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Ambetter Insurance specializes in health insurance plans on the Health Insurance Marketplace. These plans are also sometimes called Obamacare plans.
Ambetter is a very unpopular health insurance company. Most customers do not recommend Ambetter.
Ambetter health insurance's covered services include preventative and emergency care, therapy, behavioral health help, medications, maternity, and hospitalization. It is an on-exchange health insurance option in the Health Insurance Marketplace from Sunshine Health and Superior HealthPlan. It is operated by CeltiCare, a subsidiary of the Centene Corporation.
Health Insurance Marketplace plans are intended for people who do not have health insurance coverage, and only certain customers qualify for coverage. Thus, Ambetter health insurance is somewhat of an exclusive health care plan insurance company.
To enroll in Ambetter health insurance, you need to apply during Open Enrollment. Open Enrollment for 2019 health care coverage runs from November 1, 2018 to December 15, 2018. You may qualify for a Special Enrollment Period after December 15, 2018 if you have a Qualifying Life Event.
Ambetter enrollees are given access to an online portal through which they can make all of their payments, view health care plan benefits, and take care of logistics like obtaining a member ID card. The member portal offers extra features, too, such as providing reminders for members when they are due for another doctor's visit or allowing them to take a health risk assessment to determine which steps they can take to live healthier.
If you're looking to get an Ambetter plan, you can view their health plans by first selecting the state you live in and then selecting a metal type for the health plan tier you're most interested in. From there, your options open up to several different plans with varying prices and benefits.
Ambetter health insurance plans available include: Ambetter Essential Care (Bronze Plan), Ambetter Balanced Care (Silver Plan), and Ambetter Secure Care (Gold Plan).
Ambetter Essential Care has lower premiums, but higher out-of-pocket expenses. Ambetter Balanced Care, the Silver Plan, offers higher premiums and a lower out-of-pocket limit. Ambetter Secure Care has higher monthly premiums, but the lowest out-of-pocket expenses of the three plan types. In some cases, premium subsidies may be available through the Affordable Care Act depending on how your annual income compares to the Federal Poverty Level.
Members can track their claims 24/7 through the online portal, as well as connect with member services at any hour of the day. The subsidy estimator in the online account also helps members see how much they would receive for reimbursement for a treatment with their benefits.
Ambetter provides more than just logistical tools for members. Many of the extra features they offer also send the message that they want their members to get healthier and stay healthier. These tools include a 24/7 nurse hotline that members can access for questions and medical needs.
There are also health-promoting programs such as the StartSmart for Your Baby program, which provides support for expecting mothers. Ambetter has support for members coping with behavioral health issues, chronic illnesses, and similar struggles.
My Health Pays is Ambetter's rewards program to provide incentives for members to live healthier with better habits. You can earn money for taking a survey provided by Ambetter, getting a flu shot, or having your wellness exam, and this money can go toward your next premium. Members can be reimbursed for gym membership payments as well.
Dental and vision coverage are available with Ambetter, but the benefits and availability of each are entirely specific to the state you live in and the type of health plan you've signed up for. Dental benefits, for example, is not available in Texas, but vision insurance is. Dental coverage includes exams, cleanings, and screenings, overall, and vision benefits include yearly eye exams and glasses or contacts. Those seeking vision coverage and dental benefits in addition to health insurance can find options through Ambetter.
It's somewhat difficult to access specific information about the types of health plans Ambetter has. Its website primarily just explains the metal tiers (gold plan, silver plan, and bronze plan) as well as how essential health benefits are covered by every plan. To find out what kinds of plans these are, such as Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO), not to mention what prices and benefits you qualify for (like out-of-pocket expenses, copayments, deductibles, covered services specifics,and if you need prior authorization for certain medical services), you'll have to contact a representative.
Up front, it's important to know that Ambetter is part of the Health Insurance Marketplace (HIM). It's Centene's option for HIM plans, which is intended for people who don't have health insurance and maybe don't qualify for typical plans.
In HIM territory, Medicare isn't an option. For example, if you qualify for Medicare, that's the legal option for you to get rather than taking advantage of Ambetter plans. Medicaid and CHIP are HIM plans, too. Ambetter has PPOs, HMOs, and EPOs. However, they don't offer Health Savings Accounts (HSAs).
Ambetter plans are available in a select few states. These are Arkansas, Arizona, Florida, Georgia, Illinois, Indiana, Kansas, Massachusetts, Mississippi, Missouri, New Hampshire, Nevada, Ohio, Texas, and Washington. If you don't live in any of these states, then obviously Ambetter isn't an option for you. Even if you do reside in one of the states they service, make sure to check the location of their in-network providers for your state to ensure they have an in-network provider near you.
Unlike many of its competing insurance companies, Ambetter doesn't have a mobile app. Some companies provide this for enrollees to access their accounts right from their phones, making communication and logistics much easier. Ambetter hasn't provided this yet, making account management slightly less convenient than with other companies.
