Ambetter
4.9
Overall Score
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Jack Arterberry Wadesville, IN
Worst insurance I have ever experienced!!
Had to have rods and screws installed in back due to a fall.
After a year and a half have a popping and grinding in back ,,called primary physician office they referred me to an imidiat care orthopedic dr,,they did grays , ,couldn't see anything wanted to do an MRI
Insurance denied wanted to do 6 weeks of therapy!!!
It's metal on bone grinding when I walk
I paid for MRI out of pocket and Dr wanted me to see original neurological surgeon to look at scan,,
He wanted to do a CT scan ,,,insurance again denied,,,
He set me up for surgery to remove hardware,,,
Get a letter today insurance deny surgery to remove...
Have an appointment with therapy Tuesday ,,have already talked to therapy and they agreed that therapy will not fix problem.
5 years ago
Linda Church Saint Joseph, MO
This company is the worst. I have been fighting with them for since January. The gov reinstated my insurance because of their mistake on May 3rd. But Ambetter says I owe them 6000 bucks in back pretax premiums. August 1st the gov paid for a new policy which they show is active until the end of Aug. I had emergency heart surgery the 17th and AB is saying that I am suspended on the new policy even though it was paid by ACA. I have been fighting with these clowns for over six months and now they will not pay the hundreds of thousands for my emergency surgery. I also got a new and better policy from ACA that will go into effect Sept 1st. I have not been able to get my meds or my insulin since June when they decided to throw me under the bus. I wish they had a star for below 1, then I could really rate this company.
5 years ago
Gail Hermitage, MO
I am needing an mri an ambetter Insurance has denied it. I have 2 disc missing on L4 qn L5 in my lower spine I have DDD an bulging disc arthritis nerve damage thru out my back an severe muscle spasms that goes from the middle of my spine to my chest. Ambetter claimed it is not medically needed an I need to have new nerve complaints..so here goes another appeal an probable another denial. Said my injuries are old an so are my test but before they will pay for a nerve conducting test I have to have proof I have nerve damage..all they do is deny your request from drs. I think they should call this Insurance the death panel Insurance they want your money but wont pay for nothing..I'm needing surgery an cant get it till I get that MRI that's being denied to me. I thought they pd for pre existing conditions nope they dont..if i don't get this approved by Nov I'm dropping them. Worst Insurance company ever..I'm literally in tears over this..stay away from ambetter
5 years ago
Melissa Silverman College Corner, OH
HORRIBLE. A scam.
I have been on the same ADD meds since 2017. We switched to Ambetter on the exchange for 2019 due to their co-pay for this med being $50. They immediately started denying my medications, and basically said that whatever my doctor had prescribed did not matter; I would not be able to get my medication unless I tried a different, generic medication first. I tried to discuss this with them directly but to no avail. So I took the different, generic medication, which has neurologically destroyed my tongue (even though I went off of that med after 2 months).
They still will not approve my doctor's prior authorizations. First, they told me the doctor had given the wrong diagnosis. Honestly, I don't know how adult ADD is the wrong diagnosis for Vyvanse, since that is what it is made for. So the doctor submitted another prior authorization with a different code for ADD. Denied again. So instead of the medication costing me $50, which they scammed me into believing I would pay for this med, I am paying $300, and have to stop cold-turkey because of the price.
I called Ambetter again today, and after wasting over an hour on the phone, the first person the representative called (with me on the line) said they hadn't received any prior authorizations (a lie) or my doctor's appeal (a lie). He tried a different person at apparently a different place, Amanda, who said that it was denied because, again, the diagnosis was not suitable for this med. The representative (Jasper, who was actually quite helpful) asked what the exact issue was ... then Amanda said that it was denied because I hadn't taken the generic, alternative med yet. WHICH I HAD, for two months, and have permanent damage from it. So SHE LIED. It wasn't about the diagnosis, it was about this med, which they could easily see I have taken since THEY HAVE PAID FOR IT.
Now my doctor, who has not been given accurate information from Ambetter about what she needs to do to get this approved, has to submit ANOTHER prior authorization with the info on my prior usage of their recommended alternative, which is information they had already and is just one more bogus excuse to deny coverage. And she said the doctor needed to request a peer-to-peer, which was information they didn't share with my doctor.
I have been trying to get my medication back since JANUARY. Almost 9 months. We pay $12000 per year for two people and a ridiculously high deductible ($12K) and I can't even get my meds. Ambetter is a complete scam and they only exist to take advantage of people on the exchange. The internet is full of very, very, very angry Ambetter clients who have also been scammed.
They have also disabled any comments on their FB page because they were all negative (unethical) and took away the ability to message them on FB (also unethical).
This company should not be allowed to be in business. They are keeping people from becoming or staying healthy, and every road block is there on purpose and completely arcane.
5 years ago
Tiff Houston, TX
Ugh I didn't even want to give them one star... this insurance company is horrible!!! I am in Houston Texas yet can't seem to find any providers in my area. Had a procedure scheduled for today, an epidural of my neck. I took today off of work and had a friend drive me AN HOUR out of my way. I am in alot of pain and when I got here... surprise! They can't do the procedure because Ambetter has not authorized it yet. I have been fighting with them for TWO HOURS trying to get this approved when they've know about this for weeks. They can't tell me why it's not been approved, and they won't tell me when it might be. Everytime I call I get a different story as to why it hasn't been approved yet. And... they don't have ANY supervisors that will speak to me about this. I am so pissed.
