Ambetter
4.9
Overall Score
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Alex Chicago, IL
Awful, this is embarrassing. The first five PCP options listed in my zip code are from a health center that moved TWO YEARS ago. When I called to get assistance from a representative, she was looking at the same screen that I was and offered no help what-so-ever, other than blindly selecting names from the list, which I am going to need to call myself in order to verify that they still exist. She asked no questions about my preference or about my healthcare needs nor did she offer any useful information on the PCP's themselves. The whole thing is a sham and this company deserves to go out of business.
6 years ago
Rebecca Watkinsville, GA
Like so many others, if I could give zero stars or even a negative star, I would do. Ambetter is a horrible company. My children, due to divorce, have to receive their insurance through the Marketplace and Ambetter was the only choice I had when choosing a plan. Since January, I have attempted online and through telephone calls to assign a PCP to my children. In November, 2017, when I had to sign up for insurance, the pediatrician they had been seeing was listed as a provider. Through February, she was listed. Today, however, when I went on line to pay (the only part of Ambetter's website that consistently works), I discovered that my youngest had been assigned to a doctor whose main office is almost two hours away (I live in Athens, Georgia and the office is in Austell, Georgia). The doctor does, however, also work at the local health department. When I go to the website of the health department, it clearly states that it's mission is to serve children living in poverty--that is is for the uninsured and the underinsured. Am I to understand that I am paying over $231 a month for my youngest child to be assigned a doctor that he can actually go to FOR FREE? Is Ambetter, by assigning him to this doctor, admitting that is is a subpar insurance company? It would actually be comical except that if my children become ill, we are in serious trouble. If an insurance company can't handle easy tasks like letting members choose their own PCPs, I fear to think what will happen if we actually ever need any type of medical care.
6 years ago
Kyle O'Malley Tempe, AZ
If I could give AmBetter negative stars I would... What a terrible decision I made signing up for health insurance through them. I also partly blame the sales consultant who sold me on the this insurance. I have an infection/abscess that is imperative that I get it worked on immediately. Even though my deductible is an astronomical ($7500) and they won't actually be paying for anything, they have to authorize the surgery and have made me cancel the surgery I was supposed to get today and wait for them to authorize it which may never happen. Also, during this whole process I had to middle man everything between them and my Dr's office. Being put on hold for hours at a time. I'm really confused as to how that's my job... I thought that's what I paid this company $350/month for. On top of it all finding a Dr who takes this insurance was almost impossible and from the looks of it seems like I was extremely lucky I actually did. What ever you do STAY AWAY FROM AMBETTER.. I will be looking into legal action against the company for forcing me to postpone this urgent surgery.
(by the way I am a very active and healthy 28 year old male who never has health issues. This is the first time I have had to see a specialist/needed surgery and have been paying my premium for over 15 months)
6 years ago
Ben Auxier Chicago, IL
I wish I could rate this 0 stars.
This company is literally useless.
I am kicking myself for not looking into customer reviews while choosing a plan. All the details in the marketplace looked great. Reasonable, affordable, nice coverage.
It's only now, as I attempt to make my first in-network appointment, that I realize this network is basically non-existent.
Don't let their website fool you. They have this great, handy page where you can look up lists of "in-network" physicians. There is a 90% chance the person listed doesn't accept Ambetter at all. Maybe never did. It's just a straight up lie.
Run. Run away as fast as you can.
6 years ago
Susan Bohannon Martin, GA
I do not have Ambetter insurance. In fact, I have no insurance at all. I was looking at my options, and from everything I've read, it sounds like everyone should run as fast as they can in the opposite direction from this insurance company. Never before have I ever seen any company with nothing but negative reviews. I never did see a positive review. Isn't there an agency with the government who oversees this sort of thing? If so, then they all need to be fired for not doing their job.
I feel bad for everyone who bought insurance with this company. It is a shame and a disgrace that you now find yourselves at war with them - just to provide the service that you paid for and expected in the first place.
Please remember that YOU paid them for a service, which technically means that they work for YOU - not the other way around.
Stand your ground, and never give up. You hired them, and you can fire them. Ambetter is by no means the only insurance company in existence. Sometimes companies have to be reminded of this fact.
I am really sorry that you are having to go through this nonsense. I wish you all the best. ?
6 years ago
kathy moran Smyrna, GA
Terrible! Excessively expensive. Most doctors do not accept this insurance. I had to obtain all new doctors except my primary care who got added to their program.
They DENY everything! The refuse the information provided on the pre-authorization.
It's a scam. They require you to "try 3 other medications", even though you have provided proof from your previous doctors (not in the AmBetter network). This is so they can charge you MORE . You have to pay for those medications, that don't work and could potentially cause you harm because they do not work. Their customer service SOP is to repeat their mantra. Please explain what I am paying for? I cant go to my doctors, the cost is outrageous and they deny medication so that you get sick and they can charge you for unnecessary medications. My doctors HATE this insurance. Unfortunately, there is no choice in this state due to our republican led congress, senate and so called president.
