Ambetter
4.9
Overall Score
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Catherine Scanlan Seattle, WA
I've read many of the reviews and agree with many and disagree with a few. I've never had a problem with Ambetter paying my claims, as long as I am enrolled according to them. Earlier this year, January-February timeframe, I went to pick up my insulin and it was over $1,000, when it was supposed to be $25. They said they cancelled me because I hadn't paid my premiums for several months, which I had. After hours on the phone, I paid what they said I owed and they reinstated me. After sending them front and back of cancelled checks, they gave me a credit on my account. Today, I was checking on a prescription for insulin that my doctor said they submitted 11/29/23. The pharmacy initially said they hadn't received, it. I called the doctor who called the pharmacy and they said it was a problem with my insurance. I called Ambetter and they said it was a problem with the exchange. I called the exchange and they said that I was eligible and enrolled through 12/31/2023. Apparently, when I renewed for 2024, Ambetter put in a start date of 1/1/24, which somehow cancelled my insurance for December 2023. After several hours on the phone in a 3-way call with Ambetter and the exchange, they said they would fix it. The problem is I am out of insulin in a few days. It is the weekend so nothing is going to happen. However, insulin doesn't stop for the weekend. I am beyond upset. I have Type 1 diabetes and will literally die without insulin by the end of the month until the new insurance takes effect on 1/1/24. As it is, it looks like I will have to go a few days without it even if they reinstate it as promised and can't go to the hospital without insurance. I shouldn't have to spend hours and hours doing some else's job and fixing someone else's errors.
11 months ago
Bill Hov Lakeland, FL
I DO like the coverage. The problem is for me to find a doctor that speaks some English. Luckily I found a good American doctor that is about an hour away from my house, but worth the trip. All the doctors near me, I can't even pronounce their name let alone spell it. Anyway, today I wanted to talk to customer service because the same plan has changed how deductibles are paid. I was paying $50 month for a certain prescription but this year they want all their money up front. So I've already met my deductible. MY Problem is customer service. After going through a dozen questions to verify my identity, it took over 10 minutes just to answer my simple question, "Do I need to pay my full deductible up front"? Even after I finally got an answer she proceeded to ask about other things like self help care and other junk. Coverage is great, customer service is really bad (and hard to understand).
1 year ago Edited January 23, 2023
anita aeverettconsolatore
Excellent for low cost however that means low quality and denial of necessary procedures they have already performed giving me excuses as to why that are redundant .
Spinal arthritis of lumbar ,thoracic and cervical is painful and treatment is exercise , diet , ibuprofen, ice and then injections when that doesn't work .
It transpires into a rhizotomy which kills the nerves of the spine so I can walk .
I can't get one two yrs ago then be satisfied with a letter explaining the injections when I've gone that route already so something is up with the company .
Everytime an overhaul of a company turns them into stupid leading stupid it's always money but healthcare to old people who worked all their lives should not be the victims
2 years ago Edited May 11, 2023
Lashawn Partee Arlington, TX
I have no complaints with them overall they have provided the needed care for My husband and I. Customer service has been good. He even told me that when he needed assistance with finding a specialist that they actually took time with him to call and find a Specialist that could see him. They have also covered all prescriptions. And my monthly premium is very affordable.
4 years ago
Hpalmer Marietta, GA
Maybe it depends on where you live. So far my experience with Ambetter in Georgia has been very good. I can't image how I would have paid for $400 plus a month health insurance right now. Plenty of primary care doctors and specialists here that take it at Wellstar and the quality has ranged from so-so to excellent. (I am in the surrounding suburbs of Atlanta). I haven't needed to get ahold of them for anything yet so I can't rate that accurately.
4 years ago
Sarah Barger Little Rock, AR
I think it must depend on what state you are in. I have Ambetter Arkansas and I love it. I do receive a subsidy so I don't pay a huge premium. I also don't have any major health problems, They are excellent for routine care, chiropractic, mental health etc. I do not have dental. So far they have covered everything without any issue.