5 years ago
Mike Emrick New York, NY
I guess i get what i pay for. $25 a month. After i left my company to enter a new career field needed some insurance for the mean time. Took over a month to sign up cause i got locked out of the system and customer service would ignore my calls. Then finally after getting on it took another month to receive an insurance card with my named misspelled "matthaw". Im still waiting for a refund bc i couldnt show my insurance to the front desk lady at my doctors which is $150. Maybe for Christmas ill get the refund. On top of that will only cover generic medications which isnt a problem if the medication im on had a generic but doesn't. Have to wait 8 weeks bc insurance wants me to try a generic bc its cost effective. Not going 2. I take 2 meds which one is generic and one is not so might have to pay out of pocket until i get it approved. Ambetter is last resort cheap insurance that only covers a few doctors and some vitamin C. I dont think anyone who has a serious medical condition would survive long with this insurance company.
5 years ago
PattiPhx Phoenix, AZ
The Accumulator Functionality doesn't work, therefore, the customer reps, members and medical providers are given inaccurate information. Ambetter told my doctor I had only paid $2000 of my deductible, when the truth was I had paid all but $36. I almost was unable to great radiation treatment for breast cancer because of it. I over paid my out of pocket amount by $120, and was told to ask the hospital to return it. Do not get insurance from them!!!! They don't care and have told me to be patient, the problems started in February why should I be patient. Ambetter should be able to provide accurate deductible and out of pocket totals. i'd given them a zero if I could. i even filed a grievance with the company , their answer, you over paid, sorry for the inconvenience, we are working to get documentation so you can get the $120 back.
5 years ago
Susan M Sellersburg, IN
I called Ambetter before I had a procedure done to make sure it was covered and they assured me that it was covered and my only cost would be a $5.00 co-pay. Of course after the procedure was done received a bill. I called Ambetter customer service and 2 different people said that I would not have to pay it because it was a covered expense. Someone in customer service offered to dispute the claim. After over 2 months of the claim in review, I found out by Ambetter customer service that it was not a covered procedure. What a crappy way to conduct a health insurance business. Geez. Thanks a lot for nothing.
Very disappointed,
Susan M.
5 years ago
Jay Finlinson Plano, TX
I signed up for this insurance company because they said my medicine was covered by them and I could continue to see my doctors of which I have had for years. I have been trying to get my medicine for weeks now. They are still giving me and my doctors the run around. My doctors have done all they have been asked to do yet I still am not approved to get my medicine that I have been on for years. I cannot recommend this company. I have spoke with them and they say to do this and I will get my meds. I do what they ask and yet nothing. I can't function properly without my meds. They keep coming up with reasons to postpone helping me.
5 years ago
Paul Evanston, IL
I have a Gold level plan costing over $13,000 per year with their Ambetter Health Insurance. This company is effectively operating a scam. It may not meet the legal definition of fraud, but it certainly meets the moral definition.
I have a $1000 deductible policy. They have very limited options for providers and hospitals with the hospitals being among the worst around per Yelp reviews.
Even after getting approved for procedures supposedly covered by Ambetter, I have been saddled with the bulk of the bills. For example, I needed medical imaging work done. Only two hospitals with bad reputations are in-network in a city/burbs with a few dozen hospitals. I got the pre-approvals for the imaging procedures, but then Ambetter refused to pay for the radiologists ($2200.00) who read the tests. I had no choice of radiologists that the approved hospital used. I didn't even know who they were until I was billed. Ambetter says the radiologists are covered in the plan, but must be billed through the hospital. The hospital and the radiologists say they cannot bill through the hospital. Ambetter won't budge. If they won't cover the radiologists at one of their only two approved hospitals, then they aren't really providing me coverage.
As I've seen how Ambetter/Celtic operates, I am realizing that even with my pricey $1000 deductible plan, even if I use their very limited in-network provider list, I could one day end up with $100s of thousands in medical bills that they won't cover because of the way the game the in-network rules.
Most recently, I needed urgent care. I checked their site for the nearest urgent care clinic in their network. Nearest one is over an hour drive away--that's for urgent care. There are dozens of urgent care clinics within 10 miles of my location. None are in-network.
I would advise anyone to stay away from Celtic/Ambetter for insurance. Even if you pay an arm and a leg for coverage, they exploit every legal avenue available to avoid actually providing the coverage you think you're getting.
5 years ago
Velvet Miami, FL
On Thursday June 20th at 9:45AM I called in and spoke with a "Debbie", she was so rude and spoke so fast I could barely understand her. And at some point in the call she needed to speak with my husband who was working in the other room. I walked across the house and gave him the phone and with no prior knowledge of how rude she was with me, he was instantly shocked and asked her to please slow down and asked if it was possible to speak using "please" and "thank you" as he always does. She ignored that request, verified some information, my husband could barely understand her, and when he gently asked for her to speak up she muttered some swears and redirected the call to the general 800 number. NONE of the changes were made, she undid 35 minutes of phone work out of spite. We had to start all over with another rep. No one is "monitoring or recording" any calls out of Debbie's line, it's all a big headache (this happened before) and I'm tired of AM Better's lousy service. If changing my PCP is such an ordeal, I can only imagine what they are like when I have something important like an emergency. The bad reviews I have read on here so far are all credible in my opinion. Good luck in your searches :)
5 years ago
Jordan Germantown, TN
Like this article says, Ambetter should be a last resort. It certainly was for me; I signed up for my insurance very late, as my mother cut me off of her insurance without telling me. I was attracted to Ambetter for the low premiums and seemingly comprehensive coverage. However, there are very few places in my town in Tennessee that accept Ambetter, and many of those places are poorly rated, and far in between. I cannot get therapy for my PTSD because no psychologist will accept my insurance. Pretty much anything that’s not emergency-level necessary is not covered by this insurance. The price is nice, sure, but I almost always have to pay out-of-pocket, whether it’s a simple prescription level Ibuprofen or an actual appointment. Being a holder of this insurance leaves me a bit worried about any emergencies that may occur since I do not feel protected or secure with this plan. The lack of a mobile app leaves some accessibility concerns as well, since the website frequently crashes for me and the interface is a little confusing. Ultimately, I came to this website to see if anyone else’s experience with Ambetter was similar to mine, and unfortunately I am correct. If you can, please seek out a better service for insurance.