6 years ago
Paula Mock Conroe, TX
I had to give it one star only because there is not a negative selection. I chose this insurance through the healthcare marketplace because it seemed to have a lot of providers. I have contacted over 25 of the physicians on the list, only to find they do not accept this insurance. In my opinion this is fraud, since they misrepresented information. I am 49, have had a heart attack, am diabetic, and have other issues. I am simply trying to find a primary doctor for a simple checkup and refill basic prescriptions. I contacted a nurse from this group and was basically told that to get my blood pressure medication I should check into a hospital and complain of chest pains. I would highly recommend that everyone avoid this healthcare provider at all costs. The customer service reps are courteous but they are limited on their assistance.
6 years ago
C Nordy Greenwood, MO
If I could give 0 stars, I would. Ambetter is THE WORST health insurance I’ve ever experienced! I’ve been on the same medication for years and suddenly when I have to switch my health insurance, now they won’t cover my medicine. Instead they want me to try the cheapest option out there that has already caused me severe gastrointestinal problems to probe that a higher dose of that won’t work before they’ll let me use my standard medicine.
Meanwhile my blood sugar is now out of control because I can’t get the meds I need. So I’m essentially paying hundreds of dollars a month to a company to feel like I’m in a 3rd world country:
6 years ago
Bernie Johnson Spring Branch, TX
This is by far the worst insurance company I have ever done business with. From not covering knee injections (that were never a problem with my previous insurer) to basically denying virtually every claim you make and forcing your Doctor to jump through hoops to get coverage - they are the worst. I think they have a standard business practice of denying claims. Now...they apparently have a new plan to screw consumers regarding specialty drugs that have loyalty programs to help cover your deductible. According to my specialty pharmacy...Ambetter is fighting allowing the loyalty cards as covering your deductible. They are a horrible company.
6 years ago
Joy Roach
Horrible insurance. My husband has narrowing of the aortic heart valve. He is supposed to have a yearly echocardiogram but Ambetter refuses to cover it. Ambetter is the only health insurance we can afford, so my husband hasn’t had an echo or seen a cardiologist in years.
His primary doctor said he needs to be on a specific heart medication but Ambetter refuses to cover it. The doctors office called Ambetter and explained the situation and told them that it’s legit, he really does need it. But Ambetter refused. He never got the med. I hate this company but it’s the only one on the ACA exchange in my area in Georgia. I have no choice.
6 years ago Edited September 14, 2021
Joel Mitchell Boonville, IN
Good luck getting medication if you happen to be allergic to the "standard" treatment. For six days customer service repeatedly lied to me (and the pharmacy) about never having received prior authorization from the doctor for my prescription. The customer service representatives' job was clearly to make me shut up and go away without doing anything to resolve the issue.
When the doctor called to find out why they had not acted on her prior authorization they finally admitted to having received it but denied the claim anyway (with different people citing different, contradictory reasons for doing so). If you can afford any other health insurance go with that rather than Ambetter!
6 years ago
Jay Fort Myers, FL
Please note everyone who has written a review here. Klafter Olsen & Lesser has a class action suit against Ambetter's parent company covering all the complaints we have all experienced. Please call and inquire about signing on to the suit. Ambetter customer service does not exist. They channel you through multiple depts where no one has the authority or the desire to help you with your issues. They lie about timelines when prior authorizations were submitted and deny claims for no logical reason. They do not have adequate providers for skilled nursing, It has been 45 days since they received my Rx for my infusion and I still do not have nursing to administer the drug. I have spent over 30 hours with Ambetter and their two specialty pharmacies with no resolution. The company is not trustworthy and customer service is not qualified to handle any logistical problems.
6 years ago
Rhonda Athens, GA
If I could have given Ambetter zero stars I would have! I was forced into using this company because it was the only option I had for insurance on the open market in Georgia. My first experience was needing an Gynecologist so I went on their web site and it listed 9 in and around the area I live. I called everyone of the ones listed and NONE of them accepted Ambetter!!! Some even wondered why they were on the list, as they had never agreed to accept Ambetter Insurance. So basically this company lies and is deceitful. Shame on you!!!! They charge basically the same thing I was paying last year to BC/BS but their services and provider options are way below par. I'm so angry and frustrated. If you can avoid using this company do so....find something else if at all possible.
6 years ago
Ale Marietta, GA
"POS", and that doesn't mean point of sale either. I will let you figure that out. Worst company I've ever dealt with. I was automatically signed up in December of 2017 for the 2018 calendar year (previously was covered by Blue Cross Blue Shield). Also received a notice from Am better stating I was covered as of January 1st 2018. Went to the ER and personal physician and gave them my insurance information. All was good until my doctor's office called and said the insurance company denied my claims. I called Ambetter and was told they hadn't received a payment from me. I immediately told them I hadn't received an invoice or payment request and agreed to pay immediately for January and February 2018. They accepted my payment and told me I was still covered from January 1st 2018. I specifically asked if my policy would cover my doctor and ER visits from January and February and was informed by an Am Better Rep I was covered and to ask the Hospital and Doctor's office to refile the claim. THE CLAIMS WERE DENIED AGAIN. I called Ambetter, just to find out they cancelled my policy and transferred me to The Market Place so I could resolve this matter which was Ambetter's responsibility. Have now called several time and Ambetter keeps claiming policy is cancelled, however was initially told payments were made and I was also covered from January 1st, 2018. Made payments, haven't received any information other than it's being revised via The Market Place. Sounds like a used car dealer that takes your money and screws you by giving you a piece of crap. Wow, Ambetter the used insurance dealer!!!! P.S Have almost $13k or more in healthcare bills that have to be paid. My luck never have to go to the doctor but when I do my insurance wouldn't cover me. In the Market Place's defense, they are working to try and make Ambetter pay. Hoping it works.