4 years ago
Maribel Ruiz
I have good experiences with Ambetter,the only thing is some doctors don't accept their insurance but it's getting better.Sometimes u have to call a few times to receive ur card but a million times better than blue cross and blue shield Anthem,had problems with them since day 1,never used it until it was canceled,they wanted $1,300 a month,ridiculous.
5 years ago
Mary Johnson College Station, TX
I switched to Ambetter after a nightmare experience with Blue Cross Blue Shield of North Carolina and Texas. I've only been using it for a few months, but so far my experience has been excellent. My chosen provider accepts their coverage and I'm proceeding ahead with my scheduled wellness checks.
5 years ago
Yolander C Henderson Merrillville, IN
Ambetter is a good company. They're prices aren't too bad, and they contact you personally to inform you when certain preventive care is needed. The only thing I have a problem is with new medications. I have severe migraines, and finally an injection that reduces migraine days to at least half of the migraines per month has been aporoved by the FDA, but it isnt covered. I can't afford to pay my Ambetter premium every month, plus 575 every month for the shot I need!
5 years ago
Gloria Etta Hamilton Waco, TX
Even though Ambetter did not approve of physician recommended Bariatric Surgery, because I have high blood pressure and in a pre-diabetic condition, I am still grateful to have the insurance. For the most part, it’s a good insurance to have. My copayments are low on prescriptions and office visits. I was badly in need of healthcare and couldn’t afford it before going to Healthcare.gov. I was in so much pain from Osteoarthritis wearing away at my hip joints. I felt like nobody cared even though I have worked hard most of my life. And I still work. Ambetter is all right with me.
6 years ago
Christopher Primosh Little Rock, AR
Benefits are terrific but, the rewards pays card... I had my hip surgery October 2017, I was going to use the card for my electric bill and November, after 8 months I was finally able to activate it. Between October 15th and January 21st I Must Have Spent at least 3 hours on the phone with these people until I finally gave up just this morning I thought hey I'll give it a shot. I finally got my benefits, the people on the phone with ambetter their representatives had no idea how to activate the card put me through multiple people and then finally hang up each and every time although they did ask for a call back number in which they never called back they were very uninformed
6 years ago
KMS Overland Park, KS
I'm the medical proxy for a friend who had a stroke on 1/8/2018 and his Ambetter policy has performed beyond my expectations. I'm not sure why it's totally subsidized but he pays $0 for an exchange bronze plan (HMO) with a $6800 deductible. Any HMO is going to have fewer providers and more restrictions, but the main problem seems to be that it's new in the market and the provider list changes constantly. Having met his deductible on day one of his hospitalization, the plan is paying for home therapy, nurse visits, and has a decent drug plan. I don't have any problems with the website which is every bit as informative as my own BCBS plan. No major complaints from us.
6 years ago
Jack Lewisville, TX
I'm very sorry to hear the negative stories from other members. I have been fairly pleased with Ambetter. True, they are very picky about who you can see and what they'll pay for. Thus, you definitely have to do your homework up front. You can't just go see the doctor you like; verify they're in Ambetter before you go.
In mid-2017 I became a cancer patient. This included chemotherapy and surgery in 2017, and we had no significant problems with Ambetter. I say no significant, as there were times that we received bills from someone "out of network"; for example, the hospital is under plan, but perhaps the lab they use isn't. However, that isn't strictly an Ambetter issue, as we've underwent that through the years with both Blue Cross and Humana.
Three stars because it could become a bit tricky to find a doc you really feel comfortable with. I like my primary guy, and the oncologists have been great. On the other hand, there isn't a physician out there that my wife is comfortable with.
To conclude: Ambetter isn't perfect, but it's not bad. Do your homework before charges, and even be prepared just in case there's an emergency.
