Ambetter
4.4
Overall Score
JustJJ West Plains, MO
Absolutely the worst insurance company I have EVER dealt with in my ENTIRE life. Switched to Ambetter and paid my first premium in December 2022. Had questions about discrepancies between Ambtter's website and Healthcare.gov. Ambetter customer service was USELESS. After hours spent in phone calls and being shoved from one operator to the next, we were basically told we'd have to wait until Jan 1st, 2023 to see the updates on Ambetter's website. January rolls around and NO CHANGES. Yes, bait-and-switch!
Strike 1: HORRIBLE/unknowledgeable customer service that barely understands the English language.
Strike 2: Ambetter NEVER sent my Insurance ID card nor a welcome packet.
Strike 3 and my biggest gripe: Healthcare.gov showed a $0 copay for generic prescriptions before meeting the deductible. However, Ambetter changed the rules mid-game and decided that I need to pay my ENTIRE DEDUCTIBLE before getting ANY coverage for ANY prescriptions!
YOU'RE OUT, AMBETTER!
Thankfully, I caught on to their underhanded tactics before the second open enrolment deadline of Jan 15 and was able to switch back to Medica.
Bottom line: Ambetter gives no indication of caring even a tiny bit about its members and misrepresents the actual benefits offered to Healthcare.gov.
THUMBS-DOWN, NEGATIVE STARS, & a GOLDEN RASPBERRY AWARD for Worst Insurance Company.
2 years ago
Brenda Campbell Grand Rapids, MI
Premiums are lower than most. But, you get what you pay for. Terrible customer service. I finally asked for a supervisor and she could not even get that. I called to ask why my claim was not paid in full. I had 100% coverage after deductible was met, and it was. They did not pay 100% of my ambulance claim and I wanted to know why. She asked several times what was the date of claim, what was amount, etc. Finally the last time she asked for the billed amount, I got mad. I’ve trained customer support staff for over 30 years in various positions. I skied what the problem was. She said her computer was having difficulty. I asked her why she does not write down information from the customer so she doesn’t have to keep asking. She said they re not allowed to use pencil and paper! I’ve never heard of anything so stupid. And, they need to provide ENGLISH SPEAKING SUPPORT PERSONNEL! DO NOT GET AMBETTER INSURANCE. WE LEARNED OUR LESSON AND WENT WITH BLUE CROSS.
I believe Ambetter does not fully train their staff. Most likely they don’t train them because they don’t speak the same language. AMERICAN COMPANIES NEED SUPPORT LOCATED IN AMERICA. ENOUGH IS ENOUGH.
2 years ago
Ivette Lago Hialeah, FL
IF I COULD GIVE THEM LESS THAN ONE STAR I WOULD! I'VE ONLY HAD AMBETTER FOR 11 DAYS AND I WISH I WOULD'VE NEVER LEFT MY PRIOR HEALTH INSURANCE CARRIER. MY SON HAS CROHNS DISEASE AND NEEDS HIS INFUSIONS VIA IV EVERY 8 WEEKS OF HIS LIFE, DOCTORS OFFICE HAS FAXED 7 TIMES THE AUTHORIZATION REQUEST, HAS EVIDENCE THE FAXES ARE GOING THROUGH AND YET AMBETTER STATES THEY HAVEN'T RECEIVED ANYTHING AND DO NOT HAVE THE AUTHORIZATION READY. I'VE SPOKE TO CUSTOMER SERVICE, SUPERVISIORS AND THEY ALL ASK FOR MY CALL BACK # IN CASE I SOME HOW GET DISCONNECTED, WELL GUESS WHAT I HAVE GOTTEN DISCONNECTED 3 TIMES A NO ONE CALLS ME BACK NOT EVEN THE SUPERVISOR! SO SAD....
2 years ago
Larry Wood Springfield, MO
1-4-2023
We did our homework before choosing Ambetter for health insurance. However, we did not find out how terrible this company was until we were fully signed up.
First, calling customer service is useless, you are put on hold and never gotten back to. You are given wrong,completely false, and incorrect information at every call, if you can get any information at all.
Hours and hours of phone calls with no correct answers to your questions or concerns.
Before signing up we checked on line and were told verbally that our family doctor was in network.
However, after signing up we were told our doctors group were ALL considered SPECIALIST and we were not allowed to keep our doctor. MAKES NO difference what their website says or what you were told before you signed up.
Terrible, Terrible company.
It's not like they are a cut rate insurance company. For one person in our family, Ambetter was being paid around $1300.00 a month for health insurance. Not only that but the first $1500.00 of medical expenses came out of our pocket. Only then did Ambetter start paying for any medical expenses.
How can such a terrible health insurance company be allowed to operate in the USA?
We cancelled our policy with Ambetter and went to another insurance company. We are paying much more, out of pocket, for the new health insurance, but we felt like we had no choice but to do so.
You cannot believe anything Ambetter says on their website or information they put forth.
say or tell you.
2 years ago Edited January 5, 2023
Michael J
Signed up with them through a healthcare .gov agent due to finding the low pricing attractive. Only to find out after calling around my area that same day that their website listings of practices who they stated would accept their insurance was completely fabricated and/or out of date. As almost every single of the 10+ ones listed in a 25 mile radius I made an inquiry to confirmed they would *NOT* accept Ambetter insurance, and/or hadn't accepted in quite some time.
Filed a cancellation and refund request direct through both healthcare.gov and Ambetter, which on both ends was acknowledged and accepted. Followed up by a switch to different insurance company who's accepted location claims on their website was legit. After a very extensive information gathering session with an Ambetter rep on the phone I was assured everything was squared away, and that after confirming my cancellation with healthcare.gov (which I did) I could expect my refund in 5-10 business days.