6 years ago
Dafni Lustig Orlando, FL
IT IS TRULY BEYOND BELIEF HOW BAD THIS HEALTH INSURANCE IS.
First off, they do not update their provider directory on their website (which they're so proud of!), and as a result, I spend at least half an hour whenever I call a doctor to make an appointment, just to be told that they are not working with this insurance any longer! This has happened to me 3 times.
Last time I called a phone number that the lady at the member services gave me for an ear doctor, only to hear on the other line:'Sorry, it is a facility with eye doctors here.' Great!
And since I have chosen my PCP over the phone with them, they have failed 4 times so far to put the specific doctor on their system (instead they have a name of a doctor I never chose!), so now that I have an appointment with my PCP tomorrow, I will not be able to see her, because they have put the wrong name of a doctor on their system!
STAY AWAY FROM THIS HEALTH INSURANCE IF YOU CAN!
6 years ago
Natalie San Antonio, TX
When I first got Ambetter, it seemed alright. I got my pair of glasses through Ambetter, and went to the clinic once with no hassle.
Suddenly, Ambetter is no longer used at the same places I went for my glassess. I asked around, and basically nobody uses it! So, I cancelled my insurance since it's useless...but the cancelling part is why I am giving Ambetter a one star review. I called to cancel my insurance numerous times, yet I am still getting letters and emails about making payments. Not to mention, the newer premiums are ridiculous.
I'm not paying for insurance that is useless and way too expensive.
6 years ago
James Hall Phoenix, AZ
I don't know where to begin and I'm not going to spend more time here other than to list mwhat I've learned from 3 years with this "health plan" and too many hours ospeaking with "customer support:
(1) they are trying to rebuild their computer system and it's a mess. They have 3 different member IDs as they migrate to the new system yet the system does not always "know" about the legacy IDs -- worse yet, some cust support people are unaware. The result is you will often have no way to actualy discuss your account with them.
(2) Their online website is a total mess. Links are broken, data is incorrect, provider listings are out of date. They even changed their domain without telling members - or even providing a forwarding link. omfg.
(3) The billing system is FUBAR. I received a bill for hundreds of thousands of dollars (montly premium!) and -- they will have difficulty just figuring you latest balance. They've actually sent me cancellation notices due to the fact that theyir system simply has no idea what your balance is -- or: has it mixed up with previos policies that you may have had with them.
(4) the "provider directory" is insanely out of date. They claim it's updated but I've called so many of these doctors only to be told that they've left the plan months ago. When this is pointed out they will blame the doctos for not updating their own profiles in the sysrem. It's a joke.
6 years ago
Shari Glendale, AZ
This company is the worst!!!! They keep sending me the wrong ID cards and every time I call they say the new card is "in the mail". Every card I've received in the mail has the old information from last year. In addition, the cards I've received only has my son listed and not me (I am the primary policy holder, he's only 4 years old). I have also had to call about questions I had regarding my schedule of benefits. Everyone I speak with gives a different answer. Some tell me I need a referral to see a specialist, others say I don't need a referral as long as the doctor is in network. Which one is it??? I also find it incredibly irritating that there are only two Pediatrician's on my plan and neither is close to where I live. WTF? I do not at all feel confident about this insurance plan and strongly dissuade others from signing up with this horrid company.
6 years ago
jessica Bentonville, AR
I am trying to figure out how to file a grievance and complaint. I have had Ambetter for 3 years and have never had a problem until now. I was told a couple weeks ago that I would need to make a payment of $91 to get my insurance renewed for January 2018. I did not have the money but I went ahead and over drafted my account so that I could get my insurance back. Come to find out, the agent did not realize that I am with Ambetter through my state and that I did not need to make that payment to get my insurance reinstated. The state of Arkansas would do that. I was upset and sent an email in. I received an email back from them on 1/16 that they requested a refund for my account and I would get that money back since it was their error. Well, I called to check on it that day because I was worried they wouldn't do it and come to find out, they had not. That agent said she would put the request in right away and it would take 2-4 business days to have it credited back to my account. She said it will be there by Friday. So Friday rolls around and it is not in my account. So again I call back and this agent tells me the request is open and they are working on it so it should be available in my account next day. Saturday rolls around and it is not in my account, I cannot call because they are closed on the weekend. I called this morning, and the agent says "Sorry I see a note in here that you are not going to get a refund" I said I need to talk to a supervisor because that is not what I have been told. I am on hold for thirty minutes, I never got to talk to a supervisor and the agent came back and said the original request for my refund was not done correctly and that is why it never happened. She said she would request it today and it would take 7-10 business days!!!! I said you need to talk to whoever you need to talk and request that this gets expedited because this was Ambetters mistake and they need to make it right. She placed me on hold for another 10 minutes to tell me "sorry but they said it takes 7-10 business days and there is nothing they can do" I asked her for a number to file a complaint and she gave me the 1877-617-0390 number to call (this was the number I was on the phone with!!) Someone needs to look into my account and make this right and get this expedited immediately. My state lets me pick which health plan I wanted for 2018 and I picked Ambetter again. I am trying to figure out how to cancel this request and choose another plan.I would rather pay more to get treated fairly! It is never OK to do people this way. You were quick to take my money but you sure as heck will not give it back!!!!! I have worked in customer service for 10 years and there is ALWAYS a way to put issues at the top of the "Que" especially since it is your companies fault.