5 years ago
D. Wingo Loganville, GA
I am so pissed! I have been fighting with Ambetter for years. I tried to go into my account today to make sure nothing was wrong. Because they are constantly putting in the wrong information. One hospital claim wasn't even mine. It was another patient!! Well I couldn't go into my portal because It states it didn't exist. So I had to call them again. And now they said my account is suspended!!! They said I didn't make a payment. I even paid 8 days before it was due! So then they said the marketplace said I had two accounts. I called the Marketplace and they said NO WAY. That my account is up to date and no issues. So Ambetter had to go into my portal because I couldn't. After 5 phone calls they said that my 2016 policy information is in my 2019 portal. And they don't know what happened. I have a Dr appointment this Wednesday and prescriptions that need covered. But they said it will take up to 10 business days to fix my account!!! Which I do not believe!!! And I cannot see a DR or get my scripts until it is fixed. I was given no reason this happened. Just that they messed it up AGAIN!! This insurance company is messing with people's lives and no one makes them accountable! GOD HELP US!!!!!
5 years ago
Donna East Colleyville, TX
This is the ABSOLUTE WORST INSURANCE EVER! WE LIVE IN TEXAS AND MY HUSBAND WENT INTO SEVERE ATRIAL FIBULATION IN SOUTH CAROLINA AND HAD TO HAVE A CARDIO VERSION. AMBETTER HAS REFUSED TO PAY BECAUSE WE WERE OUT OF STATE. FIRST THEY SAID IT WAS BECAUSE IT WASN'T AN EMERGENCY; WHEN THE CARDIOLOGIST PROVIDED A LETTER SAYING IT WAS THEY STILL REFUSED TO PAY. WE NOW OWE A HOSPITAL $10,000.00 DESPITE HAVING PAID AMBETTER FOR A LONG TIME ALMOST $1,000 A MONTH. ALSO, MY HUSBAND WAS TOLD THE HOSPITAL HE GOES TO IN TEXAS WAS COVERED AND THE CARDIOLOGIST HE WENT TO IN TEXAS WERE COVERED-THEY WERE NOT AND CLAIMS WERE DENIED. SO FAR WE HAVE RACKED UP OVER $18,000 DUE TO UNPAID MEDICAL CLAIMS BEING DENIED BY AMBETTER. ONE STAR IS ONE TOO MANY!
5 years ago
Tired St Louis, MO
Had them for years then I got a little behind on my payments so I worked a second job to catch up every thing. Missed a dead line when I made the last payment by 4 days and they sure used it to cancel me. Wouldn't work with me at all. It was my fault for not reading all my paperwork and seeing the deadline(I was working two jobs ) ,but 4 days late on a payment and won't work with me at all. I made the payment on 8th of the month evidently my deadline was the 4th,but it took my payment and then didn't tell me I was cancelled till the 18th of the month. Way to have a heart Ambetter You were lucky to have us we're healthy and hardly ever used it.
5 years ago
JPR Columbus, MS
Apparently any income (taxable or not) will reflect on your assistance. Had several people I work with in tears this year as they were handing over $1000’s at tax time.
Also, terrible network (all the worst doctors in your area) and the website never works. Plus you can expect to jump through hoop after hoop after hoop trying to prove who you are and your income, ect.
You will either stay on hold forever or find yourself using a website that never loads. Only to find yourself facing another bureaucratic hoop.
We had to cancel in May because we couldn’t get on the website to upload our information, and when we tried calling we were told that was the only way.
$1000’s thrown down the drain in bills and taxes, and the policy was more expensive than if we had both paid for several visits and medications out of pocket!!!
Awful, terrible company!
5 years ago
Cecilia Hamilton Dallas, TX
I have had Ambetter for 16 months and have not been successful finding any ob/gyn in Dallas. Even when I call them, they supposedly call the providers and verify that they take my insurance and then when I call to make an appointment, they don't. The same is true for the website. None of the people on there actually take my insurance. I'm starting to think the Texas market is completely fake. I need to see someone and am long overdue. 8 hours this week alone, with Ambetter customer "assistance" trying to make an appointment and no success. One person they gave me was only high risk pregnancy and I'm not pregnant. I tried all of this last year and eventually gave up because I was so frustrated. I pay $717 per month and have no illnesses or medications yet they can't seem to assist me in getting my annual exams. I will probably go to Planned Parenthood and pay out of pocket at this point, even though the annual exam is a benefit. I guess it's a hide and seek benefit. If you can find a doctor you can have it. This is how they save money, by taking all of mine and being a fake insurer.