Fast forward 10 business days latter and with no issued refund. Called in to Ambetter again and was told there was absolutely no record on their end of my refund request. Proceeded to go through the extensive information gathering process again, including a direct 3 way phone call to a healthcare.gov rep who confirmed direct to their rep my earlier cancellation/refund request. After which i was again assured my cancellation was squared away and that I could expect an issued refund in another 5-10 days.
Fast forward another week latter and I get a follow up email stating I was now eligible to sign up to their website to access my account. Found that strange so called back in to Ambetter a third time to inquiry about my refund status, and was again told for a 3rd time that there was absolutely no record of my refund request, but that they would be happy to file a request for one.
Borderline criminal behavior experience as far as I'm concerned, and which basically forced me into having having to file a charge dispute with my credit card company to end the blatant run-around. Would give Ambetter a zero star recommendation to anybody looking to pick them up if i could.
2 years ago
KMP Charlotte, NC
Please heed these warnings.. This is the absolute worst insurance company I have ever dealt with. It starts with their website and trying to locate a in-network provider. The website is constantly crashing or provides falsified information. I tried locating a Family physician which was advertised on their website as such and when I called, it was actually some mental health clinic in another city. Claims will be denied but there is no real way to no for sure if you are in or out of network as it seems its all arbitrary. Customer service is useless and lie over the phone saying a Dr. is in network. I know this because I couldn't verify anything on their crappy website which forced me to call and I was given false info about an in network provided and was charged 1K for a basic mammogram that they refused to cover. I cancelled them mid-year and got temporary insurance for the remaining year because I couldn't take the hassle and mistrust anymore. They should be banned from selling insurance and sued into oblivion. Please use Blue Cross Blue Shield instead. I've never had an issue with them and learned my lesson the hard way using Ambetter.
2 years ago
ron Silver City, NM
Absolutely useless. No doctors or few in network, same with hospitals. May 22 my gp referred me to a cardiologist, August appointment. Upon checking not in network. After many calls to Ambetter's Philippine call center referred to cardiologist 55 miles away. Failed stress test and he referred me to 3rd cardiologist 125 miles from home who took ambetter. Scheduled angiogram but cancelled 2 days before procedure by hospital due to not in network. Got ambetter recommended 4th cardiologist, scheduled angiogram which was cancelled exactly as before by the new hospital. Ambetter reps are useless, waste your time and there is no one else you can call or get passed on to.
2 years ago
Hannah Columbus, OH
Run away from this insurance. Filed an appeal for an over $20,000 emergency room visit for my then 5 day old son. Buckeye Health Plan promised a response by September 13th, I have heard nothing, and when called to follow up was simply told it was "in review" with no further explanation. I feel very foolish for having not read reviews prior to getting this insurance. If I could give zero stars a would. It is horrific to me that this insurance is offered through healthcare.gov, which is where I signed up for it. There should be some sort of vetting process for this government run program that is supposed to be helping people.
2 years ago
Won’t Back Down Lemont, IL
One word describes Ambetter: horrific. Horrific network (very few hospitals or doctors), horrific customer service (they try to confuse you and/or deny everything, their people often barely speak English and it sometimes takes hours to get an answer on the phone, which usually is “no” ) and horrific coverage (if you need to use it, they twist the facts and take ridiculous positions and force you to fight them). I had to first file a grievance after they denied a claim, even though the claim was clearly covered. Had to go to the state department of insurance to file a complaint! They finally paid after the complaint was filed. It all took 2 years!!! I even know insurance law and pointed out specific policy provisions and legal theories as to why the claim was covered and only when I got an independent third party involved (department of insurance) did they react. Stay away from this place at all costs. You will have nothing but headaches and anguish if you need coverage for something other than a doctor visit. You have been warned.
3 years ago
Justin Crafton
Worst insurance . Nobody accepts Ambetter but when you ask them if there in network with your doctor they will almost always say yes. All Ambetter has done is made it were lower income families don't get enough money to help cover a real health insurance pain since they base how much you get on the lower cost plans. Ambetter has blanketed the Marketplace with cheap low cost insurance. The reason they can offer it cheap is because they don't have to worry about paying any claims when most doctors don't accept there insurance. STAY FAR AWAY FROM AMBETTER INSURANCE. NO INSURANCE IS BETTER THEN AMBETTER INSURANCE !!!
3 years ago
Megan Maloney West Chester, PA
The worst. Both my Pennie representative and Ambetter are responsible for this sucky review. The rep asked if there were any doctors I needed in network, I gave them their name and was assured a bronze plan from Ambetter that cost about $320 a month would be my best option. Turns out my doctor does NOT accept Ambetter. I tried to call Ambetter prior to showing up to my appointment and was put on hold repeatedly and then they sent me to a Pennie representative without giving me any knowledge that they were patching me over to them. Obviously, they couldn’t help me. Horrific customer service. Also, no one I’ve spoken to has heard of this insurance so I have no idea who accepts it.
3 years ago
Diogenes DeFawkes Warner Robins, GA
The provider listing website is useless. Literally had to call random doctors until I found one that took Amuseless. Finally got frustrated when the website showed no optometrists in my entire state, and called the customer service number. The gentleman with a very heavy accent and a limited english vocabulary had to escalate the issue. After waiting 15 minutes he gave me 3 providers, none of which accept Amuseless. One advised me that even though they keep getting referrals they stopped taking them after a few clients got stuck with huge out of network bills after being told they were in network. After my experiences and reading others horror stories I will be changing providers this upcoming enrollment cycle. These people are useless. Go elsewhere if you want actual insurance and not a scam company.
3 years ago
SaneB4Kidz Leavenworth, KS
I've had Ambetter for several years and I was always happy with it.... Until recently. Lately I'm having issues with prescription coverage and my medical claims getting paid. Earlier this month I found out that as of October 30, 2022 my Primary Care Provider, my Orthopedic doctor and the hospital we use will no longer be accepting Ambetter Insurance and several other doctors, clinics, Urgent Cares and hospitals in the area are doing the same. I will definitely be changing insurance companies this year during open enrollment
Based on my experience, I would not recommend signing up for Ambetter insurance. Your choices will be very limited when it comes to in network coverage for any type of service.
