Ambetter
5.4
Overall Score
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Tammy Herman Austin, TX
When I signed up with Ambetter it was posed as a ppo. They took away my tax credit even after I sent them all info requested that was backed up by the IRS. They gave me the credit initially then lost my info. Even had my email incorrect. All of the providers that were listed when I signed up are no longer accepting this plan. I broke a bone recently. When I called them for a list of orthopedic doctors they gave me six providers. I called of them. Not one accepts Ambetter anymore. Finally after calling them again I was given only one in all of Austin Texas who accepts this plan. I pay $570 a month. Ridiculous. I am disgusted to the point of educating myself on filing a class action suit against them.
7 years ago
Ashley Bartow, FL
I have had this insurance for almost 3 months and I have not been able to get my prescription for my chronic migraine syndrome because it is a name brand with no available generics. They have requested multiple times that my doctor tell them why I need this medication. It is the only medication that has worked and I can't get it because without insurance it is over $300. I have had to go 3 months without medication. I get 3-5 migraines a week. DO NOT get them.
Also, every doctor they had listed as in their network is NOT in their network. I checked with the insurance company before I bought this insurance and they told me every single one of my doctors take this insurance. Only one did and I can't see him without a referral due to the wording in our insurance. A doctor that I have been seeing for over 3 years on a 6 month basis I cannot see because this insurance is complete and utter crap.
7 years ago
Robin Price Fort Wayne, IN
I am very disappointed with this Insurance co! I switched from PHP due to the cost but this Insurance is not worth the savings! It took forever to get an Insurance card to start off. Then it was one problem after another. Every month I get a new statement with another months premium added! Keeps saying I am deliquent even though the payment clears my account the 1st of every month! Billing calls must be outsourced to another country because everytime I try to call and straighten it out, I get someone that can barely speak english, I can't understand them and I end up hanging up! I have tried contacting by email several times to straighten this out and I get no response. Me and my daughter both have had to switch several medications because they refuse to authorize them. My gastric reflux symptoms are awful now because they will not cover anything that works for me when I am already borderline Barrett's Esophagus. Guess they would prefer to pay for Esophageal Cancer? Everything seems to require pre-authorization which they either deny or twiddle there thumbs on authorizing. As soon as there is open enrollment again I will be switching back to PHP or Blue Cross, if I have to get a 2nd or even a 3rd job!
7 years ago
Barbara Lowe Barker Chicago, IL
This insurance is an actual racket! They are charging people the lowest rates, best co-pay vs deductible, but AREN'T providing ANY avenues for care. They are putting DRs on their providers list that are retired, dead, have stopped taking Ambetter or still undergoing the application process to become a DR with Ambetter. I called 11 DRs to find a primary care physician and these are the results I experienced. It's coincidental others are coming up with the same experiences? I came into this with no expectations... I didn't know what to expect, I know now that I am paying $159 per month for nothing. I can't get any care under this plan. I have found NO Drs that will take this plan. I have even spoken to Drs who explained the reason why they won't deal with Ambetter is because they won't pay. It's like getting Detroit to pay their debt before they go bankrupt.. not going to happen. Run! Get private insurance!
7 years ago
lea depew-grunow Orange Park, FL
THEY ARE TERRIBLE!
Every possible thing with this company is disastrous. They fill my medication through one manufacturer only, which is a manufacturer that no pharmacy uses. Every month when I need to go in for a refill they have trouble filling my prescription which ends up causing a 2-3 day delay during which I'm stuck without medication. I am an undergrad student who has been receiving medication for a learning disability practically my whole life, me having to go 3 days (sometimes a week) without medication is very stressful. If you already have enough of "life" om your plate, do not sign up for this insurance! I can't stand the fact that I'm stuck with them until the end of the year. They need to hurry up and get out of the insurance business!
7 years ago
Tanisha Lenae Columbus, GA
Okay so, Um I'm not even a customer yet, but I Signed up over the phone recently. The woman I talked to her name was Jennifer **** and she was extremely nice and all but I recieved no calls or nothing discussing my insurance I was supposed to get for $95 a month but she had told me there was going to be a $115 charge which included the application fee and I'm guessing the first charge, but I only see that $24 and some change is taken out. I really hate the idea of being scamed...... And I just hope that isn't the case and honestly don't want to judge without knowing what is going on, but I feel ad if that is what happened. I left a voicemail and got a little snappy this time and told her there was going to be a report filed because this is my third voicemail I've lleft her and nothing in return... And I am honestly just a person trying to help myself because I have no insurance. And NEED some. ASAP....