5 years ago
T.C. Fayetteville, GA
If I could give them a negative rating I would. I have been trying to get in to see a doctor since January 22, 2019. Today is April 12th. I finally found a Dr. that takes Ambetter whose new patient wait list isn't 6 months out. Yes that is correct because I am a new patient to these physicians, the earliest I could be seen was August 4th. (Seriously!!!) I got an appointment for April 15th, received a call confirming the appointment on April 11th, Call from Dr's office on April 12th canceling the appointment. Reason - "the Doctor will only be doing physicals and since you are not here for a physical she can't see you!" Unbelievable!!! I am not giving them another cent! The worst insurance ever!!!
6 years ago
Maria R Somoza Melecio Skokie, IL
If you are looking for Health Insurance do not pay your hard earned money to Ambetter. As many of you know, in October 13, 2017 I was working in Dallas, Texas. I had placenta previa (where the placenta is near the cervix) and had painless bleeding. I had to go to an Emergency C section and as soon as I found this out I called my husband to inform him and he also called our insurance Ambetter to be added on to our insurance. It was approved for her to be on our insurance. Months past and the hospital filed the claim but Ambetter denied it Baylor S and W filed multiple claims and Ambetter had multiple excuses (hospital didn't file on time which they did in that 90 day period, baby's name didn't not the claim, the baby's birthdate didn't match the claim, etc.) THEY REFUSE TO PAY AND MAKE ANY EXCUSE IN THE BOOK TO DENY CLAIM. AMBETTER IS SUCH A SCAM.
6 years ago
Chad Koch Westmont, IL
I have been in a fight for over a year for them to cover a bill I am not responsible for. I found a primary doctor and called in to have the customer services rep make sure she was listed as my primary as the website function never changed anything. After this approval I went to the doctor only to receive a $108 bill a few months later for a new patient service. I had a $1 copay. I called to have them fix this error. Apparently my Doc was not listed as "in-network" until months after I saw her. Why did they approve her as my primary? Why was she listed as in network on their website? Why am I still trying to get this dealt with 12 months later after 4 appeals and 3 grievances? Oh, and that bill has since gone into collections and is now affecting my credit score. Thanks Ambetter! You are the worst insurance I have ever used!
6 years ago
River Grayson, GA
Today is April 8th, 2019 and I called Ambetter twice and their system was down. I have written six complaint letters to Ambetter concerning their terrible services and none have been answered. I have been denied services and prescriptions after having paid my premiums. I have had to call a total of nine times to establish a primary care physician. Each time I call the representative it is always an incompetent human being who is unable to remember the reason I called or that I had already established a primary care provider on a previous call weeks ago. A supervisor whom I escalated the issues to was rude and nasty to me. After having paid for my insurance, my provider ran my insurance through Availity and is was showing me as inactive. Ambetter charged me twice for one month of service and still showed me as inactive in their system. I have requested my ID card three times and it has been over a month, I still do not have an insurance card. These are just some of the few issues that make this the worst insurance ever.
6 years ago
B Austin, TX
Terrible customer support service. I have had this insurance for 4 months, and I have never once been able to login successfully to my member account on their website. I called multiple times for help, and each time I got the run around and horrible communication. They would say they are creating a "ticket" and that they would follow up with me via a phone call when my problem was resolved, but they never called back, and the issue after 4 months has still never been resolved. I still cannot login. So, I haven't been able to pick a Primary Care Doctor or see anything related my coverage online. The customer service representatives have been rude, inconsiderate, unsympathetic, robot-like, and unwilling or able to resolve my issue. As of writing this review, the problem is still ongoing. I cannot stand this company and their customer service. DO YOURSELF A HUGE FAVOR AND STAY FAAAAR AWAY FROM THIS COMPANY. The worst. Ever.
6 years ago
Deedee The Colony, TX
Ambetter is a fraud of a company. I have been trying to get an infusion for the past month and nothing can be done because:
1) the infusion centers that can administer the medication are not in network or
2) the infusion centers that are in network cannot administer the medication. I have spent countless hours on the phone with them trying to find a place that works. When I call they give me a list of infusion centers that are supposedly in network and then when I call these centers to use their facility they tell me that they are not in network. They have even given me centers that no longer exist! I am very very frustrated. I have been waiting for over 30 days now for a medication that has a rush on it all because my insurance company can not find a place for me to do my infusion. When I ask to speak to a manager they send me to the resolution center. They are insensitive beings that do NOT care about your health or wellbeing and only want your money. This isn't even about money its about finding a place to receive my medication. And because of Ambetter I am left in the wind..What to do now? I don't know
6 years ago
Matt Canton, GA
This company is an administrative nightmare. They can rarely find you in their systems and online access is very far behind piers. I got locked out of my account for some unknown reason and had to wait 24 hours to access it after customer service reset it. A month ago they canceled my policy and couldn’t even tell me why. Later I found out the exchange forced them to cancel it because I didn’t provide my ss# when I signed up. Ironically the week before I got my form 1095-a from the exchange that guess what had my ss# on it. Unfortunately, this is what happens when choices get limited because of obummercare. I guess they are used to working with people who get their insurance for free so they have very low expectations anyway. Not this guy!