6 years ago
Jay Carmel, IN
They suck. Some doctors they list as being in-network are not really in-network. Be careful.
Around the middle of this month, I got insurance through my job and I then canceled my Ambetter insurance (hooray!). For the past week, my wife and I have been trying to get a refund for the 2 weeks this month that we won't be using their insurance. We've made at least 10 phone calls, and only 2 of them ended up getting through to a human. One day, the phone system at Ambetter was down. One day, I got stuck in a loop (I pressed 7 for 'other issues', and then they repeated back the menu I had just heard). Another day, I just didn't have enough time to go through the menus and wait for a human.
6 years ago
Brianne Royse City, TX
Ambetter worked well for me when it came to treating my depression. I paid $1 per visit, my prescription was cheap.
Move forward two months and I discovered I was pregnant. Here's where it got extremely messy. I was unable to see a doctor until I was 20 weeks along in my pregnancy. My child has hydronephrosis band cerebral spinal fluid on the brain, something that would have been noticed if AmBetter had been capable of helping me locate an OBGYN. the list of doctors in my area (Dallas, tx) was full of wrong information, wrong numbers, they didn't accept AmBetter, weren't taking new patients or they were "high-risk" doctors only. I called AmBetter numerous times to get help locating a doctor, and they found one... Two hours away. I live in a large metroplex, how do you NOT have doctors!? I couldn't afford the four hours of driving it would take, especially if there was an emergency.
For weeks they tried to find me one, and they did. I went to my first appointment to be informed it would be my last, they were no longer accepting AmBetter insurance. More embarrassing, the physician told me that many women were in my position because AmBetter was not ran properly so many OBGYNs would no longer be accepting it.
So the struggle began again to find another physician, at about 20 weeks they found me another one, this physician wanted my deductible upfront immediately and wanted to charge me fees for my appointments and ultrasounds as well as my deductible, because he doesn't report the v deductible as paid until after the delivery.
What was the purpose of this insurance? A monthly fee of $160.00, a high deductible, no doctors, paying full price for procedures after meeting the deductible... It was ridiculous.
6 years ago
Terri Las Vegas, NV
Is this company a scam??? I paid premiums for my whole family and still have not received cards. However I did receive bills from them for the second month of premiums. I cannot log into my account online because when I click on "log in now" a "Not Found" page comes up. When I call, I either get a busy signal, or go through the waiting process only to be hung up on. I have never been able to reach anyone on the phone. I can't find any doctors in Las Vegas that accepts this insurance and I can't log into the website to find providers that I can go to. Again, nothing can be resolved because I can't get in touch with anyone. I initially signed up with automatic payments and since I can't log into my account or get in touch with anyone I am unable cancel this bogus coverage. I seriously think they created this company to scam everyone out of money.
6 years ago
William Hale Atlanta, GA
Ambetter is one on the worst companies in existence. They say they want to help you yet instead the employees and supervisors argue with you about everything., They blame the marketplace on everything but the marketplace tells a different tale about what occurred.
They are useless. They never back down only argue with you. Customer service is a misnomer with these folks.
Stay clear they o them they are re not your friend. They refuse to listen to your concerns and denigrate you on the phone.
They argued that i owed them a monthly y premium of about $82.00 from April 2017 although they never sent me an invoice telling me that. I asked to make payments and they refused. They are ridiculous - $82.00 ? for a national insurance company? Really? Wow the marketplace told me Ambetter cancelled the policy and told me to call them back. I did. They argued with me that the marketplace cancelled the plan not them.. They accepted no responsibility. for the policy being cancelled.I had to go to Kaiser to get a better insurance company and I did thank God.
t
Do not enroll with Ambetter they are sharks and not in your best interest by far.
William Hale
6 years ago
Alan Palider Chesterton, IN
The worst health insurer ever. This POS was borne out of the disaster known as obamacare. Very few doctors and hospitals take this insurance (and for a good reason). They do not review and discount; so, since everyone has an extremely high deductible, you get stuck paying the bloated insurance price on your own. The reps are extremely inarticulate (my guess is they might have a second grade education at best). The reps are also extremely rude. I usually have to call a minimum of six times before my request is met. The latest is my insurance cards. I just got off of the phone with a moron for this same purpose (this is, so far, my third request). I hate, hate, hate, hate this company. But thanks to obama all of the other (decent) programs are so expensive I can't afford it. Many of us are stuck with this garbage. Hopefully, things will get better. I'd love to see this company go belly up.