7 years ago
Katrina Mintz Cleveland, GA
I reported Ambetter to the Georgia Insurance Commissioner today. They have sent me in circles since June denying claims. They have only nine oncologist on their website now IN THE WHOLE USA and not one in the state of Georgia. How deceptive!!! An insurance company with the peach state symbol that has not one cancer doctor in the whole state. When I call their services division, they just tell me the cities within a 100 miles they have checked and tell me they are sorry they can't help. THEY ARE SORRY! IT TOOK VERY LITTLE EFFORT TO SEND PAPERWORK TO GEORGIA INSURANCE COMMISSION. STAY AWAY FROM THIS COMPANY. THEY HAVE GIVEN BOGUS NAMES OF DOCTORS AND BOGUS PHONE NUMBERS TO ME NUMEROUS TIMES.
7 years ago
Rebecca
I live in GA. They have providers listed on website or you call to verify or find a provider and when you actual call to make an appointment oh the doctor doesn't take Ambetter. You contact Ambetter and inform them and they apologize and tell you that they have plenty of doctors in Atlanta which is 250 miles and 5 hours away. They cant even verify their prescription services co pay. I was better off going to the public health clinic and using Good Rx. A year later I still cannot see an orthopedic doctor or a neurologist and I am in so much pain that I can not walk. Then when you call the customer service rep ask me if I have had my Well Woman appointment or my colonoscopy that I need to do this but no doctor takes their insurance in Savannah. No not get this insurance. A word of advice the Insurance Commissioner's office advised me that they have to provide coverage locally and how to do it. Call their office for information. It took me 9 months just to get an ID card from them. Please chose another company and make a complaint to the State's Insurance Commissoner. This is graud. The HIM is very aware of this and does nothing. How horrible can this be?
7 years ago
Richard Christy Olive Branch, MS
Awful. Just awful. It's like being on Medicaid except you're paying for it. You get to see the lowest rated doctors, in the oldest and funkiest offices with the most outdated of equipment. And you're lucky to find these. Most doctor's offices either chuckled at the notion of taking this insurance, or had never heard of it. Then when you call in to find a doctor they tell you there are 4 within 120 miles. I mean cmon. Anyways I resubmitted with a life change of an increase of an extra $50 every two weeks on my check and picked Humana this time so I can actually see a doctor whose name I can pronounce.
7 years ago
Darlene Meldrum Marysville, OH
When I enrolled my physician was listed, with the healthcare market place you sign up in the fall and insurance doesn't begin until the next year. When my insurance took effect my physician was no longer on the plan. Now I have to pay for each physician visit in full! No, I'm not switching from a physician I know well and trust to someone who doesn't have much of a practice because they are either new or not very good. Every time you need to find out if a physician, lab, or anyone else is on your preferred list you have to call because the website doesn't work. Since the beginning of the year they have told me they are working on this, it's been 8 months and no resolution. Of course when you call it takes forever and the person doesn't speak English! Today I received a bill saying I owe for my yearly eye exam, it states in my booklet that this is covered 100%! After being on the phone with Ambetter rep for 22 minutes I'm informed the claim was submitted without a code #. I called my optometrist office and they said they were told that routine eye exams aren't covered. I called Ambetter back and went through all the questions, explained the problem, another 22 minutes on the phone. My optometrist has to resubmit.
I would save a lot of money not having health insurance and paying out of pocket for everything. I hate "Obamacare" and will never do business with Ambetter again.
7 years ago
Jan Cook Stephenville, TX
this company is a huge FRAUD!!! first off they dont explain anything to you when you call & if you get cut off (which ALWAYS happens if you ask hard questions) you never get the same answer or you get cut off. i got a letter on 07/13/16 telling me that they had cancelled my policy for non payment--which is odd since I just got an invoice from them which i pay every month!! now the interesting thing is the date for cancellation was 04/30/16---now i go to the doctor once a month EVERY month! not once did they refuse me or say anything different. i call & was told that all my payments were set aside because they were waiting for a new file from HealthCare.gov--why?! I then was told oh no you arent cancelled at all just suspended till they got an updated file....ok i then call HealthCare & was told nope cancelled is what they told them & no need for a new file for anything since i was signed up for the entire year.