6 years ago
Maria Alvarado Harlingen, TX
All the folks that gave a 1 star need to learn to read to take advantage of the benefits. Just follow the rules . I'll bet this year of 2017 they have paid about $200,000 in benefits with a $600.00 deductible!! Just pay attention to your account on line. Learn to use the online resources . They have several very good providers on network!!! I signed up again for 2018!!
6 years ago
Tamara Canton, GA
I will tell you they are great however-- warning-- you must use their in-network dr's. I was diagnosed with Thyroid Cancer had to get a total thyroidectomy - radiation, etc. They were awesome. I did have to drive about an hour into Atlanta for the right care. They do have some local PCP. If I have an emergency visit to an ER- meaning my local hospital - NO COVERAGE. I have to drive an hour as there are only one or 2 hospitals in the entire area closest to me i troublesome. Just hope no emergencies pop up.
7 years ago
Glad to have insurance Boerne, TX
I have had a good experience with Ambetter, after I digested the fact that the provider directory on the web site is inaccurate & the customer service reps are pretty dumb. I apologized to my GP for being paid poorly and he said Ambetter pays him fairly. They seem slow to approve referrals: my GP had to telephone a few times to get approvals, but the MD staff in referral department was very helpful once my doc talked to them. The plan I have gives $$ incentives for taking their exercise/lifestyle quizzes, for getting a flu shot, having an annual checkup, and the money is transferred to the Ambetter credit card promptly. I am glad to have coverage and I have had no other problems. The monthly bill and the Member Explanation of Benefits is straightforward.
7 years ago
Clair Melton
I've been buying insurance through the ACA for 4 years, after almost 20 years of going without. I get what I can afford, which isn't much. But hey, I'm used to how capitalism works. Normally, I require only basic maintenance services, so my experiences have been fairly uneventful. But this year I broke my arm down at the wrist, which required surgery. While Ambetter was a little frustrating to work with initially (info on the website is outdated, so multiple phone calls were required to find out which doctors/surgical centers to use), once I got the important info from them, I didn't have a single problem with their providing coverage, and doing so at the expected amounts. That's how insurance is supposed to work, so I'm quite satisfied with that aspect. However, I just got notice that my network physicians have terminated their contract with Ambetter. When I look online, it says my nearest gynecologist (for example) is several hours away. So that's a problem. I'll be calling them to see if there are actually some in my city to choose from. Wish me luck!
7 years ago
Bart Harrison, AR
I've been reading all these bad reviews, I have only been on Ambetter since Jan 1 2017, but have had very good service.
I was wondering about Meds I was already on being included, no problem whatsoever.
I'll keep you updated. Happy in Arkansas!
7 years 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.
6 months 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!!!
8 months 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.
8 months ago
Waylon R Lambert
Ambetter is a joke...For example, I just called with issues, and I spoke with a "customer service rep" who didn't have a working phone...Yes, you read that correctly...A phone CS who didn't HAVE A WORKING PHONE...I was transferred and the next rep justified the fact that the first didn't have a working phone by saying "Things don't last forever..."...This exchange is so symbolic of just how pathetic Ambetter is...It took 4 months to get my auto draft set up, and in the meantime, the company sent a letter saying that it dinged my credit report for not paying my premiums...When I thought the premium was on auto draft...This entire company is just an excuse for rich folks to prey on poor people...I had surgery and wound up paying more than they did for service...Yet, they got over 700 bucks a month from the govt for my coverage...I wonder whose pocket that cash wound up in...Do yourself a favor and run as fast as you can away from Ambetter...The company of non working phone phone reps...It's almost surreal...