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I bought Ambetter coverage thru the marketplace for 2018 and 2019 and on several occasions they have denied claims as being "out of network" even though all my doctors show up as "in network" on their website. I truly believe that when they are having cash flow problems they just deny the claim and leave it up to the provider to sort it out. Calling their customer service is a complete waste of time, nothing is ever done to resolve issues. So glad I will soon qualify for Medicare.
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.
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.
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.
I called to make sure they would cover the Cologuard test and was told yes, it would be covered. Guess what? Now I have a $649.00 bill. I've appealed twice and they have denied it twice. This test must be covered because it is part of the ACA. DO NOT SIGN UP WITH THIS INSURANCE!!!
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 :)
Charged me $800 dollars more than my premium was suppose to be and when I called they told me it could take 30 days to refund. Asked for a supervisor and was told none where available and I would get a call back. Still no call back. On top of that they changed the plan I choose to a terrible plan.
I switched to Ambetter after a nightmare experience with Blue Cross Blue Shield of North Carolina and Texas. I've only been using it for a few months, but so far my experience has been excellent. My chosen provider accepts their coverage and I'm proceeding ahead with my scheduled wellness checks.
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.
TYPE ONE DIABETICS ON PUMP THERAPY, BEWARE! This insurance company only offers one medical supply company to order your pump supplies and they are the worst. J and B Medical Supply took over two months to get our order only to over charge me and get my order wrong. I've been trying to rectify the issue but I can't get anyone to call me back. It's been over a month that I've been calling every other day and no reply. UNBELIEVABLE!
Not sure who is the biggest crook, Ambetter or the Healthcare Marketplace. Lost coverage for 2019 after correcting a document error of THEIRS 3 times, now they say they can't reinstate unless I pay nearly $800
This company should be called AmNotBetter There first line policy is to deny everything from a bandaid to an emergency surgery
I was scared to get the Ambetter from Peach State Health Plan after reading all of the bad reviews on here but it was all that was offered in the Marketplace for my area. I have been very happy. I have had their insurance for nearly 6 months and they have paid everything promptly with no issues. Of the nearly $6000 we have only had to pay a little over $100. I have had no problem finding doctors, although I must say they all have to be affiliated with the local hospital. Sure, I'd rather have better choices but I really did not expect more. I have been happy with every doctor or NP I have seen, especially my NP. I have no problem with their website either, including earning rewards on the visa and using it to pay my phone bill. We have not had health insurance for many years and this has given us peace of mind. I have not had to call them but I did message them on the portal a few times and got a quick response. It would be better if they sent an email saying they had replied though. I had to keep checking the message box. We thank God our health has been cleared except for a few small issues, thanks to Ambetter.
This is catastrophic insurance ONLY !! They pay for virtually nothing until you hit your deductible. They market this as full coverage but it's not.
I have had Ambetter for about 1 and 1/2 years and have not had a complain. They have everything displayed on the members website which makes it easier to see what is being submitted and paid.
They stole a months worth of premiums from me and wouldn’t cover me for any services for the whole month.
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!!!!!
DO not enroll unless you really have no other option. You will not be able to leave unless you go through the market place then they go behind you and re instate you. They also will automatically enroll you with out notice. then report you to credit bureaus, CLOSED account as started a new job back in feb2019 and they had already enrolled me for 2019 still sending me bills....
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.
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!
A better has had incorrect billing information for me several times. Each time I address it, I am told it will be corrected. In the mean time I am denied benefits and appointments because of it. I have called several times since January. The care is limited. There is no Urgent Care. I am in fear and anxiety often.
I have been denied a scan for the bulge on my right side 3 times in the past 2 years. I was told there is no reason for a scan. Finally the plan allows me to have one but has my account payment information wrong and denies me. It’s been 3 years and I still have a bulge on my side.
Last year they made a mistake billing me for a plan I did not have they cancelled plan I did have and tried to not take payments for it This year they issued 125.00 credit to myhealthpays card is bogus after 4 months and run rounds like card need be cancelled and reissued you need to activate it and most recently we do not take it as payment to your plan can use at some places yet places tried for things stated it was still refused they also hang up on you give up on them pay extra for health elswheree
Bought this insurance because I thought one Dr. I liked was on it, surprised he’s not, so now I’m stuck with a Dr. farther away! So upset and I guess I should have read reviews. Just got my May bill on April 29th, glad I already paid it, due on May 1st.
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!
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.
Am better sucks. Suppose to have gotten a ppo gold standard and they gave us Am better. We use to get Aetna/ Blue Cross. No on accepts this insurance and we're paying a premium of approx $600 a month. Do not go through Obamacare, cause they are the ones who tricked us into this. Called Healthcare.gov and they said they could do nothing, even after they scammed us. Obamacare is a scam, farce and criminal organization. Going to cancel and go private...somebody that can be trusted.