6 years ago
M. Summers Blackshear, GA
They are waiting for my wife to die. They will not even approve diagnostic tests for my wife who is having heart problems. We have a great hospital 8 min away,but Ambetter does not approve. There are approved doctors in our area, but they don’t have access to the nearest approved hospital which is over an hour away. I despise this company and will launch a 100 million dollar lawsuit if my wife dies while waiting on them. Wake up America! This is Socialism! Ambetter was the only ACA company in Georgia this year. They are getting almost $1600.00 a month subsidy for us. For what? Our doctor, which is not in their network, told us that Ambetter is turning down treatments all over our area. I’m contacting my Congressman next.
6 years ago
Vicki Halfway, MO
They r a terrible company. They have denied almost every claim my doctor has sent in. I have a herniated disc and they denied the MRI. I had to go pay for it out of pocket. Then they denied when he sent in for a procedure to help me. This company does not care about their clients when you call in they don't care all they care about is getting your money doctors are even fed up with this company it is the worst company we have ever seen I know a lot of nurses they say this is the worst company they have ever had to deal with if you are smart and you want a good company you will go somewhere else everything you will regret getting insurance from this company
6 years ago
Tasha Calhoun City, MS
I have has ambetter for 3 years and it is wonderful! I have lots of doctors to choose from and they pay alot on my Bill's. I love they rewards programs as well!
6 years ago
Shannon Concordia, MO
Very poor insurance coverage. This was my only option in middle Missouri; especially for maternity coverage. 8 months after utilizing the maternity care, having the child, I'm still receiving bills/EOB's from the hospital & provider because Ambetter HAS NOT paid their portions of the bills-things that are "COVERED" in the policy. Multiple companies-hospitals, anesthesia companies, women's clinics (every company I've used during/after my pregnancy & delivery) their workers have made it known their distaste for ambetter because it's failing to hold up on their end payment and coverage wise. The healthcare workers are telling me that I need to get different coverage if I have the option. Something is not right within Ambetter. I got it through the marketplace. Never again will I use this company for anything.
6 years ago
Jeannie K Chattanooga, TN
Chattanooga, TN Joined Ambetter January 2019 from the Marketplace and I'm absolutely disgusted by this company. If I can save one person the hassle that I went though, this review will be worth it. I lost several hundred dollars, don't be like me - verify what I'm saying for yourself.
Despite what they claim and what their provider list shows, there are ZERO doctors, offices, or even hospitals that accept this insurance. The customer service rep actually verified this by personally calling each office from the list to ask if they would accept an Ambetter patient. The closest office was in Atlanta with a 3 month wait for a new patient.
The first several doctors in the list were in Minnesota. I'm in the eastern part of Tennessee.
I briefly had Ambetter for 2 months in 2016 then cancelled before we used it due to moving states. Fast forward to now and Ambetter still hasn't posted my new policy online - it will only pull up the old one. I have called and written emails but no one responded. I was told that I would have to get a new email address and make a new account to even see my current policy. They had no way to update or add my policy to my online account - I couldn't even make the payments online because they were credited to the old policy which was cancelled.
I am begging everyone to please file formal complaints with their state insurance compliance office and ACA Marketplace. Hopefully there will be another class action suit again.
6 years ago
MADINTEXAS Pflugerville, TX
Let me start by saying that when you only have a choice of 3 urologists in an area as big as Austin, TX that should tell you something. Their provider network is horrible an absolute joke, the website lacks in its ability to assist you in finding a provider and so does calling customer service!!! No one and I mean NO ONE wants to take the insurance and I have been told it is because AMBETTER takes forever to pay them or they deny claims based on random things so the docs are forced to collect from us.
I also found out that they also service MEDICAID which should make them prepared to handle the challenges of healthcare! Nope, it just makes things worse because basically, it is MEDICAID except we are paying for it!!! IT IS THE WORST INSURANCE I HAVE EVER HAD AND I AM STUCK WITH IT UNTIL NEXT YEAR!!!!! I HAVE ALREADY PAID $7900 OUT OF POCKET FOR A SURGERY THAT SHOULDN'T HAVE COST MORE THAN $4000 IT'S JUST A TRAVESTY AND I CAN'T BELIEVE IT'S ALLOWED TO OPERATE! DID WE NEED HEALTHCARE REFORM? YES, I BELIEVE SO, BUT NO ONE IS REGULATING THESE IDIOTS!!!!!!!!!!!
6 years ago
Lynette D Bratton Pearland, TX
I bought an Ambertter plan to save $100 a month on my premium. It wasn't worth it. I have been diagnosed with a Pituitary BRAIN TUMOR, which is believed to be benign. The risk of a biopsy outweighs its benefit. I have to have an annual brain MRI to ensure that the tumor has not changed or grown, which would be indicative of cancer. No insurance company has EVER denied an authorization request for a brain MRI. Ambetter DENIED my BRAIN MRI despite receiving all previous med records, MRI's, and lab results. They wanted my current complaint illness (duh....a brain tumor). I was forced to pay over a $1,100 out of pocket.