I then find out that they have refused to pay my medical bills by returning them & telling the dcotor office to resend it with a different code-- they do & it gets rejected again but told to use the other code & its a circle jerk!!
i just went in for my monthly appt & get told that Ambetter now said i was cancelled & never covered for non payment which meant i was told that i had to pay 4 months of bills or they would refuse to see me!
this company is worthless & a scam!!!
7 years ago
Stewart Pooler, GA
Horrible, horrible, and horrible! Please be aware of this insurance company scam. Purchased Ambetter through in agent Jan 2016 in my local area. Purchased plan that did not require specialist referrals. In May of 2016 needed to see a specialist. Learned the nearest specialist was 119mi away. Contacted Ambetter and was told they would authorize an out of network provider and expedite request because I was ill. Contacted specialist and informed me the physician I chose still does not have letter of authorization. Contacted Ambetter and was told I would need to go to my primary care physician for a referral. Contacted the doctor they chose to schedule a visits for a referral. Doctor informed me that they have explained to Ambetter since Jan 2015 they do not or have ever accepted Ambetter. Contacted Ambetter and was giving another provider. Contacted his office and was informed he has never heard of insurance company. I normally do not post reviews but If you read this please avoid Ambetter membership at all cost. The company starting to remind me of an upcoming "American Greed" episode
7 years ago
S Brown Killeen, TX
We signed up for this insurance because we could afford the silver plan and receive a little more coverage. We researched their website and looked at all the doctors that would accept this insurance and we thought we had found a decent plan. Unfortunately, as soon as we started calling doctors on the list to schedule appointments we were repeatedly told over and over that they do not accept this insurance. Finding doctors has been a long, tedious process and we have ended up spending so much money out of pocket, we might as well have just stayed with a bronze package with another insurance company.
7 years ago
maikeru1 Decatur, GA
Ambetter's slogan should be "For people who can't do better" because that's exactly what it feels like with this insurance company. Here's the breakdown of my experience with Ambetter:
The good:
Insurance plus dental, the cheapest rate their is.
Easy to contact them and the staff were friendly to me
I didn't have any issues with auto-pay until I had a job change
The bad (the real bad):
You don't know who is in your area. The coverage map you have to look at to select your provider is NEVER updated. Expect to spend hours and hours calling to see who offers what. You might as well not even use the website. You're left feeling that you just have to select who you manage to find.
You can pick your primary care doctor on the website if the are accepting patients. Funny thing is, since Ambetter never updates their database you are able, and likely, to pick a doctor that either no longer accepts ambetter insurance, or doesn't even work at the same hospital anymore. Completely useless function. Expect to get the lowest common denominator of doctor choices.
FOR DENTAL:
This was a nightmare to find somebody for my dental work. More than 80% only accept child patients. Finding somebody who accepts adult patients is just pure dumb luck. Take what you can get. I live in the middle of Atlanta and I could only find 3 possibilities.
The only reason I give this review a 1 instead of a 0 is that "you get what you payed for" can be loosely applied here...
7 years ago
Maria Pelaez Miami, FL
BIG JOKE! They cancelled my policy then when we started receiving bills from medical providers it took me more than 5 months and dozens of calls to Ambetter to finally get this straighten out. At one point I would call the customer service line and they would hang up or they also have automatic message of a guy saying that he can't hear us and giving information about ID cards. It's a joke. Worse, when I called to complaint about the message and that it takes me 30 min to get a hold of anybody, the lady Lynn didn't even seem surprised. I had problems with enrollment, disenrollment, wrong information, cancelled charges that weren't supposed to be cancelled, you name it! I've talked to Sabrina, Chayra, Darielle, David Rex, Tina, Carmen and the list goes on and on. Don't waste your time!