3 years ago
AmbetterIsTheWorst Tulsa, OK
You're reading reviews right now to ensure you make the right choice. Back away. Now. I mean it. Go with that other plan. I don't care how cheap Ambetter is or what plan you're choosing from them. Expect full days on the phone with constant disconnects to solve account issues that arise and they will arise. Guaranteed. Expect hour-long waits on hold before you hang up, when the poor customer service person who has no authority or information you need inevitably has to escalate your issue to a higher-up who never answers. Expect ACA violations, Ambetter shirking their legal responsibilities for preventative care as they will never properly cover procedures as such even if required to do so. Expect a very limited range of doctors where necessary appointments take 3+ months to secure. Expect billing issues, overcharges and major out-of-pockets that Ambetter should be paying but finds a way to avoid, confident that you won't bother finding a lawyer and feel you're powerless to do anything about.
Expect all these things, because they will all happen. Ambetter is the worst health insurance company in the United States, which likely means the worst health insurance company in the developed world.
Based on the fees you'll be paying for the year, you are literally better with no insurance at all. Just. Don't. Do it.
May they finally get sued into oblivion and
3 years ago
ANPR Miami, FL
Horrible…!!! I have been in ciatic pain for a month and a week, they don’t care…!!! Authorizations that never come thru, 3+ hours to be in de scalating dept, nothing gets done, I even change the plan to a better one, paying more and nothing…. How can people live with pain and this people don’t care….. now they said that my Pain management company duplicate the request… IT’S THE SAME… just with an URGENT SIGN…!!!! If I go to an emergency room they will give me a shot and won’t help, I’ve been there 3 times….!!!!! It’s a joke…. No answer s, it’s like they are dealing with animals..!!!!! They tell you a different excuse every time…!!! Please help….!!!!! I can’t take this pain anymore….!!!!!
3 years ago
Joan Castro Dallas, TX
The insurance is a the worse to pay for medication. It's almost impossible to get approve for medication. The always asking information from the primary doctor office and when they receive the reason the patients need that certain medication they still denied the medication finding another reason. And asking for more requirements. They insurance literally assume the doctors prescription is not vaillid and the patients is not sick enough even after the proper testing saying the pecient is sick. They are expensive and NOT RELIABLE when someone needs the medication. They're only good to collect payment but they put all kinds of barriers to respond financially for someone medication.
3 years ago
Reno Dog Reno, NV
Company should be called AmWorse. Do not get insurance from this company. They will find any reason to deny coverage. My back doctor referred me for an MRI of my upper spine due to chronic pain which I had gone to physical therapy for a year before with no significant improvement. Ambetter denied the MRI and said I needed to do physical therapy (again). I started the physical therapy and after four sessions at $100 out of pocket per visit, I learned that Ambetter denied payment for physical therapy because it was not pre-authorized! My PT had checked when I started the therapy and at that time, pre-authorization was not required. They changed their policy a few weeks after I started PT and refused to grandfather me in. This was not the first major issue I had with this crappy company. I changed to a different insurer as fast as I was able. DO NOT INSURE WITH AMWORSE!
3 years ago
Laura Schott Philadelphia, PA
I "only" pay $62/month for this insurance due to a tax credit but the plan I have is typically $250/month and it doesn't cover ANYTHING. It should be illegal. I have been trying to find a primary care doctor so I went to the Ambetter website and all these doctors came up as "in-network" but when I actually call the office to schedule an appointment it turns out I'm actually not in-network with them. I have been unable to find anyone in Philadelphia, PA that accepts this insurance through their portal. When I signed up for this insurance I chose a primary care provider (at random since I didn't have one) OFF OF THEIR WEBSITE, and when I went to schedule an appointment with her she didn't accept this insurance. I don't know how they can legally claim that all these doctors are in network with them when they're not. I would rather be uninsured than give Ambetter any more of my money. I will be getting different insurance next year.
3 years ago
Nabrin Noor Ellenwood, GA
So my grandma was required to have surgery to remove an infected toe and after we were sent home we couldn’t figure out why we couldn’t have home heath come in. After calling the nurses, the hospital and then the insurance I figured out there was a balance due. There was no phone calls or anything to let us know that the referral wouldn’t be approved unless that balance was paid so I spend 8 hours talking to people for no reason when it could have easily been sorted if someone from insurance would have notified me. Now we are on day 3 after discharge with an old dressing on a wound. Does Ambetter wanna pay for amputation of the whole leg instead of focusing on helping us prevent further infection?
3 years ago
Laura Langford El Mirage, AZ
If I could give Ambetter ZERO stars I would. It has been over three months, more than 3 hours of phone calls and still no-one at AMBETTER seems even slightly aware of the policy that they created for all of the state of Nevada. In Nevada, despite my reading of my benefits, I found that they do not have any idea that on April 1, 2022, they installed a new policy for specialists. These doctors are not permitted to see any Ambetter patients without a "Authorized Referral". Ambetter, however, has "Authorizations" and "Referrals". They do not have anything called an "Authorized Referral". Hmmmm.
The office manager at the Gastroenterologist informed me (as well as the Ambetter representative, who I had on the phone) by reading an email sent to all Referring Doctors in the state of Nevada - Ambetter will not pay visits of any kind (including initial consultations) without an "Authorized Referral". So let's just hope that my 3.5 hours and ticking away are not wasted and I can FINALLY figure out what Ambetter means by an "Authorized Referral" and I can teach every referring doctor and specialist in the state of Nevada.
But wait, there is a new development - I may not even be covered for at all to see a Gastroenterologist... Curious indeed. Seriously, what good is health insurance that doesn't cover your GI track? Okay, but I still can't see the doctor because the CATCH 22 of "Ambetter Health Insurance". They sure don't care about making making me BETTER, just themselves.