9 months ago
Andrea Podolski
I have been trying to get a refund for initial payment as I was in a fragile mental state from a recent health crisis. I got this call for Insurance, he said I didn't have much time and I need to get a supplemental provider. This occured on December 8, 2023 as I was getting assistance with my affairs the case worker told me that I didn't even need what the representative repeatedly told me I needed it. So on January 2, 2024 I cancelled this policy and asked for a for a refund. I called 4 more times on the fifth call the representative Rebecca told me, I wasn't getting a refund because I was covered in January 2024, not so I cancelled it as soon as their Holiday break was over 01/02/2024 and I could speak to someone to cancel. I feel I was conned because the representative knew my current health state was compromised. I'm so disgusted with this company with their manipulative ways. I was treated awful while trying to get a refund. I'm still recovering and this kind of stress was the last thing I needed. I cancelled it, I never used it, all I did was get conned. I would never recommend this company for your health care after the way I was treated. Also, on the sixth call after sitting on hold for ever when I asked for a representative to speak with so I could ask for the supervisor since Rebecca refused to let me speak to the supervisor on my fifth call, I was hung up on!!!
9 months ago
Sherrick Thuesmunn Seattle, WA
AVOID THIS INSURANCE. It seems like a scam company, but I think they're actually just completely incompetent.
I'm currently going through my second denied claim appeals process. The first time, I used their website to find an in-network doctor, and went to that doctor. When the claim was denied, they told me the doctor was out of network. Their website is completely inaccurate. But this inaccuracy isn't just a one-time thing, it seems like around 50% or more of the info on there is outdated or inaccurate. I initially tried to set up an appointment with the doctor Ambetter had automatically designated for me as my primary care physician, but when I called the office number listed for that doctor, they told me that doctor hadn't worked there in years!
So I tried again to get a PCP, and this time I went through the process on the phone with an Ambetter representative. They walked me through everything and we made sure the provider was in-network and near my home. After going to my first routine office visit with that provider, however, I got a $700 bill from their office! I checked online and my EOB said that the whole claim was denied, and they put a reason that was very cryptic. I called Ambetter to explain the claim, and they honestly had no clue what was happening. They couldn't explain it at all. I called the doctor's office, and they explained to me that Ambetter told them the claim had been denied because I went to see a PCP different from the one they had on file for me as my approved PCP. But it was the same person!
Ambetter will give you cancer. Only sign up with Ambetter if you hate your life. I now find myself in the unlucky situation where I am actually just not going to the doctor anymore. Of the three claims I've made since starting with them, they've all been denied for different BS reasons. I've appealed two of them, one is being processed while the other did result in reimbursement for me. The third was small enough that I didn't deem it worthwhile to spend the requisite 10 hours on the phone with support and all the stress the process entails.
So now I can't switch my health coverage since open enrollment has ended, but my insurance is so untrustworthy I can't really go see a doctor unless it's an emergency. The only reason I haven't canceled is I need my monthly medications and in case of an emergency. Heed the warnings of others: STAY AWAY!
9 months ago
Leah Haynes Keller, TX
This company somehow obtained my info and had started sending me Bills/ invoices after I was n an accident and already covered with my states insurance Medicaid, Granted after I became 21 in November and they are somehow claiming they paid some of my medical bills from an accident i was in!! I only found out about my SUPPOSED membership through my contacting them and them telling ME I did sign up to become a member and I am VERY AWARE I have NOT signed up for ANY IAMBETTER anything!! They've sent a bill to my lawyers with my name as well as a person named Antonio M!! and this is in FACT the hold up for my financial payout!! I MAY sue them next for this unwarranted confusion, it fells like someone who works for the ER also moonlights for obtaining injured soon to be uninsured victims, because how else did they obtain my personal information and to mix it up with Antonio M' is CRAZY!!
9 months ago
Brian Wall
This is literally one of the worse insurance companies I've ever dealt with and you should avoid them at ALL cost!! They are horrible in all areas including coverage for services received. My wife was covered by them and we chose to cancel the plan due to financial hardship and horrible coverage. Once I cancelled the policy and turned off auto-pay the illegally debited by account for two months of premiums, which is theft! We cancelled the policy prior to them doing so and completed the process they suggested to receive reimbursement for their illegal act. It's now been over 60 days (reimbursement should be received within 7-10 days as per their representative and it hasn't been. We have contacted them multiple times with no resolution. In fact, whenever we DO contact them they continue to give bogus reasons for why we haven't received a reimbursement for $436.58, which included "you have an outstanding balance" of one month's premiums. When asked which month that would cover they were unable to clarify. These folks are a bunch of crooks and only out to take advantage of people even if it requires illegal actions. I've filed complaints with the insurance department AND the better business bureau as I believe these two entities are there to represent the people in such situations. If Ambetter is in the mix to consider, shop elsewhere until you find a company that is now owned or operated by them!!