7 years ago
Tammy Wayne Schererville, IN
I purchased this on 5.25.2016. Their system did not register my payment. As a result, I did not show as "active". I called them on 6.3.16 to attempt to straighten this out. I had to "prove" that I paid. I did and had at least 5 different customer service reps tell me 5 different things. Liars!!! On 6.6.16, I still do not have insurance. As a result, I am a Type I diabetic without insulin. Further, I will not have insurance for at least 72 more hours. As anyone knows, insulin is like buying liquid gold. I can't afford it as I lost my job due to my position being eliminated. I paid for insurance so I would be able to afford my insulin. Now I will likely end up in a coma, or die. I explained this to Ambetter, but they claim that their hands are tied and can't do anything until U.S. Script updates the system. Apparently, life does not matter to insurance companies. I will die in comfort knowing that I will not be fined for not having insurance that failed to cover me!!
7 years ago
David Happe Waconia, MN
Worst health insurance we have EVER had. I cancelled it after 90 days. Here's the deal : Expensive premiums through the ObamaCare Florida exchange. Almost NONE of the doctors listed on their web site will actually take the insurance, and the ones that will are the worst rated/reviewed doctors in the State. If you go to a doctor out of state? Not covered. They assigned me (a 45 year old male) a primary doctor... I didn't pick it. Guess what? They assigned me a PEDIATRICIAN 45 minutes away from my home. If you don't go to the assigned doctor? YOU GUESSED IT... denied claim as you didn't use your "primary" physician. In short, this insurance is a 100% SCAM intended to fleece people out of money to subsidize other people. It's literally the WORST. Oh and if you are travelling? No coverage. ANYWHERE in the United States. Use an out of network emergency room while you are vacationing? NO COVERAGE. It's the worst. RUN AWAY from this scam.
7 years ago
You know Seattle, WA
Ambetter Coordinated Health is the worst company that I have dealt with in this digital of the new millennium.
1) Billing: You can't pay t:hem. You can pay by credit card and walk away and they will pre-authorize your payment to your bank making the funds unavailable then after 10 business days they don't take the money and then suspend your service for non payment.
-To combat this I sentdthe the receipt in their messaging system telling them to make sure they follow through with the transaction. know one should have to do this.
-They didn't have proof of any transaction that you have made. The customer service agent doesn't have access to verify that you even made or attempted to make a payment. However after I complained in March they now show transactions and the receipt. Even with that the payments that they show that I have made in the last six months are inaccurate or incomplete.
2) Customer Service: they cannot see or access any real information. Don't leave a survey it is not their fault. But they should tell you the truth about their limited access instead of speaking strongly and frustrated with the customer in repeating wait 3-5 business days.
-They can't tell you what happen to a payment that wasn't processed to be resubmitted and they can't see any receipts.
-When they make a mistake in not completing the transaction it takes forever for them to clear up the suspension they have against you from using your insurance. Even though it's their fault in not processing the payments. The agents will state it will take 3-5 business days . When you come back with the statement "but your record shows you have had the payment processed and out of my account for 7 business days" there is no answer and the agent gets angry and repeats 3-5 business days and there is no one in billing that they can transfer you to to get real business taken care of rather than speaking to a frustrated agent that knows their information is inaccurate.
3) The phone system know more about processed payments than the website or the agent does but still unreliable.
4)I have never had such a hard time paying for services in my life. I don't know the other end yet. Being that we have had the services for 5 months and I gave them the last payment 3 business days ago because I am going to another company They still haven't paid for my services from 45 days ago. It's pending because of the payment they did not take out of my bank after the funds were there and pending for 10 business days. We are full paid until the end of the month but we are still suspended.
5) On their side it seems they only want to take payments from checking accounts and not credit cards. I guess because they know there is flaw in their system. But I don't want to give out that info because it's easier to dispute/ trace a transaction with a credit card and it's easier to cancel a card. But to cancel a checking account because of potential fraudulent activity is a greater impact on the consumer. So I don't like to give out my checking account info.