6 years ago
Alicia gironda Valrico, FL
Scammers! They took $351.36 out of my bank account just a week before Christmas! I filed for a refund, was told 3-5 business days, then told 14 business days.. Just called after the 15th business day and the refund was never even issued! I've been hung up on multiple times by customer service reps because they didn't know what to do to help. I've remained as calm as possible with them, knowing it's not directly their fault.. I've gone above them and spoken with supervisors and management and have not been told anything in regards to whether or not my refund has even been approved or not. $350!! All because i had auto bill pay set up to take $12.95 every month for my insurance.. They automatically re-enrolled me and took the money without my authorization! Calling the insurance commissioners office today! DO NOT INSURE YOURSELF THROUGH THIS COMPANY. customer service is a joke!
6 years ago
Sandra Virginia Beach, VA
Ambetter, please check and update the doctor's phone numbers on your website. I keep getting calls for a doctor in FL where the area code is wrongly listed as 757. This wastes so much time for clients and for me. Thank you.
6 years ago
Rachel Dowda Lake Worth, FL
This is the ABSOLUTE worst insurance I've ever had.
They were impossible to reach...I always was on hold for 30min or longer.
I had to get treatment for a serious medical condition, and they wouldn't work out a single case agreement, even though what I needed wasn't covered in network. They finally agreed after I waited two months finally getting an attorney involved. Meanwhile my condition just kept getting worse.
While I was trying to get coverage during that time, they would agree to a place, and then a few days later call and change their mind. My case worker kept saying she was new to my case and thats why she didn't know what was going on, but in reality she was my case worker from the beginning. This company was very deceptive and difficult to work with. I would NEVER choose them again, and I'm encouraging all my loved ones to stay clear of it also.
6 years ago
Patrick Daly Shawnee, KS
If I could choose less than 1 star, I would. This company has been incredibly unprofessional in the time that I have had them as the provider for my daughter. First of all, their website doesn't even allow me to create an online account because my daughter is less than 12 (she is 2 years old). Why would anyone assume that someone less than 12 would be the one creating the online account to pay the bills? Second of all, they dropped a bunch of providers/hospitals last second before 2018. And finally, when I tried to call in to make a payment (because I am unable to make an online account to do so), I talk to someone who I can barely understand because their grammar is so bad. This someone says, "call back in an hour and talk to someone else about making a payment". This company is incredibly unprofessional and should not be allowed to operate in this fashion.
6 years ago
Arthur wanatowicz Muncie, IN
I received a letter notifying me that I was canceled on nov 1, 2017. That was what I wanted and I went to the healthcare website and removed my name by going into the my account. They sent me a letter stating I lost my chance to sign up because the healthcare window closed. Then three days later I received a congratulation letter that I was enrolled for 2018 and a bill for $1800.00. I called ambetter and the lady said I wasn’t In the system and transferred me to a rep from the gov website. She told me I was not enrolled and did I want to get off Their email and do not contact list. I said yes. She also told me the website does not send out bills. Ambetter is a maze of confused people.
6 years ago
Amanda Chicago, IL
Hard to find doctors that take this insurance. Too hard to find a new doctor even though i hate my old one. Their billing is so slow. I pay by check and even though the date on their bill is after my check cleared, they half the time claim i didn't pay last month and the call reps chew me out for doubling up on payments even though I pay every month. This last month i actually did miss a payment. I need to pick up a Rx and even though my payment shows rec'd Thursday and went thru Friday, it's Tuesday and they still can't clear my suspended status so I can pick it up. They say it will take until Friday for my status to clear. The cost has also kept changing at pharmacy over this and they can't explain why. (It's birth control and so should be no cost to me). Price has gone from $500 to $140 and even shows a copay? ALSO, their my health pays reward program is bogus. There's an error when you try to sign up and calling does nothing. They just say keep trying. Perks you can't get, false advertising.
6 years ago
Hunter Memphis, TN
DO NOT USE AMBETTER/MAGNOLIA!!! After I moved out of their coverage zone, they essentially refused to cancel my coverage even though I was no longer eligible for it. On the phone, they assured me that my coverage was terminated, then I was charged for another month. When I called back, they said I was still enrolled and then REFUSED TO terminate my coverage. I eventually had to do a three way call with ambetter and the healthcare marketplace just to ensure they would terminate my coverage. They told me I would be refunded for the month I was wrongly charged for, but I never received that money. I've been considering calling and asking about that money, but losing that much money might be worth it to never have to deal with this horrible organization again.
6 years ago Edited September 14, 2021
Kat Mesa, AZ
Why isn’t “No stars” an option? I underwent cancer treatment 18 months ago, and due to all other insurances leaving The Marketplace for 2017, I was stuck with Ambetter as they were the only insurance offered. I was to have a PET scan every 6 months as a follow up protocol for the next few years, because, well- cancer.
My PET scan in April was denied by Ambetter. They authorized a CT scan, and of a smaller body region. After finding enlarged lymph nodes in September, another PET was ordered. Denied. But they authorized a CT, which showed nothing. I then had an ultrasound and needle aspirates. Positive for cancer. A PET was order again to find out where else the cancer may have spread. Denied! Come on!! My oncologist spent 30 minutes on the phone with Ambetter to get it approved! Can’t wait to see what else they deny. If I they had authorized the PET back in March, I may not be in the boat I am now. Thanks Ambetter for toying with my life.