6 years ago
David Plummer
Because of the obvious collusion in the health insurance industry, Ambetter from HealthNet was the only Health Exchange insurance provider in Maricopa County, Arizona for 2018. This company isn't worth ink it takes to print their name. With completely incompetent customer service, completely incompetent IT services, completely incompetent billing processes, completely incompetent claims processing, the only thing they have going for them is that ACA didn't have a 100% PUBLIC OPTION! If I could arrange it, I would drive this company into insolvency and force their liquidation and put all their executives in jail. I have been forced to file multiple complaints to regulators in the states of Washington and Arizona and the Federal Government in Washington, DC. They have repeatedly blocked me from accessing my account information. With 2018, they have come up with a "new" website that has again blocked me from accessing my account. Attempting to call them was fruitless and also indicated that this problem was probably widespread because I was on hold for 30 minutes before finally giving up with their call center. So I called their corporate office at 314-725-4477 to escalate the issue to their executive offices. Given the pattern and history with this company, I would encourage EVERYONE to skip calling the call centers and start calling the executive office. Further, if so inclined, skip calling altogether and just start submitting every complaint, no matter how big or small, to your state's Insurance Commission and Attorney General. Make this company answer for their incompetency to government lawyers.
As of December 2018, I have 4 outstanding claims that have all been denied repeatedly with a false basis for denial. The PCP that they paid in several claims in the middle of year, remains unpaid for claims in the early and late parts of the year. It appears that being in-network is associated with some random number generator as there is no consistent response from this fraudulent company. Claims being denied 5 and even 7 times is not a failure of the provider but a failure of the insurance company. CONSUMER WARNING: Retain Ambetter at your own risk!
6 years ago
Amy S Glenwood, AR
The absolute worst company. I never received anything from them. No policy info, insurance cards, etc. When the Aflac agent signed me up, they told me I should receive something in the mail from the marketplace showing I had insurance coverage. After 3 months of checking they kept telling me they couldn’t find me in the system, yet somehow I was getting a bill for coverage by Ambetter. I couldn’t get any info ever so I didn’t know if this was a scam or what. Now I just had my taxes done and I’m being penalized for $1259 for over credit paid by the insurance?!! Insurance that I never benefited from or even knew I had. BIGGEST SCAM EVER
6 years ago
Valentin Port Saint Lucie, FL
Ambetter is politician connected organized criminals. The company must be investigated. They take money but refuse to provide any adequate services or any at all. I was a member of this shameful operation. I've tried to set up an appointment for medical check up, first of all they state that i can choose....I did but end up with them again....they offer to choose from their own network of doctors that should be allowed to take care of rats and pigs (pigs are too much for their brains). I've tried to set up an appointment, well good luck, minimum three month and after great pressure 6 weeks minimum, they've set up their system this way. I got an appointment.....it was MUCH worse then back in Soviet Union, MUCH, MUCH worse. I was met by an assistant / student.....after few minutes i new it was something that i will not stand, horrible,....doctor showed up....with her hands in her pockets, arrogant look and questions that were addressed to a ....... sitting in a room somewhere.... i knew i had to RUN for my safety from these type of "doctors"....I literally told them: "I'm out" i do not need anything and ran away. American health care is taken over by organized criminals and supported by corrupt politicians both Dems and Reps. Ambetter must be investigated by Finnish or Dutch but not by their own American criminals. I'm SHOCKED. This is very light comments i have.
6 years ago
Trish Greathouse Kansas City, MO
I choose Ambetter because it their plan stated it covered Humalog before I chose them. I elected them on 12/15/2018, for coverage starting on 1/1/2019. As of 1/3/2019 they don't cover humalog at all. How can they lie and get away with it. I ordered a replacement pump and supplies, starting with their DME partner Edge Park on 1/10/2019, it took until 1/14/2019 to get Edge Park to take my order, when they had received everything they needed from Medtronic on 1/9/2019. They like to give you the run around, then it took them from 1/14 to 1/23 to actually submit the documents for approval. They were asked on the 18th to make it urgent as supplies were running out. On the 24th Ambetter doesn't even show it being received. Ambetter is the one who chose Edge Park, Ambetter should do something to be sure that patients do not run out of supplies during their long drawn out process. I tried to lodge a complaint on the 18th against Edge Park with Ambetter I was disconnected and they took my number to call back incase of loss of call, I have yet to receive a call back. So I called on 1/24 to see if my complaint was lodged and they can't tell. This company wants their premiums on time, yet they cannot provide any type of timely service themselves. Oh and since it takes two weeks for them to process paperwork for approval denial, how am I supposed to pay out of pocket for a month supply of medical equipement and their premium I am not made of money.
6 years ago
IndyMom Indianapolis, IN
Ambetter is the worst health insurance company I have ever encountered. We had coverage with them for 2018. High deductibles, high premiums, high co-payments, and it almost never covered our medications! Now, fast forward to 2019, I terminated our policy the day before our new coverage with another company started (December 31st). Ambetter was taken off our healthcare marketplace account completely, yet Ambetter claims our policy is still active for 2019 and is still sending us monthly premium bills. I called the Healthcare Marketplace to get this taken care of, and they said there is no record of a 2019 policy with Ambetter. The marketplace is sending over information to Ambetter stating we are not enrolled for 2019 and to cancel whatever policy they think we have with them, so now we are waiting to see what happens next. Thank goodness for the helpful Customer Service with the Healthcare Marketplace. Ambetter is the worst health insurance with the worst customer service I have ever encountered. I will never recommend them to anyone and I am so glad to get rid of them for 2019.