Worst "Health Insurance" I have ever had in my life! This, as "Obamacare" is a joke! Expensive, extremely high deductible and then they deny to pay anything else that's supposedly covered.........Emergency room visit, blood testing, etc. The only thing they paid for was prescriptions, which are cheap enough through GoodRx anyway. You also get bombarded with emails and mails, and their "customer service" is pathetic! Terrible company and I hope they go out of business! Should have known better than to deal with a company called "Ambetter" anyway!
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!!!
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.
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!
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.
I have had AmBetter since July 2018. I have read the majority of the hundreds of these reviews and it seems as though folks either didn't have other options and also didn't do adequate research about whether the physicians, hospitals and urgent care centers that they prefer were covered by the AmBetter plan they were considering. I went with an AmBetter 4 (which is a Silver plan on healthcare.gov), I have a low deductible ($600) and 100% co-insurance after my deductible is met. I pay $0 for my medications and since I am self-employed, I actually pay the full amount of what this insurance premium is per month (roughly $400/month.) I have on-going health issues that they haven't penalized me for, I have received all of my 3-month prescriptions without issue as well as over 15 other Rx's that are monthly. (As I said, I have seriously, life-threatening, on-going health issues.) I just spent 8 days in the hospital being discharged on 03/30, today is 04/07/19 and ALL of the hospital bills ARE PAID IN FULL. Again, I did extensive research before selecting AmBetter as my provider. I am very pleased with them and have zero complaints. Again, I pay my premium on time, researched my physicians before selecting their insurance and understood what type of plan I was selecting. Doing your research instead of expecting someone else to do it out for you is the truth behind the majority of the complaints in all honesty.
They denied a life-saving test ordered by a specialist. They are not doctors!
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.
That do-not deserve even one star But it seems I can’t click done unless I give them that one star - It’s a Horrible Joke for an insurance company!!! I WISH I had read this before the girl that helped me with insurance found it for me!! The TURNED down an Echocardiogram AND a stress test for my heart!!!!!! Who does that?!?! My cardiologist ordered the tests Because I’m having problems with my Heart!! My Heart But they in their Grand All Knowing foresight Do-Not feel its necessary -Really after all ,Who Needs a heart-Duhh
That’s my second year with Amberter And this insurance it so good . They have a rewards card I recommend this insurance
This "insurance" is a scam. Nobody in my area accepts their plans and they don't cover anything, including diagnostic tests.
Never trust Ambeter. I was ripped off by Ambetter. They went into my bank account and took all of my money. I am fighting with them daily and they will not return my money. I first thought it was an honest mistake and quickly found that this is serious. They actually stole my money. Nearly two thousand dollars.
I use Ambetter from coordinated care second year. I have a problem when I want click my login, I haven’t access to my health pays rewards. Every time when you visit your doctor must check information about your doctor work with your insurance or no.
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
droped St lukes from there providers did not inform me . as I have cohcolear inplants I need to use them for yearly check up. they do not under stand . when I took policy out they where in network now refuse to pay or put on dedutable
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!
Worst company that I have ever dealt with. They are thieves. They took my premium and then didn't cover my daughter when she needed shots. I ended up paying $500 out of pocket because they "lost" her information in the system. Beware consumers! Bad bad business here....
Poorly run at the Executive level. Last year I got two of everything mailed and 12 membership cards. CEO must be clueless this is huge wastes of funds. They outsource prescriptions to a company called "envolve pharmacy solutions" utterly clueless company with zero customer service. They recommended I switch to a new drug for diabetes and now they are denying the prescription THEY recommended. Again ckearly Am better CEO care nothing about service if I had options I would take them but there are no options for me outside of marketplace.
worst ins ever. Couldn't find me a doctor or cardiologist. Suffered for a year with them. Then they don't pay the bills they are supposed to and you wind up getting sued, customer service is non existent. trying to get a live person takes hours, they give you false info when you can get someone..do yourself a huge favor avoid this company like the plague
If I could give a negative star I would. I had a ureteral stent placed in Jan for a very large kidney stone. For some reason they cancelled my insurance even though I paid the premium so no one is getting paid. After numerous calls and some of them 3 ways still not insured. Finally I signed with another co starting April and can then get my lithotripsy done. This is a 3 mth delay to get this stent out. It hurts. I wrote my congressman who will be investigating.
I was denied services and prescriptions because of an error made by an Ambetter representative. Anytime I call and try to verify my information they always say member not found. Each time I speak to a representative they ask me if I have a primary care doctor despite having established a primary care doctor with them and them giving me a reference number. This is by far the worst health insurance I’ve ever had in my entire life. .
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.
This company is horrible. They cancel my insurance and took a payment from me and refused to give it back. Customer service is clueless about company procedure. They refused to let me talk to a manager. These people upset me so much I was in the hospital for 3 days. I will recommend them. This company doesn't care about you or health...they only care about money. They don't pay for nothing and they very lazy. Please do not get insurance through these people.