3 years ago
Adrienne Wissa Phoenix, AZ
Was not able to reach a representative for MONTHS. Finally reached someone today. Spoke with them for 20 minutes and we're disconnected, they never called back. Spoke with another representative for 40 minutes and disconnected, never call back. Now waiting 40 minutes to speak with supervisor.
Last year paid for my daughter's birth and prenatal visits out of pocket. Had an ER visit in December for her, they didn't even cover 20% despite deductible being met. No one is able/willing to answer why. Tried to get her an audiology appointment, no one would answer when I tried to find an in network provided. Finally gave up.
Exhausting and worthless.
3 years ago
robert lee Little Rock, AR
Ambetter is basically a type of legal Scam...to scam people who cant afford health insurance. If you dont get pre-approval, nothing is covered. Whenever providers call Ambetter to get preapproval, they find themselves either unable to get through or on the phone with someone who barely speaks english and who only gives you a web address to send records and authorization requests to. Ambetter never gets back with you. Then you call again and you are sent to the "provider relations" call center (wierd that it's a call center right?) but all you get almost every time you call is a recorded message telling you that the system is down and telling you to call back. If they do answer they tell you they need more information. Trying to collect is a massive dead end.
Basically, in most cases they make it virtually impossible for the provider to collect payment, which throws the bill back onto the insured member. And since Ambetter usually never even processes the claim, the member is left with a giant (unajusted) bill.
3 years ago
Darlene Tucker Scotts Hill, TN
I would give zero stars if I could. Ambetter: lowest cost plan in my area, because Ambetter has the benchmark plan. Makes other carriers unaffordable even with tax credits. Getting prescriptions filled is a nightmare unless it's a $4 generic. For brand name RX you have to get prior authorization(PA). If the rx has a lower starter dose in the beginning, you will have to get prior authorization again to refill the normal dose! My 1st one took months. They decline it the 1st time and you have to appeal. Meanwhile, you go untreated so they can save a few hundred dollars during the delay. Expect to spend 45 minutes to an hour, minimum, if you have to call them to get assistance.
3 years ago
Donna Reeves Charlotte, NC
This is my experience this evening.
My first phone call—at 8:30 call disconnected before anyone answered
Second call—someone answered, I gave my info and even gave a call back number, but the phone call was disconnected—no one ever called me back.
Third call—someone answers. I give my name, date of birth, Member ID, name of the medication and the dosage. I explain that I am calling because I didn’t receive a reimbursement that another representative told me I would receive if I paid the $529 for farxiga. The rep states, “I will have to transfer you to that department.” The transfer does not go through and the call is disconnected.
Fourth call—someone answers; I give my name, dob, member id, name of medication and the dosage. I get transferred to the customer relations department, but in order to speak to anyone I have to have my NCPD number. A number that I do not have so that call is disconnected.
Fifth call—get representative; explain the reason for my call; then the rep takes my name, dob, member id, name of medication. I explain that I need an NCPD number and I don’t have that info. I ask if they have it and then I am put on hold. The rep comes back and says that they don’t have the NCPD, and I will have to call my pharmacy in order to get the number. I know that my pharmacy closes at 9:00 p.m. It is now 8:55.
I spend two or three minutes going through the CVS phone tree and finally contact the pharmacist who gives me the NCPD. I then call the number for member services that the rep gave me. The rep gave me an incorrect number. I hang up.
Sixth call—get the rep I had on call number three; give her the same info as my previous four calls. I explain the purpose for my call. She then tries to transfer the call, but the office is closed and won’t be open until Monday at 8 a.m. This could have been told to me on any one of the previous five phone calls.
This company is just...the worst.
3 years ago
Elizabeth Conard Philadelphia, PA
Ambetter is literally the worst. I signed up for my health plan because, at the time I signed up for the plan, it listed many doctors and hospitals as in-network in my local area. Upon the start of my health plan, I discovered that almost all of the doctors listed as in-network on the Ambetter website are actually out of network. I had to drive 45 minutes out of my major US city to get to the closest urgent care, and I still got a $150 bill from the urgent care clinic. I was unable to obtain the mental health counseling I needed through my insurance because the VERY FEW offices around my city that took my insurance were not taking new patients. None of the other major hospitals and clinics that I’ve gone to for blood work, ultrasounds, etc knew if ambetter was in-network, meaning that I had to obtain services without knowing if I had coverage, resulting in several large and unexpected medical bills. I also could not trust the information I got from the ambetter portal or from customer services because the offices and doctors listed on the portal had proven to be inaccurate. I’m basically paying $100 out of pocket plus hundreds in healthcare credit from the government per month to get no benefits besides my $25 prescription refill. I literally want a refund for this insurance.
3 years ago
medrevur Elmhurst, IL
For Ambetter / Buckeye Health in Ohio
My opinion.. STAY AWAY AT ALL COSTS.
Literally the worst health insurance company I have ever dealt with (worst company of any type in fact)... some of the people are nice to deal with but they can't save you.
The moment a dispute of a claim is sent to the back office to review, it goes into a black hole with no hope of resolution. They deny appeals through their process, appeals that have been well documented by their own reps (with their own reps saying this absolutely should be paid), and the denial reason is a couple words that make no sense whatsoever.
They run out their own self-defined clock on the appeal process by taking months between responses and then refuse to examine the issue further.
This company has cost me thousands of dollars I absolutely should not have owed.
Why stay? I was over a barrel, this was the only company in healthcare. gov that covered the doctors I had found for some serious health concerns and did not want to use other doctors.
The stress this company added to my life through their horrendous billing is criminal.
Even today, as writing this, I am getting a bill from a procedure 11 months ago that for a preventative procedure that is 100% covered under my policy EOB, which they paid and THEN pulled the payment back from the provider with no explanation. I thought I'd gotten away from these monsters and they still creep in a year later.