6 years ago
Carrie L Matthews Decatur, GA
Thank you for being there Ambetter for us during my husband battles of cancer medical was never a problem.All medical,hospital,meds,chemo treatments. Thank you
6 years ago
Brenda Schaumburg, IL
BEWARE ... On my annual physical, I got hit with a co-pay, then my mammogram bills were refused. After Ambetter rejected the site billing, the site re-billed and sent an appeal letter, which was also rejected. Then the radiologist bill was rejected since "there was no site bill". I received an Ambetter EOB for the site bill, which shows the name of an Ambetter recommended site, but they still claim there is no site bill. I have contested, appealed, etc. for over 12 months, the bill is still not paid! Annual physicals and mammograms were supposed to be paid in full, but this has been a disaster.
For $945/mo. for one person, with $5,250 deductible, this is what you get from them!
STAY AWAY FROM AMBETTER!!!
6 years ago
Jessica Damstra Cumming, GA
Worst insurance ever!!!!!! After canceling they still charged me, said they would send a refund check that still hasn't come. Called to check on it, spent 45 min and got hung up on! They say it has to be refunded the same way it was paid, which was through my checking account. The first time I called to ask for a refund I was told they could not add funds to my account and they would have to mail me a check. The rewards Visa card is a joke, they say you can use it at Walmart but it doesn't go through, and they cant tell me why it doesn't work. They kept saying its because I'm no longer a member, but I received an email saying you can still use your rewards card 90 days after canceling your coverage. And as far as"coverage" goes, it's useless if no one takes the insurance!!
6 years ago
Kay Anderson LaFayette, GA
Was told by Ambetter Dr. Wayne R in Trion was in our network. Made the appointment after driving 20 minutes and when my husband and I show up, we were told Ambetter had Dr. R's address wrong. Therefore, they could not get paid until Ambetter corrected. The doctors office had called already and gave Ambetter the correct information; however, Ambetter had not made corrections. We left after making the appointment in December for our January appointment, so we could get med refills. We planned ahead, but it didn't pay off. Thank you Ambetter. You receive $1500 per month and we get nothing in return really. No doctor I've ever seen is in our network....not one! We are from a very small town and now have to travel far just to see a doctor. So miss Alliant!
6 years ago
Katie Mesa, AZ
Trying for 3 weeks to get a pre-authorization for a biologic medication that I have been on for 4 years and for 2019 they told my doctor I don't need a pre-auth; however, I know I do, as it is an expensive medication that is done by infusion. I called Ambetter myself and have been given four different answers! I have two weeks until I must get my medication and they are either totally inept or totally trying to pull a fast one (as in, telling me I don't need a PA, I get the infusion and then they tell me they won't pay it because I didn't get the PA). My next step is to file a formal complaint with the AZ Dept of Insurance, as I cannot deal with this runaround and my doctor's office has spent over 10 hours on this!
6 years ago
Peter Ko Peachtree City, GA
A very bad company, trick their customers with their reward program. I spent half hour in front of the computer to finish a health survey for $50 debit card reward. They sent me the card because I earned it by spending my time and effort to put in my health data. However, when I did not enroll with their plan in 2019, just a few weeks ago. They suspended my debit card, claiming it is their policy. How could they take away something you earned? This is a total greed for such large company. It is ashamed for company with such deceitful practice to their customers. I wish government can take some action and punish their bad business policy.
Everyone be aware and used up your reward debit card immediately. They deserve no star but I cannot move to next page without picking a star.
6 years ago
Laura Wellsville, OH
Our family recently picked up this insurance through open enrollment. I wish I hadn't. We pay nearly 400 a month and have to drive 4 towns away (passing a non covered hospital on the way) for hospital care in the network. To get to a dermatologist, I have to drive over an hour away to towns I've never heard of. As for a PCP, they aren't far away but they are only affiliated with the hospitals that are not on the providers list. What's the sense? One or the other won't be covered either way and that's after the 6000 dollar deductible. I don't know what to do. I been crying all year with this possibility of breast cancer coming back.
6 years ago
Casey Raleigh, NC
If I could give a zero I would. My daughter has had a heart condition since I was 24 weeks pregnant. She requires medicine and visits to a pediatric cardiologist monthly. When her cardiologist said they would not be accepting BCBS anymore they recommended Ambetter to us. To our surprise when we went to ask for her medication that she needs to LIVE be covered they told us that they would not cover it until we met our $6000 deductible and even then they may not cover her cardiology appointments. What?!?!?!? How is that ok?!!! I am filing a lawsuit. They should not be allowed to offer coverage when they literally cover NOTHING! You pay totally out of pocket until your deductible is met. And I mean YOU PAY FOR EVERY SINGLE DOCTOR VISIT. There is a special place in hell for the people behind this scam.
6 years ago
Dacia Kirkland, WA
Zero stars for this fradulant company. I purchased a plan from them that would cost me $140 a month for my premium, they changed the rate to $318 a month and said I pay the updated rate or I lose my insurance. I explained it is fraud to add to the cost of my plan. I signed up for the specific plan based on the monthly premium, that is where I signed the T's and dotted the I's. I will not pay more then the $140. Lucilky the health exchange is resubmitting my paperwork to them, if ambetter does not abide by our agreement then I can get new insurance through a special Enrollment period. I will never choose Ambetter again. Horrible company with customer service worse than any company I have ever felt with.
6 years ago
Erik D. Hamilton Lynnwood, WA
This company is absolutely a trash. I called both the WAHealthPlanFinder and Ambetter to cancel my policy on last October. Today, they just sent me a bill saying they just renew my policy for the 2019. Because I forgot to turn off the auto-payment, they just come and take my hard-earning money. I don't even give a hint that I need their health insurance. After looking at the reviews, I find hundreds of people have the same situation as me. I really cannot trust to give their my bank account as well as personal information for them right now. I will call them back tomorrow to ask for the refund as well as delete any tie I have with them as soon as possible.