6 years ago
Ross Kleman Decatur, GA
BEWARE, call any Dr they are advertising as 'in network.' This company is dishonest. Marketplace website and their rep on the phone told me three of my five main family Doctors are in their network. When I called the Dr offices they all reported that they haven't been, are not now, and aren't going to be next year covering their insurance. One said they aren't accepting new Dr members even if they wanted to join. I have reported them to the Georgia Insurance Board and would ask you to as well if you find these illegal practices. Once you sign up you are stuck with them for a year and as you can see from the reviews, no one is happy. I told them of this and a week later all three doctors remain listed as 'in network.' You will regret signing up with this terrible company.
6 years ago
Denise M Garland, TX
If I could give this company 1/2 of a star, I would... and they only get half because they covered most of my prescriptions. However, even though I live in Dallas, paid for the PPO plan at $667 a month... not one time did they actually pay a doctor's visit. NOT A SINGLE ONE! My thyroid needed to be looked at by an ENT... not some rare specialty... an Ear Nose and Throat doctor... IN Dallas. The closest one they had on the plan was in Ft Worth. I submitted everything to go through that doctor's referral process, which took 6 weeks... only to be told that the ENT that Ambetter sent me to, after being on the phone for almost an hour and a half... that doctor told me, again after 6 weeks of calling and following up... that they don't take Ambetter. Try calling ANY doctor, they have never heard of this company. This is a scam!!!!!!!! This insurance company should be put out of business... they are committing theft with every premium they collect.
7 years ago
Danielle Miami, FL
If I could give this insurance a 0, I would. This is the worst insurance I've ever had. I called to see if the doctor I wanted to go to was covered and they told me he was. Then after I go I received a bill because he wasn't covered. Now I have been disputing this claim for 4 months. No one ever calls back when they tell me they will call me back and I can't even count how many times they've told me that they were going to escalate the issue. I can't believe how bad the customer service is because every single insurance that I have had in the past has been very helpful. I'm definitely cancelling this insurance and telling everyone I know to not waste their time and energy.
7 years ago
Randy Constan Tampa, FL
Its a shame that this company was even allowed to qualify for ACA silver plans. By making their plans cheapest, that diminishes the tax credit based assistance to pay premiums for all plans. That would be fine, if not for the obvious reason they can make their plans so cheap: They have no doctors! Oh they have a list, but if you've had a history with other "REAL" companies like Fl-Blue, United Healthcare, Aetna, or anything like that, and have had a few medical issues, you know that you'll likely never find a single one of your doctors in the Ambetter "network", and further, none of your doctors will have even heard of Ambetter. The ACAs future is obviously in jeapardy at this point. But I still wish Ambetter was never allowed into the ACA.
7 years ago
Maria Garza San Antonio, TX
Warning to all seeking an insurance plan please do not and I repeat do not go with Ambetter by Superior through the Marketplace. Its been a nightmare trying to find a doctor that takes this insurance, even facilities will not take this insurance. The doctors that see you at the hospitals that are in contract are not in contract so you will be responsible for paying these doctors hundreds to thousands of dollars. My thyroid doctor dropped me because Ambetter wouldn't pay and also because they kept sending him people to see from out of town. I am so glad that my plan ends December 31, 2017, finally this nightmare will end and I hope to pick a better insurance that pays and will be accepted by doctors.
7 years ago
Nathalie Gooding Miami Beach, FL
They provide decent coverage at an affordable price but their so-called "member resources" are terrible. The website in particular is very poorly designed. Links lead nowhere, information on one page contradicts another, there is little overall logic to the way information is presented and finding a doctor is the most frustrating, fruitless process ever. Calling member services is no better! Each person who answers the phone tells you something different and most are just ill-informed.
7 years ago
DARLENE KELLER Selah, WA
If I could give this company a negative rating, I would. My primary care doctor who I have seen for over 20 years stopped accepting Ambetter insurance as did the majority of specialists in my area and one of the major hospitals. I did a search on Ambetter's web site for a primary care physician and started calling clinics and doctors on their list. Most of the doctors on Ambetter’s approved physician list were not accepting new patients or were 6 to 7 months out for an appointment. I found a doctor 50 miles from where I live that was on Ambetter’s online search list of in network physicians who was accepting new patients and could see me within two months. I specifically asked when I scheduled my appointment if they accepted Ambetter insurance. They assured that they did. I saw this doctor twice and had standard blood tests done at their clinic to the tune of about $1,000. My claim was denied. Out of network provider. I now see that this doctor is no longer on the list of network providers. No one bothered to inform me or my doctor about the change and I have a bill I cannot afford to pay. Some people say having Ambetter insurance is better that not having any insurance at all. Actually it is like having no insurance at all! Thank goodness I will be on Medicare in another few months which presented my next problem with Ambetter. I spent over 45 minutes on the phone much of which was on hold, talked to 5 different people repeating the same information trying to terminate my coverage when Medicare takes effect. When I questioned why such a simple request was so difficult for them to handle, I was rudely told that I had called the wrong number for policy termination. Gee I called the only number I had for them which was their customer service number. I repeatedly told them the date for termination which was the end of the following month which was already paid for. I even sent them an email through their web site with the termination date IN WRITING. Well they terminated my insurance one month early. Who knows how much time and effort I will need to make to try to correct this mistake. I purchased Ambetter insurance through the state change because the premium was what I could afford. I would have been far better off to have spent more and purchased insurance from a company that is reputable. Bottom line....stay away from this company. They are the worst of the worst Their insurance is worthless and their customer service representatives are ill informed, rude and imcompetant.