Criminal.
3 years ago
Kimberly L. Houston, TX
Their customer service is absolutely horrible to deal with. Not only are they extremely rude but I've been flat out hung up on and/or disconnected on purpose by them numerous times. Their customer service reps continuously give you false information and the runaround. I've contacted them about a simple issue multiple times and every single person I spoke to gave me completely different information. I've caught some of them in complete lies. They seem like none of them know how to do their jobs. They could stand to get some customer service training and skills. And maybe learn about their company instead of constantly giving customers wrong advice and information. I dread every time I have to call these people, because I know how difficult it's going to be, no matter what the issue is. The worst customer service I've ever dealt with.
3 years ago
Irritated Counselor Olathe, KS
I am a mental health counselor GETTING OFF AMBETTER AS A PROVIDER! After I see a client a few times, they begin to harass me for records. Currently, I just found out that they have been faxing me for records of a client UNDER ANOTHER COUNSELORS NAME and on. RANOM PUBLIC FAX. Not even my fax number, somehow, the owner of the fax machine was able to trace the faxes to me.
Total HIPPA violation. No idea how they found this random fax number that is not my fax number. Totally irritating to deal with them! Goodbye AMBETTER! Have fun finding new mental health providers that love to work for free.
3 years ago
DJ Bruffett Wichita, KS
I would give no stars if that was an option for Ambetter. I think I ambetter off without this insurance! I had to get marketplace insurance, so I poured through all available options. This one seemed ok at the time. My last insurance was less money on premiums and they covered much better. I have to pay for preventative check ups out of pocket with Ambetter. They get 619.84 per month for my individual plan and do not cover squat!!! So I pay 619.84 plus my check up visit of 200.00. I am a healthy person and dont require much medically other than 2 prescriptions for hormone replacement, and daily vitamin, which is pretty common these days. I am so disappointed with the corruptness that comes with price gouging people. It has become the norm and acceptable practice that we are just suppose to sit back and allow.
3 years ago
Tyler McCoy Owasso, OK
Tulsa Metro.
Ambetter is beyond abysmal. They took 2 months for me to receive my insurance after paying early enough it Jan. 1
When I requested a psychiatrist in my area they sent me a number for a place 90 minutes away. I reluctantly called them....... It was a phone number for an Elementary School. The Elementary school was familiar with this problem and knew which office to transfer me to.
Neither DR at the office was even a Psychiatrist. Same names as I was told, just completely different specialization.
Finally I payed out of pocket for my psychiatrist, got a medication prescribed, got hit with a prior authorization, got declined, the DR office and I were given 2 different reasons from the insurance company for why it was declined.
The incompetence is so strong with Ambetter, I honestly wonder if it's intentional malice.
I cannot wait for open enrollment so I can get a real insurance company.
3 years ago
Golf Forlife San Antonio, TX
Garbage insurance. Deceptive practices in terms of listing providers on their website they say are within an exact plan, but then do not honor claims. THAT IS CALLED FRAUDULENT PRACTICES, AND BAIT AND SWITCH to give the consumer the impression they have more doctors in-network than they actually have to get them to sign up. Once you sign on, you're locked in for a year and unable to see the doctor you thought was in their Network. I will file a complaint with the Texas Insurance Department, as well as the State's Attorney General's office to force them to clean up their act. I will also try to have them removed from the Marketplace because they're bilking the government for payouts while lying about the doctors they have in-network to patients, and refusing to pay. Ambetter is acting like an unscrupulous insurance company as long as they falsely give the impression they have more doctors in-network than they actually do to get consumers to sign up.
3 years ago Edited April 26, 2022
Angela Bell La Marque, TX
OMG! Wish I could have rated them a -0- star rating, and certainly wish I’d seen this prior to purchasing their policy. BUYER’S BEWARE! Horrible service; they basically deny every physician requested procedure, then request peer to peer conferences for basic, necessary medical interventions. This is a horrid company, that lacks compassion for people in need of medical attention. They must be operating on a reward for denial system. Talked to a disgusting customer service representative who was offensive, insensitive and down-right malicious. I’m so through with this agency; I’ll pay a penalty to drop this monstrosity. I get free enterprise; but these people should be shut down permanently.
3 years ago
Ryknow777 Wichita, KS
This insurance is an absolute scheme and extremely deceptive. My wife and I signed up for one of their private health insurance plans and found out that barely any providers are willing to take this trash insurance. Customer service agents are hilariously incompetent and without resources to answer the simplest questions. They cover basically nothing. DO NOT SIGN UP FOR THIS INSURANCE. Trust me, the stress that follows is not worth anything. My wife and I can no longer afford our meds and NOTHING goes toward our deductible. We had to change several medications because they don't want to cover anything but the very few medications on their formulary, which are all the cheapest meds on the market. We can't wait to finally be released from this hell when next open enrollment comes around. Do yourself and your family a favor and avoid this insurance at all costs. Despite all the lawsuits brought against them, they've changed nothing and they do not deserve your business.
3 years ago
ENERGY HEALTH KC Lee's Summit, MO
It looks good on paper but, in reality, it's a mess. I signed up for auto pay....numerous times. But for some reason they aren't taking my payments out and then I get overdue bills. They can't tell me WHY this keeps happening. I live in a state that makes the federal gov't pay back for overcharging for insurance. One year I got over $3,000 back. The next year (when they stopped taking my payments again and I had to call) I was told they could take out my measly $35 payment out of my refund for the remaining few months of the year. This time I only got $182 back. And my payments went up to $94/ They took the first payment out in December (for January) and then no more after that. My last phone call to them lasted an hour...most of it on hold waiting to talk to someone without an accent who could get to the root of their billing problem..... and then the phone just disconnected. I called back and went through the same BS with another Phillipino. Got no answers just a "thanks for your payment...our autopay has been having some problems". This has been going on for over a year now. Heaven forbid I should need it in an emergency only to find out my account has been suspended due to "non-payment". Who has this kind of time to go through this rigmarole every other month?!!!!