Now I understand when people say I should read the bad review first before I buy something for me and for my family.
6 years ago
Stephanie Jacksonville, FL
They never update their website. If you think that your doctor takes ambetter just based on the website think again. You need to call you physician because ambetter will never take that physician down and they trick you into thinking you’ll be covered. I went to a certain place for an eye exam but before we started they asked for my insurance and I gave them my ambetter card. The looked at me and said we do not take that. I showed them the website and they asked to call ambetter to see what was going on. Turns out they don’t have a contract with this eye place. SO WHY IS IT ON THEIR WEBSITE!!!! Luckily the people I speak with are nice but they can’t help you. It’s like ambetter knows not give there employees to much abilities on their webpage because then those people could actually help.
6 years ago
Max Lohr Dallas, TX
I have used Ambetter by Superior before and it is cheapish and stingy when the doctor asks for anything special, but generally it is OK once 'proof' has been given that XYZ is needed.
However, the place is run by malicious idiots who use helpess telephone minions to make false apologies about even the worst and most harmful malfeasance.
In 2017, they double charged me for January 2018, and it took 2 months to get that straight. I let it go. It was a small amount.
This time, they have surpassed themselves in malfeasance, tinpot-baron-robbery, and chicanerous corruption.
Today December 17, 2018, Ambetter fraudeulently debited my family bank account for over $860 in advance for the January 2019 payment. This is fraud because the correct and contracted-by-the-US-government amount for the first month was less than $50. They have stolen the $860 only 8 days before Christmas. The funds were not all going to be spent on the Holidays, but some of them were, and they are now gone.
Their telephone minion and his flightless bird of a higher-up just hold out their hands (figuratively) and say they can do nothing about it for some unspecified time of 5 to 10 days, which, based on past experience, likely will be at least as long as 10 business days.
That's funny, as in a devilish joke. Their computer snatched the bucks out of my account in a blink of an eye, and so surely it could replace them as promptly. But no, that would require personal attention and the intervention of important decision-making and responsible persons inside Ambetter. I suppose Ambetter's MOUTH works when it's time to consume funds, but Ambetter's OTHER END does not, due to corporate constipation. Like a rodent, Ambetter is also unable to regurgitate that which it should not have eaten!
The minion also told me what happened -which he should not have.. There were two figures for the monthly cost that showed up in their broken-yet-again computer system, one correct, and one incorrect at 71 times the rate, and instead of them investigating that obviously confusing situation, some other minion simply decided with no further checking, to have the computer simply withdraw the insane 71x amount. He said that this is a growing trend, this sort of "error". So they know about it!
My family's custom regarding holiday and celebrations expense is that we do not to use credit cards for them. We put aside $ and use a budget, and we really do have very fine celebrations to which we all look forward. No debt.
So you can see where this is going. Ambetter is "the grinch who stole Christmas", and indeed, most of January! However, we will not be put out of good cheer this Season, because we know what the Season is for. It's little comfor that Ambetter will be getting a switch and lump of coal and a whipping from Krampus.
I had to call the bank and report this fraud. The bank has temporarily replaced the funds, so at least our plans won't be disrupted for now. All of the emergency worry placed upon us by Ambetter is not appropriate.
6 years ago
Linda D Cantrall, IL
Ambetter is a huge headache when trying to help a parent to at the very least enroll. Ambetter sent an invoice that was not received due to being out of state and mail was not collected properly. Ok...our fault. Then sent another invoice that included the first invoice and a new total that included a price difference for a new health bracket that he qualified for. Ok... no problem. The invoice was mailed with a ck to cover the total right away. A couple weeks later a letter is received stating that the application for the ins. was not processed due to the lack of payment of the first invoice. Umm...the first invoice was paid with the revised invoice. A week later another letter comes stating that the coverage that was applied for is not longer available, so if you don't contact us then we will just enroll you automatically into something of their picking that will actually be better for him. Okay no problem.
2 days later a ck and a letter stating that the actual ck that was received was an over payment of the invoice and because you didn't pay that first invoice that was not received, you get no insurance and have to start all over again!
I spent several calls and hours on the phone between Ambetter and Marketplace in reference to just getting him enrolled and why the ck was sent back and denied all together. One pointing the finger at the other and it's beyond words that I can actually post on here. So if you are helping a parent or trying to get this insurance yourself look elsewhere or if you have to go with them keep a close eye on them and write down everything you can about your call if you have to talk to them. Oh and for those trying to help out a parent or member, they say you have 24 hours of authorization from the member. Nope. You have until 10pm central time that day. As for question #4 below, It shouldn't matter if you are a paying customer or not.
6 years ago
Mitch Federal Way, WA
Every interaction with Ambetter has been a nightmare. You have to contact customer support anytime you need to do anything online because their website is so bad. It seems that anything that might cost them money is burrowed deep into the darkest corners of their site where you would never find it without guidance. In addition, customer service does not respond in a timely manner and is never very helpful. Right from the start I knew they were shady when I signed up for one price and SURPRISE, next month my bill is 20% higher! Not to mention the health providers covered are poverty status. This company preys on people that don't really have any other options. That way they can charge whatever and treat you like garbage. DO NOT USE AMBETTER!
6 years ago