10 months ago
Tiffany Cochran
I feel like I'm talking to a 1 year old when I call customer service. It's hard to understand what they're saying and the words I DO understand make no sense! I'm pretty sure SHE didn't understand what she was saying. I saved up my points and had them put on pre-paid visa. It arrived about 4 weeks later. I go to Walmart to buy some FOOD and my card was declined. SO EMBARRASSING! I call customer service and the customer service rep tells me, "Mam, you can spend your card on a bill, rent and phone but can only spend on food at a Walmart in Georgia"...I LIVE IN OHIO! So all the commercials about them talking about the rewards IS A LIE. You CANNOT withdrawal cash. You CANNOT spend on groceries (in your state). You CANNOT use the prepaid Visa card on things you need. So if you're thinking about getting the card I hope you live in Georgia.
10 months ago
Holly Myers St Louis, MO
I enrolled in Ambetter for 2024 in early November. On 11/13 I long into the enrollment portal to check on something and I see that the status says "cancelled" so I call customer service to see what that's about. The lady insisted multiple times that I was currently enrolled and it was not cancelled, and everything looked fine when I created an account for the member portal so I took her word for it. Then a couple months later in early January I tried to log into the member portal a few days in a row but I kept receiving an error message. So I called about that and they said the reason was because my coverage was CANCELLED VOLUNTARILY which it sure as hell was not. Never received any sort of email about this supposed cancellation and never got reimbursed the $680 premium I paid to enroll. So they transfer me to someone else to look into this more and get my health coverage reinstated for January. But then that person says that the notations for the call I had with the customer service said I had cancelled my plan at that time. They said they would open a case about it and someone would call me in the next couple of days but they said that it might not work out since that dimwit notated that I had cancelled my coverage. Since open enrollment is still available for a little while I may just cancel for real and go with someone else as long as they give me my $680 back. DO NOT RECOMMEND based on customer service alone
10 months ago
John Smithers New York, NY
Ambetter from WellCare of New Jersey. I WOULD NOT UNDER ANY CIRCUMSTANCES ENROLL IN THIS HEALTH INSURANCE COMPANY. Their customer service is absolutely terrible. Their customer service is in India and I could not understand what their customer services reps were saying to me because their English was incredibly poor. They sent me a letter saying my insurance was going to be cancelled and no one at Ambetter from WellCare of New Jersey could explain why my insurance was going to be cancelled. Every time I contacted them no one could answer me. I was terrified that they were going to cancel my insurance. In New Jersey, insurance companies are required by law to send out a letter about re-enrollment and any possible increase in the premium. This company never did that. I believe this company is operating in violation of the law in New Jersey. The New Jersey Insurance Commissioner's Office should investigate this company and shut them down for not being in compliance with New Jersey law.
10 months ago
Melinda McCarthy Hawkins, TX
Outsourced customer service with poor communication. Hours on the phone to try and get to a complaint department to no avail and resorted to filing a complaint with Texas Insurance Department and finally got an unsatisfactory response from Ambetter. They quoted my monthly premium for 2024 at $113. I checked Healthcare.gov and the premium was listed at $299/ month. When I contacted Ambetter they confirmed that the premium would be $299/ month. Had I not done the checking of premiums I would not have know until after open enrollment had ended and been stuck with the $299/ month. Their response to the complaint was to blame Healthcare.gov with doesn’t make sense they are the ones that listed the correct premium. How can Ambetter not know the correct premium they are charging? They have very limited in network providers . They have denied claims for my yearly dental cleanings saying I have to get all the paperwork work with codings from the office, fill out the forms and send them in since the dentist isn’t in network. There are no dentist in the area in the network. Their policy states they pay the same for in network or out of network for dental. They just don’t tell you you’ll have to do a hula dance to get reimbursed. I’m not a coding expert have no idea what they want and I would have to drive an hour to the office to get the paperwork. I gave up and just pay out of pocket even though I’m supposed to have dental coverage. The also denied a CT requested by a surgeon for a hernia repair. It’s been appealed and the surgeon send additional noted to justify and they find another reason to deny. Amazing that these denials come right as I have met my out of pocket maximum. Mean while the hernia gets bigger daily and my guts and literally falling out. Yes the insurance is cheap but you get what you pay for and I definitely would not recommend Ambetter.