3 years ago
Cassidy Robinson
My new job requires me to get insurance off marketplace. The 1st time I opted for very high end Alliant plan. I rarely use my insurance. So this year went minimal with AmBetter Peach Care.
I have a psychiatrist and have meds I fill. Otherwise healthy. I checked my Dr. before- i spoke to a representative- my doctor is in network. 1st claim denied. Ambetter said verif that dr takes Ambetter- they do. Dr office said they have had multi issues with Ambetter denying claims in the past.
Today I can not fill the RX i had fill last month. It is Wellbutrin- I have been on the phone 2 hours- they gave me 3 NDC#'s and I called the pharmacy with them. NON OF THEM WORK. I had to go to Walgreens because they are not accepted at CVS. Wellbutrin is covered but they make the customer try to troubleshoot all the problems with the coding.
I have never had to call and do the work like i have with AmBetter. This insurance is on the same cost as my monthly mortgage. WTAF!!!
Worse! I work in healthcare- and I have crap insurance- it seems to get worse every year.
AmBetter is the worst coverage I have ever had, What am I [paying for?!!
AGREE- they ask for your # incase call is dropped- LEAVE YOU ON HOLD FOR 30 minutes- DROP the call--- AND NEVER CALL YOU BACK!! What kind of BS scam is this company?! Why ask for our # if you have no intention of calling customers when calls are dropped?!! I have called them 20 times since jan 5th. Today is March 11th.
5-6 calls required until I AM NOT HUNG UP ON and actually speak to a representative who can and does try to help. THESE POOR representatives! Im sorry your company is so horrid cause' the phone reps get all the frustrations.
I HOPE at the very LEAST AmBetter offers their employees ANY INSURANCE that is NOT Am Better!!
3 years ago
Lauren Woolsey Panama City, FL
The absolute Worst insurance provider ever! Family of 8 here. Paying $1260/month for what originally appeared to be good coverage. Long list of "in network providers". Turns out to be a Huge lie and i feel that my family has been scammed. Thankfully we are only 3 months in and Daniel with Healthcare.gov was able to help us on yesterday to have new coverage with BCBS effective 4/1 (25 days away) but i still cant help but being extremely angry with Ambetter for basically robbing my family of $3600 in premiums for the past 3 months. We hadnt used the coverage as we didnt need to until 5 days ago when my son broke his hand and i AM STILL TRYING TO FIGURE OUT HOW TO GET MY SONS HAND CASTED TODAY BUT CANT FIND ANYONE THAT TAKES THIS CRAPPY INSURANCE. There is literally no urgent care centers within 200 miles that take this insurance, NO Orthos within 100 miles that take this insurance, customer service is HORRIBLE when calling ambetter for help. They basically told me "Sorry, that is your problem not ours, you should have checked for providers before agreeing to this plan". The problem is that, I DID!! there was a list of all sorts of different in network providers.
You call them and they say the have stopped TAKING AMBETTER because they are hard to work with. Also, because its ambetter, every provider automatically assumes that it is medicaid when it is not!! I paid allot of money for this plan. I am so angry and will get to the bottom of this. Do NOT FALL FOR AMBETTERS SCAM! YOU WILL PAY ALLOT OF MONEY FOR ALMOST NO COVERAGE AT ALL.... THEY PAINT THE MOST BEAUTIFUL PICTURE FROM START BUT WHEN YOU WILL TRY TO USE THE INSURANCE, NOBODY ACCEPTS IT!!! THEIR LIST OF IN NETWORK PROVIDERS IS FAR FROM UPDATED. AT LEAST40 OUT OF THE 42 PLACES THAT WERE SHOWING IN NETWORK ON THEIR SITE NO LONGER ACCEPTS THEIR INSURANCE. DO YOURSELF A FAVOR AND STEER CLEAR OF AMBETTER ALLTOGETHER. THEIR CLAIMED COVERAGE IS A LIE AND THEIR CUSTOMER SERVICE IS THE WORST I HAVE EVER EXPERIENCED!!!!
3 years ago
Gloom Bunnie Fort Worth, TX
They don't deserve a single star.
Let's start from the beginning: All of their website information as far as providers is inaccurate. The numbers aren't in service, the Dr's don't even work at any of the offices anymore, and none of them are taking new patients even though the website says they do.
So,I call them about this little hiccup.. as far as I'm concerned, stuff happens. I get it. Except, the employees don't even give accurate information. I am on call #6 trying to resolve these issues and getting put on hold just for the calls to drop 15 mins later. They'll try to "fix the issue" so you don't escalate but it's a lie, they don't get you accurate info to fix the situation.
Disgusting company, liars, scammers as far as I'm concerned. None of them know anything, none of them fix anything, and I've wasted over $200 in 2 monthly payments alone and still have 0 healthcare because I wasted the entire first month waiting for an appointment just to find out they can't actually take me!!!
SHAME ON YOU AMBETTER!! Do NOT get this insurance!!! I'm doing everything in my power to cancel it and not give them another dime, and this is coming from a very tolerant, kind person.
3 years ago
Heith Gay Las Vegas, NV
Ambetter charges high rates but does not provide even basic care. I signed up for care under the Nevada health exchange and then used their "find a doctor" to set up a physical. I spent 6 hours calling different numbers. The list is so out-of-date that it is a serious burden trying to find a general practitioner. And for those you do get in contact with, no appointments are available for 3 or 4 months. I finally called Ambetter and they told me that I could get an appointment in the next city sooner probably and I should start calling people far away from where I live. I quickly canceled before the policy was to go into affect and Ambetter assured me I would receive a full refund in 7 days. It has now been 3 weeks and there is no way to contact billing. They simply put you on hold for more than an hour waiting for you to give up. Ambetter is a common thief. Avoid at all costs.