7 years ago
Chris W Mount Prospect, IL
AM-WORST.. nothing Better about them! Let me start by saying the in-network doctors to choose from are horrid and often have the worst ratings and reviews as doctors. Also I found myself in an all Spanish speaking office with clearly mostly medicaid welfare patients because that's the Doctors available in Ambetter's plan! I had to stop seeing my Doctor I've had for 20 years because she isn't in Ambetter. (same for my oBGYN) Between spending 40 minutes on the phone with billing problems ( not getting my monthly premium bill properly and having no reason why) to fighting to get my stupid $25 credit for a flu shot, they make you jump through a whole bunch of hoops and I'm writing this review as I sit on yet another phone call trying to resolve this -- my 4th one within 2 weeks and about 3 hours of my life I can't get back. Ambetter has this supposedly wonderful 'My health Pays' benefit where you get $25 if you get your flu shot and you can get it at your Doctor's office or a participating pharmacy. 1st I was told to wait another week (as the credit is only supposed to take 2 to 3 weeks but this was 4 weeks later. Today is October 24th and we received the flu shot on Sept 2. Their system can't handle a pharmacy claim instead of a Dr. claim. Its unreal. I've never had to fight this hard over $25 before. Maybe they should just stop offering this benefit if they can't even follow through and honor it! We will NOT be getting Ambetter for 2018. Back to Blue Cross, Blue Shield we go!
7 years ago
Brent Murphree Olive Branch, MS
Ambetter/Magnolia has been by far the worst health insurance company I have ever been required to use. The list of doctors that I'm allowed to see is ridiculous, getting referrals is borderline impossible, and medications most of the time are actually cheaper to purchase out of pocket than they are if you were to use your insurance. My monthly medications would end up costing me $140 more per month than if I were to just use an RX coupon website like GoodRX...and that's just terrible for an insurance company. Random generic drugs have been denied coverage because they claimed were unnecessary when it was plain as day that it was the one medication I need most for my condition and is relatively cheap compared to other drugs on the market. Customer support is severely lacking and I would almost be better off paying for my medical costs in cash rather than paying my monthly premiums - that is how sad this company is. The only problem would be if I had to go to the emergency room I would not be able to find one in my area that would accept me, and frankly is the main reason I stuck with them.
7 years ago
Carla Goroski Bothell, WA
Billing mix up and every time I call to resolve, I spend 40 minutes going over what happened, with the rep reading their records to "get up to speed". Then they ask me to mail info...which essentially goes into a black box and I never hear back from them...nothing happens...and I don't even know if they get it....but they won't us e-mail...even for "non-medical" info. Or they say they'll put in an investigation request and nothing happens...no one contacts me and the cycle continues. I call again...yada yada yada. Argh!! I had 3 months of premium payments that were sent directly (via checks) from my bank to Ambetter. They cashed the checks, but never posted them to my account. So my account showed 3 months delinquent (non-payment). They then threatened to cancel my insurance, if I didn't pay, so I paid the 3 mos again with my credit card and proceeded to work with Ambetter to resolve the issue of the unposted checks. I sent front and back copies of the checks showing that they received them. After months of prodding, they finally posted 2 of my initial 3 payments and issued me a check returning 2 months of "overpayment". It's 5 months later and Im still fighting to get them to correctly post that 3rd payment to my account.
7 years ago
Irina Vishneva Winter Park, FL
SCHAM!!!!!!!!
I signed up for the insurance based on the list of providers on their website. In reality more than 95% of the providers do not take the insurance: OB GYN only takes you if you are pregnant; no updated primary care on the policy...
They scheduled an appointment with a OB GYN only for me to arrive and to find out that they do not take my insurance. My primary care doctor was no longer with the insurance and they did not even know about it.
Primary care doctor wait is 3 months. Dermatologist visit is only possible through a referral from primary - so good luck getting it!
Zero professionalism and absolutely no doctors available! Complete misrepresentation of the health care providers on their web site!
Please, call your doctor to make sure they really work with this insurance because most likely they do not
7 years ago
Jerry Rockwall, TX
I have dealt with several different health insurance companies customer service departments over the years and have to say that without a doubt, Ambetter (who I refer to as Nobetter) has achieved the WORST customer service ranking of them all. That along with having healthcare plans that very few providers will accept, contain escape clause language so that they pay for very little if anything towards medical services, has escalated them to #1 WORST status for these areas as well.
Well done Nobetter, you have managed to achieved a trifecta for of the areas I mentioned above and earned you the status as the Worst Healthcare Insurance Company out there. That is not an easy task to accomplish, as there are several to choose from, especially when there are providers like Molina out there!