11 months ago
Chloe wood-henrickson Olympia, WA
Worthless insurance plan. They do not have a single in-network urgent care in my city. I live in an urban area walking distance from 10+ urgent care clinics but instead I had to ask a friend to drive me 30 minutes to a clinic that was in network. If no one could have driven me then I would have paid an extra $80 for the cab fare both ways. Its a lot to try and figure out when you're already in the midst of a medical crisis. Another time I waited 6 months for a dermatologist appointment. I had a rash the entire time and it left permanent scars on my skin because of the delay in treatment. I also had a stye in my eye this year and Ambetter does not cover a single ophthalmologist in my state, so I could not have the surgery to remove it, and once again was left with permanent visible damage. An insurance plan this neglectful should be illegal, it is basically no more than a cheap scam.
11 months ago
Martin Milner Hernando, MS
Ambetter Health Insurance review
Good at claims payment. Very poor customer service, you are directed to a third world call center, not an Ambetter employee , very loud and busy background noise. Reps don’t speak fluent English, nor do they understand your fluent English. If they can’t understand or address your needs/inquiries, they eventually just hang up on you and you have to call them back and start the process all over again……
they put the CUSS! in customer service.
11 months ago
Blink Drive Roanoke, TX
Ambetter insurance is not a scam. However, every phone call made to them results in an endless loop, typically lasting at least one hour, before you can speak with someone, and even then, there is no progress. Seriously, we called them for 10 consecutive days, averaging one and a half hours each day, yet nothing was resolved.
I just want them to approve my Primary Care Physician (PCP) and assign me to any in-network specialist. Their call center is unprofessional. Even if you ask them something as simple as the current date, they still put your call on hold to get the answer from their manager. It feels as if they might as well hire stupid robots instead of real humans to work there.
My wife got pregnant for three months. They are helpless since day one till now.
11 months ago
Grace Bagno
I've never written a negative review but I feel so strongly that I don't want anyone else to go through the stress I went through with them, so here we are. I enrolled through the marketplace with Ambetter, paid several months worth of my premium, yet never received a welcome packet, a member ID, a way to create an online account, nothing. I probably spent over 10 hours with their TERRIBLE customer service who clearly has no idea what's going on trying to get this issue resolved so I could simply make an appt with a PCP. The few times customer service was willing to transfer me to their escalation team, the call dropped every time. I was never able to receive medical care, and the only resolution I got came after I filed a complaint with my state's insurance commissioner (which I highly recommend you do as well if you have issues with them). I couldn't IMAGINE having actually received medical care and having to contact them with an issue or concern. AVOID AT ALL COSTS.
11 months ago
Tanny PC Phoenix, AZ
We just took Ambetter insurance for the year 2023, as we changed from Cigna (one of the best), and in the first month itself we understood that Life’s gonna be a hell now. Every time before our visit (or for my kid), I get a call from PCP’s office saying that “Their maintenance site is down.. so you need to pay from your pocket.” Or “Your status is inactive.” And so on… Horrible customer service and poor website framework. There’s no email ID even so that we can resolve an issue with proof of documents that both parties can attach for clarity. Knock knock.. AmBetter $800-1000 per month is expensive for a middle-class person. If you take the money, make your deliverables effective or lose customers. Thanks!