3 years ago
Sharon D. Winter Park, FL
Avoid Ambetter! I did not re-enroll in 2022 because 1) They dropped my primary MD, hospital and others without notification, new providers are not close to my zip code. and 2) Admin. is terrible, the negative reviews are spot on. We had to routinely "appeal" for accurate benefits payments because Ambetter routinely denied stating "out of network", which was not accurate. I had major surgery end of 2021 and can't access 2021 Evidence of Benefits processing because I'm no longer a member in 2022, nor will Ambetter mail. I'm receiving provider co-pays but met the member out of pocket for 2021, and providers should be paid 100%. Customer Service puts you on hold for unreasonable periods, e.g. 1+ hour and often disconnects you. The appeals process is equally dysfunctional. I've contacted BBB and Florida Customer Services.
3 years ago
Anonymous Chicago, IL
Discontinued membership after being enrolled in a Vision, Dental, and Health Plan. For reference, I live in Chicago and per their tool to find a dentist, I reached out to all 27 listed providers within my area to schedule a check-up. Each of them confirmed that they do not accept Ambetter and do not know why their practice was listed on the website. Members of their practice also called Ambetter requesting information on why they were listed, requested for it to be removed, however, months later it was noted they were not removed.
Ultimately, paying $336 a month for vision, "dental", and health seemed like a waste and so I decided to cancel my membership in December 2021. I called to request a cancellation and was also provided a refund in January. In February however, $668 was deducted from my bank account by Ambetter. I called to inquire why and rightfully request a refund. 8 calls later and close to 8 hours of call time, my request was denied because the "pay through" date on their system was February 1st. I pushed back on the call I made in December and it was noted to me that I had to cancel my plan with Ambetter as well as the marketplace for it to fully go through. I called the Marketplace and they confirmed it was canceled in December and their system shows no record of me receiving coverage in 2022.
I called Ambetter back and this time it was noted that the call log in December shows that I called to request account cancellation and a refund, however, no cancellation request was submitted (by the representative). I was then told that I should have received a letter in the mail in October noting that I need to take action to cancel my plan and if not, I will be re-enrolled in 2022. They backed out of their initial reason by noting that because my plan was started under"on-exchange", the marketplace would have no record of my coverage (basically their initial reason was incorrect).
Finally, I asked what further action would have been required by me to make sure my plan was canceled beyond giving them a call in December to request to cancel it and receiving verbal confirmation that it has been cancelled and I can expect a refund. Furthermore, I was not charged in January and on February 2nd was charged for two months. They could provide no explanation other than my plan was set up to be re enrolled in 2022 regardless of calling to request for it to be canceled in December 2021.
I then asked for a copy of an application to re-enroll into Ambetter in 2022 after canceling my plan in December 2021. They were unable to find one.
I have still not received my refund and nobody seems to understand the reason for it. They have "escalated" my case twice but I have not heard back and frankly, I have given up on trying to get a refund.
Ambetter of Illinois is a scam that misrepresents information on their site from dental providers that offer coverage to lying that a plan was re-enrolled (without having supporting documentation to show the account holder requested for it) and charging bank accounts. Please avoid using this service if you are in Illinois and stick with a larger provider.
3 years ago
pooh nani Kingsport, TN
Ambetter is literally the worst. I dont know how its legal what they're doing. They'll charge you for plans you didn't sign up for or use, you'll pay for your plan and they'll say they even got your payment but they wont give you credit. They'll take your money, Bill you again, and not give you your insurance. Theres no way this is legal and im looking into fixing this. Getting my money back and making sure they never do this again. They are horrible. They literally hang up on me. I cant even contact them. I have to call marketplace and stride health and talk to them. Ambetter is worse than no insurance. Seriously.
3 years ago Edited February 2, 2022
Elle A Atlanta, GA
I've been a customer for nearly a year and I would never choose Ambetter again. Know the overviews represented on the Marketplace website aren't accurate in terms of cost, in network providers, or cost of coverage. Customer service is insanely inept, they will just read the brochure version of your coverage for you with no ability to answer any problems. The in network providers listed on Ambetter's website aren't necessarily in network (please contact your current doctors directly before signing up for any insurance on marketplace). I pay a high premium for insurance that covers nothing. Every time I tell an office what my insurance is they either grimace, laugh, or contemptuously cut me off. Please only treat this disgusting company as a last resort. I am deeply suspicious of any review left here that is 5 stars as it was likely someone compensated/employed by Ambetter.
3 years ago
Hal F. Berkeley, CA
The worst customer service I've experienced in a long time. Currently on the 5th call today. I can't connect my account with my login on their website. So far, ticket sent 2 weeks ago and still not fixed. Got a rep that said he "activated" my account, not fixed. Called again and got a phone number to Nevada Health Link, this is not my problem. Called again and was put on hold. Got transferred while on hold then call dropped. Called back, on call for 7 minutes but there's no one on the line. This is where I'm at right now. Got a bill to pay, but not sure if that's happening. Absolutely the worst.
3 years ago
Maria Tajman Fayetteville, NC
Please be aware this is the worse insurance I’ve ever had. If they had a minus star that’s what they would get from me. Now why I understand most of the doctors in my area do not accept it. Had to drive 2 hours for mammogram, 1 1/2 fir colonoscopy ( which by the way they are trying for me to pay 500+ out of pocket because supposedly it’s not preventive, did I understand correctly? Colonoscopy after 50 is to prevent colon cancer, right ?? They refused to pay for an MRI that I needed for approval on a epidural shot I needed which I had to pay myself out of pocket and they still did not approve it!! Nevertheless I changed to United Healthcare at beginning of this year and after seeing my MRI and X-rays approved it right away. Never ever again I would use their services
3 years ago
Steve D Overland Park, KS
Jan 2022: I'm a brand new customer with Ambetter - Kansas and...
