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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 offer comprehensive health insurance coverage. For health plans to be on the Marketplace, they must be a qualified health plan that covers the essential health benefits listed in the Affordable Care Act.
To enroll in Ambetter health insurance, you need to apply during Open Enrollment. The Open Enrollment period for 2019 health care coverage runs from November 1, 2018 to December 15, 2018. If you missed the enrollment period, you may qualify for a Special Enrollment Period after December 15, 2018 if you have a Qualifying Life Event.
Each Ambetter member has 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).
Each plan offers insurance coverage for the essential health benefits listed in the Affordable Care Act, but the cost-sharing rules for medical expenses are different for each tier.
Members with Ambetter Essential Care pay lower premiums but have 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.
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. This rewards program promotes health and well-being among Ambetter members.
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.
Ambetter only offers Marketplace plans. If you are looking for another kind of plan, like a short-term health insurance, Medicare, or Medicaid, you'll need to find another insurance carrier.
Ambetter plans are available in a some states. These are Arkansas, Arizona, Florida, Georgia, Illinois, Indiana, Kansas, Massachusetts, Mississippi, Missouri, New Hampshire, Nevada, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, and Washington. If you don't live in any of these states, then 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 (e.g. a primary care physician, specialist, etc.) 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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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.
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
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.
The worst insurance available. The WORST. Any Medicaid plan is 100 X better than this one. Avoid at all costs.
Horrific customer service. Automated phone service disconnect every time I call. When I'm finally able to get through to a customer service representative, they tell me their system doesn't work and I'll need to call back in 24-48 hours. They didn't offer to answer any generic questions or provide assistance. Obviously, this is a direct reflection of their corporate management and lack of training.
We have had Ambetter in Kansas for the last two years and it has been an absolute nightmare. Terrible customer service and administration. No one knows what is happening when you call them and you never get the same answer twice. If I could have given no stars I would.
I have good experiences with Ambetter,the only thing is some doctors don't accept their insurance but it's getting better.Sometimes u have to call a few times to receive ur card but a million times better than blue cross and blue shield Anthem,had problems with them since day 1,never used it until it was canceled,they wanted $1,300 a month,ridiculous.
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.
terrible, terrible company. after paying $1240 to get re-instated, they still haven’t done it after a week. they straight up lied to us! My wife is a Type 1 diabetic and she can’t get her insulin!! these people will tell you anting to get you off the phone. worst insurance company ever..!
do not pick up this insurance if you have preexisting conditions because they will drop you without even giving a reason. Don’t sign up for an insurance company this widely disliked period. They are scum and scam artists.
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.
Perfect for everything we need. Site works well. Fast response times. Always introducing new ways to make things easier. Been here for 3 years and have no intention of changing
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.
One of the All Time worst, website don't work, misleading and/or no doctors in the network, they exist only to collect the premium, and do not understand how they stay in business.
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