1 year ago
Dave & Diana M Shawnee, KS
I've had a Silver plan with Ambetter from Sunflower Health Plan for several years. The insurance itself seems to be okay. The real issue for me is their customer service and website issues.
I have the auto-pay set up. Every open season I apply through the ACA/Marketplace insurance. My income always changes slightly. This generates a different monthly premium tax credit from year to year and so a different monthly premium and a different member responsibility (actual member payment).
Unbelievably, the way their software is set up, since the Auto-pay then is different, Ambetter will not draft a December EFT. This generates a "Notice of Termination Risk" notice on your account because they did not receive the January payment!! They don't "receive" the January payment because THEY did not process it!!!! Then the Risk Termination letter takes weeks to receive this in the mail, IF you have mailings set up. Otherwise, you only know this by noticing on your December bank statement that the payment for January (paid in December), did not process. So... this means you have to call Ambetter. You see on their website a "payment amount" that is ALWAYS incorrect/always more than the sign-up on Marketplace website. This amount is completely irrelevant! You have to go to the "Invoice" tab see the actual amount that SHOULD HAVE been drafted, tell the customer service rep this and make an over-the-phone (or online) one-time payment of the correct amount. Then you have to verify that the auto-pay is still set up and then log back in in a couple of days to make sure customer service rep did process the January payment. Then at the end of January, you have to log back in to verify that the January payment was drafted and Auto-pay still processing correctly!
The customer service rep's explanation for this circus is always unintelligible! It makes absolutely NO SENSE! Really, what a messed-up system!!
1 year ago
RenoHal77 Reno, NV
After a good 6 months trying to get my online account access in order with customer service, I finally figured it out myself. I was using the wrong email address to log in with even though it was the same as what was in my account. Apparently you can have a different login email than what's in your account for communications. That is so confusing. They didn't even catch that.
2 years ago Edited June 6, 2022
Peter Morrison Nashua, NH
I signed up in Aug 2021 for a new plan. I have 2 medications that I take and get refills on a regular basis. Both were covered by the RX plan until now. I went to refill both and one was covered but the other was not? I tried calling the support line and spent 1/2 hour talking with someone in the Pharmacy that tried to tell me my deductible has not been met and was the reason. Also, she claim she saw that I didn't refill my prescriptions last year?? I got frustrated and got no real answer. I am now going to look for new insurance once again. This insurance is not cheap the difficult to see what is covered, how much, and what is not covered. Don't waste your money
2 years ago
Regina Euless, TX
I've had Ambetter Superior (TX-DFW Area) since 2018. I chose them reluctantly (I researched and saw the bad reviews), but they were the most affordable of the very dismal options. The first year was not as bad as expected, but not great either. It was hard finding a doctor that accepted them, the doctor list on the website was grossly inaccurate and customer service was not helpful. By 2019 more doctors were available in the plan and my husband and I miraculously found doctors that we liked so we stuck with Ambetter for the next few years. Earlier reviews are definitely right about them denying claims though, especially for MRI's: I think it is their policy to deny all claims first. In 2021 I met my deductible very early in the year due to a surgery and I didn't have any problem with Ambetter paying for any service after that.
However, the premium for that plan for 2022 nearly tripled and we had to downgrade. We chose Ambetter Value plan, after I checked to see if at least one of our doctors were in network. They were...so they said.. so I proceeded to enroll in that plan. Which was the worst mistake I've made so far this year.
Our doctors are not in the network and I still have not found a PCP after searching for 3 days. 90% of the doctors on the list were in an Urgent Care facility. I called Ambetter for help, and they read from the same website list...that is, if they didn't hang up or have me on hold for 30 minutes wishing I'd hang up first. Finally spoke to someone today who actually spoke English as a first language and 1 out of the 5 names she gave me actually had a working number, but the earliest appointment was 4 months out.
