The agents are clueless. They would lie to you about premiums in order to get you to feel satisfied with the call, causing more problems and then refuse to take you call. One specific person for sure would be Samantha Aquinolara (agent), lied about the call was handled properly and when called back about it, she refused to take the call. There was also no notes written by her regarding the call that she had with me the last time. So unprofessional.
1 year ago
Amy Jo Schoeberl
Absolutely horrible customer service!
I was with Ambetter for 5 years and finally gave up! I am extremely healthy and only used the insurance for the 100% covered services like yearly physical, mammograms etc. nearly 100% of the time AMBETTER would deny the claim and I would have to fight it for months. These were in network totally normal services, nothing out of the norm. The last "100% covered yearly physical" billing issue went on for over 8 months before I gave up and switched to another Insurer. If you value your sanity and your money, stay away from AMBETTER!
1 year ago
Christine Lussier Evansville, IN
So far i am finding it impossible to find a provider. Even when I called customer service because I was so frustrated with trying to do it myself online, I came to another dead end. The customer service agent was clueless and actually gave me a primary care nurse practitioner (which I asked for) but she only treated children!! Their website also leads you to one after another after another dead end with practitioners who do not do what the website says they do. I need to find another company
1 year ago
Luke Brock
I bought the policy through the Marketplace. I was with Oscar (Which was actually pretty good insurance) but they didnt cover all of our doctors, so I looked at the tool from the Marketplace said that the Ambetter insurance covered all of our Doctors. I signed up for what was supposed to be their "Gold Plan".. It was a lie.. None of our doctors took the plan, prescriptions were less buying them trough Good RX, and they refused to approve the tests our doctors ordered.. Dont waste your money..
1 year ago
dustin opper Chattanooga, TN
OUTSOURCED CALL CENTER IN THE PHILIPPINES CANNOT HELP
I have had the worst experience with Ambetter, they canceled my policy for non payment even though I paid. Then it took two months to have my policy reinstated and all they did was apologize for canceling my policy in error.. It took two mangers who didn't even work directly for Ambetter and then another 2 months to get results. They still owe me $390.00 for doctors visits during my policy cancellation done in error... THE WORST INSURANCE YOU CAN HAVE.
2 years ago
Damon Rome, GA
This is the worst insurance company I've ever had in my 57 years! Do NOT ever sign up with Ambetter. It's one step away from being a straight up scam! They refused to pay "approved doctors " saying "oh we accidentally put them on the approved list" yet never remove them from the list. They don't apply money spent to the deductible. God forbid you have to call customer service. If you get someone who can speak English, they use a litany of canned excuses for everything. Shady company! NEVER, NEVER USE THIS INSURANCE COMPANY!!
2 years ago
Ivan Lieyeth Perolino Frisco, TX
They tried to scam my employer out of 880 dollars by creating a duplicate account and claiming they didn't pay, and then suspended the account. Who knows if they will try to send the scam amount to collections to damage my credit into order to force me to pay. If so, my lawyer is going to open them a new hole 1 mile wide. Easy legal win. Avoid like the plague
2 years ago
Don Rasmussen Issaquah, WA
Worked in Healthcare as RN/ARNP for 40 years and Ambetter is by far the worst healthcare entity I've even had the misfortune of dealing with. Non-English speaking "Customer Service." Escalation, and Grievance Departments that does nothing; don't pay claims. IT which screws up your web access to their preferred online pharmacy. No one ever has the authority to even look up phone numbers or email. Mail out 26 page denials of payment to credentialled providers. All they do well is take premiums.
2 years ago
Jennyfer Rios Winter Park, FL
Obama health Ambetter/ Cano Health sucks. The worst experience with customer service. They refuse to schedule appointment, cancel appointments and refused referral from doctor as if i never saw a primary care. My son has not been able to see a primary care doctor since we got enrolled within 3 month later. They tell you is all ok and then is not. no records on calls. They are discriminating against us for our spanish names.
2 years ago