Dropping them already!
In Dec 2021, before signing up, I confirmed by calling Ambetter Customer Service, that my physician was in plan and my daughter's pediatrician was in plan. I was told they both were. Yeah!
Now 10 days into January, I cant assign either of our physicians as the PCP using my online account, can't even find them in plan. Called Ambetter C/S and was "escalated" to the Resolutions Dept. I was informed both physicians are "Specialists", not PCP's and unable to be assigned... WTH?
Nice to have known that about 1 month and a over $1,000 ago.
3 years ago
Michelle Coatesville, PA
They charged my credit card twice and never gave me a member number or account. When I called multiple times to try to resolve it they said they could not find me in the system. The foreign customer care couldn’t understand my name despite me spelling it many times. He gave me a number to help me, which I found out after dialing it was to healthcare.gov. I didn’t purchase through them so that was pointless. The next person transferred me to a number that hung up on me immediately.
At this point I had to dispute the charges with my credit card company because I could find zero person to actually help me. Needless to say I won’t be moving forward with Ambetter, this felt much like a scam.
3 years ago
MAXINE POWELL Riverdale, GA
Ambetter is a rip off. I have been paying over 2 years for my sons. I just happen to call Market Place and they informed me that I was that I was not supposed to be paying a premium for the past 2 years. I reach out to Market Place to update information and this was when I found out. I have tried calling Ambetter 5 times and they hung up on me, when I explained reason for call.
I did ask for legal department to discuss reimbursement and they did not have number. Still cant get help so I will be reaching out back to Market Place see if they can help me get over $1000 back that Ambetter took from my account each month. At least $40 month.
3 years ago
Bri Dee St Louis, MO
By far the worst insurance I've ever had. Moved states, and literally zero PCPs available. Cannot get in to see ANY doctor. The few doctors that do take this insurance are low-income clinics where you're getting the worst quality care... But like I said, haven't seen one of those in months because NONE OF THEM ARE EVEN TAKING PATIENTS. I'm paying for insurance I can't even use. I get sent an explanation of benefits I didn't ask for every two weeks in the mail, even though I'm signed up for paperless everything. No one can seem to figure out how to get them to stop sending it. The site never works, customer service is a joke and they will hang up on you if they can't figure out what you need. Lost coverage for a couple months and lost access to my therapist because Ambetter screwed up a billing issue. Never paid late once. Please, if you care about your health, don't bother with this company.
3 years ago
Holly Gutierrez Hamilton, TX
I wanted to try Ambetter out because they were a new company that I had never heard of and they were very reasonably priced and the deductible and out of pocket max were very low. My husband and I have a plan with them through marketplace. It was very easy to apply and sign up. I paid my 1st few months premiums and everything was going great. They even paid for the surgery on my shoulder, which had me almost meeting my yearly individual deductible. Around July, I realized that our yearly income was going to be higher than anticipated at the beginning of the year. I went into marketplace and changed it. When I did this, I still qualified for the same Ambetter care 12 plan, but I would be paying more for my premium, which I understood. I found out that my income change put me in a different tier, same plan different tier, I went from the 90% to the 80%, meaning what they would pay. I was fine with all that. But because I had changed tiers, they put me in a new policy with a new policy number. This reset all my deductibles. The 1st several times I called, either the person had no idea how to help me and would put my call into a supervisor, which I never received a call back. Two people spent over 2 hours each on the phone with me to try and get this sorted out. They were on the phone with their supervisor at the same time. At the end of the calls I was reassured by both of these people that my deductible from my previous policy would transfer over because it was the same policy but a different tier. I had also received a rewards card from them for doing different activities in the amount of $50. I had used it some to pay my monthly premium but still had a balance of $30. When my old policy was "canceled", my Visa rewards card on associated with thus policy was canceled as well and I lost that money, which I had spent the time to do the activities for. This escalated over 2 months. In all this time I never received a phone call from a supervisor. Finally, after speaking to someone on the phone and having to tell them for 30 minutes straight that they could not help me and I wanted to speak to a supervisor, they finally got me over to a lady who proceeded to tell me that I was lying about everything that I had been told because I could not provide her the conversation number. She told me she could see all the conversations that I had had but because I could not provide her with the number she could not verify that that's what that person said. She told me that they never transferred deductible that it was my fault I canceled my policy. And that if I wanted to use the rewards card I should have used it before canceling my policy. I tried to tell her that I did not cancel my policy, that it was changed by Ambetter because I had been put in a different tier. But she would not listen. She just kept saying you're right ma'am what can I do for you. And when I would tell her she would say we can't do that, we've never done anything like that before so what else can I help you with. When I ask to speak to her supervisor to her supervisor she denied this request. I did not have a problem with anything but their customer service. Their premiums were reasonably priced, they paid for my surgery with no problem, but the way they treat their customers is absolutely is absolutely uncalled for and unjustifiable. I will not have a plan with them ever again.
4 years ago
Maddybaddy01 Des Plaines, IL
Terrible customer service. Extremely disorganised and I get different answers from nearly every person I speak with. They take forever to approve claims for treatments of chronic pain. I have terrible knee pain- waited a month for prior authorisation for an injection. Got denied. Never mind I am struggling to function. I was diagnosed with sleep apnea 8 months ago. Still not being treated because nobody wants to work with Ambetter and their process of getting treatment approved is ridiculously difficult. I was told by some medical facilities that they won’t work with Ambetter because it is Medicaid. Excuse me?! I am paying $341 per month, NO government subsidy- for this so called “Medicaid “. Had they disclosed this when they coerced me and basically pressured me into buying them this plan, I would have happily declined. They’re a rip off company who wants to steal your money. Don’t let the cheap benefits fool you. I’m looking into lawsuit options.
4 years ago