So we have worthless insurance that we cannot change and I, like the guy who reviewed above, will be contacting anybody I can find to complain because this is just not right.
2 years ago
James Eason Fort Worth, TX
Ambetter must have an entire team devoted to finding ways NOT to pay a claim. I had several problems with them but the worst is this: In an attempt to feel confident in what I was told, I called Ambetter THREE times before my anti-skin cancer treatment (photodynamic therapy--PDT). All THREE representatives told me I only had to pay my $60 copay and NOTHING else. The doctor's office received a pre-authorization letter stating the same thing. A month later I get the bill and am told that I haven't met my deductible yet. For 1.5 years I fought this, going all the way to the Texas Insurance Commission. They ruled that even though Ambetter told me verbally AND wrote a letter to me (after they reviewed my claim) stating that they should indeed pay the claim, they still didn't. In case that wasn't clear: AFTER REVIEWING MY APPEAL, AMBETTER WROTE ME A LETTER SAYING THEY WOULD PAY THE CLAIM 100%, but they still didn't do and the Insurance Commission wouldn't / couldn't enforce it. Ambetter even went back and listened to the recorded conversations and admitted that I was REPEATEDLY told wrong information. Unbelievable!
3 years ago
briasativa Dallas, TX
I had Ambetter in Georgia and it was great. I never had problems finding a doctor nearby, it covered my prescriptions, reasonable co-pays and deductibles. I loved it! Since moving to Texas it has gone down hill fast. The website isn't working properly. I can't see my Rewards information, there are hardly any doctors available. I live in DALLAS. It's not like a small town or something. All the doctors I did find (that didn't have their own horrible reviews) ended up being mistakes. When trying to make a first appointment they all informed me they no longer take Ambetter. When I called customer service they couldn't get any better results than I could. What happened?! I'm going to have to change plans just, so I can find a doctor to go to. I have no complaint about the actual insurance but if you can't find a doctor it's worthless. Ugh.
3 years ago
Colleen Sheahan ,
I use AM Better for doctor visits, preventive screenings, and medication only. I have had no issues, also get great customer service help. If you pay your monthly premium, stay in network, and do not need surgeries, this plan will work for you
3 years ago
Lizzy Puentes Tallahassee, FL
Ambetter is a great insurance for where I resided in South Florida. They have lots of perks that you can gain from a point system they have. They also have a great reward system where you get money back if you have the debit card. That money back can be used to pay any bills you have which is so convenient!
4 years ago
Jay Cole
There Customer Service is Wonderful I've been very pleased anytime I have needed help in the past there has always been someone to help me on the first try. And for that I am Thankful For
4 years ago
hem n sah Irving, TX
I was very worried about the negative review. But All the claims for emergency room was processed properly. It was a seamless experience and we had no issue at all.
Just follow all the network networks and no issue at all.
5 years ago
Ken Greenwood Austin, TX
Perfect for everything we need. Site works well. Fast response times. Always introducing new ways to make things easier. Been here for 3 years and have no intention of changing
5 years ago
Esmer McAllen, TX
I have had Ambetter for about 1 and 1/2 years and have not had a complain. They have everything displayed on the members website which makes it easier to see what is being submitted and paid.
5 years ago
Olha Auburn, WA
I use Ambetter from coordinated care second year. I have a problem when I want click my login, I haven’t access to my health pays rewards. Every time when you visit your doctor must check information about your doctor work with your insurance or no.
5 years ago
Yous Ibra Richmond, TX
You guys are scaring me. I just joined AmBetter and had my first doctor visit with no issue. I found a doctor about 5 min away from my house and got my 3 months prescription medication fully covered. May be it is too early to say anything about the company but my first impression is okay.
5 years ago
John Fort Lauderdale, FL
I live in Broward county in FL, and all the very negative reviews are surprising to me. True, their website is not great, but other than that I have had zero issues. Many doctors to choose from, great prescription coverage, even urgent care. I am sorry to hear the problems people say they have, but again, I have had no problems at all with them.
5 years ago