7 years ago
atanu sen Chicago, IL
I was insured with Ambetter in 2016. never actually got to make use of them other than once when I had to do a preventive blood screening. I was told that if tests were done through a LabCorp, Ambetter would cover 100% of the test charges. When I showed up at LabCorp, I was asked to order the test through RequestATest.com which I did on the spot on my smartphone and got the test done with an out of pocket payment of $199. When I later made the claim to Ambetter, they would not reimburse me saying that they do not identify RequestATest.com as legit, even though RequestAtest supplied all the CPT codes for the tests and a legitimate receipt. I therefore lost my $199 straight. If you are in the market looking for insurance, please please please!! DO NOT Purchase AMBETTER!!! They will take your money and never HELP you when you need them!!! Big time CONS and total SCAM!
7 years ago
Chanel
Ambetter is that ABSOLUTE WORSE insurance company I've ever heard of! My issue with them begin with an error in the spelling of my name which I discovered about 2 days after my coverage began, this led to one of their representatives choosing to cancel my insurance (without ever being asked to do so and without my knowledge). As fate would have it, I ended up admitted to the hospital about a week later. Once I gave my insurance card and the hospital contacted Ambetter they were told my costs wouldn't be covered due to ME canceling my insurance. I then spent the next YEAR going back and forth with Ambetter about this issue since I paid my premium for that entire month and never received a refund when it was cancelled without my knowledge (therefore it was still active). And recently I have been notified by Ambetter that since it has now been over a year since the issue began they are completely refusing to handle it! Like how low down can a company be?! THEY 100% dropped the ball and did so without my consent, then gave me the run around for OVER A YEAR constantly telling me someone would contact me (normally saying within 90 days everytime), and now that they've bs'd me long enough they are completely clear from paying a bill that my premium was paying them to take care of... meanwhile I now have all of the hospital bills negatively affecting my credit! I am UTTERLY DISGUSTED that a company that treats it's members like this has been allowed to continue for so long and doesn't have to face any consequences while it destroys people's lives!!! I literally would've had less stress if I had just had no insurance, but I didn't want to be penalized by the government! If anybody has any advice on what my next course of action can be, PLEASE LET ME KNOW and thank you.
7 years ago
Steven Milman Austin, TX
I have filed a lawsuit against Ambetter and their parent company Superior Health. My complaint is that they recommend doctors who are not on the plan. Most of the providers on the plan are Medicaid clinics because Superior Health's primary business is Medicaid. In my market, they offered an Affordable Care Act product that included a reputable group, Austin Diagnostic Clinic (ADC) and to this day refer you to ADC doctors but when you call for an appointment ADC tells you that they do not take the plan. Appears to be a bait and switch situation. Meanwhile, Superior Health's parent company, Centene, boasts about record profits and about looking forward to enrolling more people in 2018. I AM LOOKING FOR AUSTIN AREA PEOPLE WHO HAVE BEEN WRONGED OR MISLEAD BY AMBETTER. PLEASE MESSAGE ME OR LEAVE A FOLLOWUP REVIEW.
7 years ago
Kim Ham
Have had Ambetter since January 1 - thanks to Obamacare - I should have paid more and stayed with BCBS. I have a claim that still has not been paid since January 5th - it keeps being denied and when I call customer service I am told at least 5 different reasons as to why it's not being paid. When my doctors office calls in they are told different excuses as well. Ambetter even stated that they spoke with my doctors office on a specific date and there is no time stamp in my chart at the doctors office that they even spoke to Ambetter on that specific day. I am soooo fed up with this insurance company....cheaper isn't always better - lesson learned. I finally had to get the Indiana Dept of Insurance involved because I was getting no where with Ambetter on the one claim. That is when Ambetter finally called me back! Said the claim will be paid and they are resubmitting with modifiers - well lol what a joke - the claim denied AGAIN!
7 years ago
Andrea Piascik San Antonio, TX
Completely incompetent company:
PROVIDER LIST INACURATE : the majority of the provider's listed as being in their network are not in their network, subsequently you could easily spend 2-3 hours calling physicians just to locate one that takes their insurance.
CUSTOMER SERVICE: service is beyond unhelpful whether you're attempting to locate a physician in network or attempting to understand your bill. Supervisor's make claims to fix an issue but it remains untouched.
BILLING: They fail continuously to set up direct debit. Although we were assured by a supervisor that direct debit was in place, they did not bill me, did not notify me and then suspended our policy.
WEBSITE: Innacurate inforamtion, personnal account information is not available, attempts to speak with their IT department to resolve the issue have been useless.
7 years ago
Inder Singh
I have had Ambetter insurance for over a year and half, and have never used it once, because it has been so cost prohibitive, even for preventative services, and finding a provider that will take this plan has been a real challenge. My wife and I pay $530/month for two relatively young and healthy individuals. The yearly deductible is $6500 per person, making it useless for any routine medical needs, except catastrophic coverage. Their customer service is horrid -after navigating your way through the labyrinth automated system, and finally getting through to a customer service representative -they will spend several minutes re-validating your personal information that should already be in front of them, then try to redirect you to someone else. Thankfully, starting this month, I will have real coverage through my federal employer and have already cancelled this turkey. Would avoid Ambetter at all costs.
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Bottom line: Horrible coverage and customer service, high premiums and deductibles, useless for any preventative or routine medical needs.
7 years ago