Watch out. I have spent more time trying to pay this company. With all of my other bills it takes 30 minutes total monthly. With this company I have spent hours a month checking to see if they payment is still pending and if they eve took the payment and resubmitting the payment after the preauth falls off and the funds become available again and being suspended most of the time because of this circle
7 years ago
Hena Parveen Bothell, WA
I never write reviews for anything, but I HAVE to for this company. It has to be one of the poorest health care insurance service I have ever had. Their reps are not helpful, and I talked to one who was downright rude! They had a miscommunication with the health exchange and did not cover me for a month (which I am willing to pay the fine for later) but now they are claiming I was covered and I should pay the premium! Even my welcome package says my effective date of coverage but they said they changed my effective date about 2 months after my coverage began! Ridiculous! I will never use this company again! They are unprofessional and won't accept their system error.
7 years ago
Janet C Gatesville, TX
since I got this insurance back in Jan2016 I have nothing but issues!!! First off my doctor is within their network but yet they seemingly make it super hard for them! they say it needs to be filed under eye doctors & then when they do they get told no its medical.....no winning! then they "forget" to credit my payments in a timely manner & threaten to drop me! i paid my bill at the beginning of the month & still nothing but a nasty letter & now they have tripled my month bill!!! i try to get into my account online it doesnt let me sign in & then i call & for 1 question it takes about 45 minutes to get an answers--most times the person doesnt speak english or does so poorly or just plain RUDE.......had o know they were this bad i never would have taken this crappy service!!!
7 years ago
Leah Dugan Chicago, IL
DO NOT EVER PICK THIS INSURER! You will regret it.
Dealing with this company has caused me time, money, frustration, and my son going without coverage for 3 months. I paid for coverage on time, every month, from Jan - May of this year. I kept receiving letters stating that I owed them money from the previous month. I would call, tell them I had paid already, and after 15-30 minutes on the phone with a rep, was told, each time, the situation was getting fixed. I did this three months in a row. In an attempt to fix the situation, I paid the extra money they insisted I owed (which I had already paid) because my son was overdue for a well visit. At the beginning of this month (May) I received a letter stating that my son's coverage was cancelled in FEBRUARY. This was BEFORE all of my phone calls. No one I spoke with at anytime over the phone told us we had been dropped, they simply took our payment and let us believe we were covered. I have since called the Market Place and they have escalated my case and we hope to get it resolved. In the meantime, my son is STILL WITHOUT COVERAGE and I have paid MORE than what I owed for literally nothing. This is the worst customer service experience I have ever had in my life. And I will be filing a complaint with the BBB.
7 years ago
Veronica Miller Spokane, WA
I don't even know where to begin. This company goes beyond negligent, incompetent, and dishonest. This company is intentionally stealing money from taxpayers, clients, and providers. What they do is calculated. I have been paying faithfully every month my premiums over the phone with my debit card, have confirmation numbers, and the whole nine yards. Just found out today that I have not even been covered since January. They intentionally put you in what they call "suspension" for some alledged mispayment. All the while they are taking your money they have no intension of paying the provider. At the same time they are taking your payments, they are collecting huge monthly premiums from the federal government and ripping off tax payers. They know what they are doing. I had one of their reps get honest with me today. He said this happens all the time and that he has chosen to pay the federal fines and have nothing to do with Ambetter or Obama Care. This coming from a guy that works for them. Go figure. When is there going to be a class action suit? Dishonest companies like Ambetter couldn't do a "better" job of sending our nation into bankruptcy than if that was their intention to do so in the first place. Do you think maybe it is? Every complaint posted in these miserable reviews I have experienced. Believe me this goes beyond incompetence. This is intentional.
7 years ago
Annie Lovato Seattle, WA
Ambetter customer service is the worst I have ever experienced. After signing on for a new plan at the start of 2016, I noticed my payments were not being taken out of my account. I called to inquire and was told that my auto pay through my bank was not set up. So, I went through the process for a 2nd time and was assured that it was set up correctly. Stil, no payment was taken out so I called again and was told the same thing and went through the same process, again. Still no payment so I called a third time and was told that the reason no payments were being made was because I had a credit on my account. Unsure of where this credit would come from I inquired about that. They were clueless. So, I took at as fact because they are supposed to know what they are doing. I then call back a couple months later because I am still not getting charged and they tell me that all I owe is $19.03 and they say my autopay through my bank is STILL not set up so I go through that process again. Here it is the end if April and I receive a letter in the mail telling me my account is suspended because of non-payment and at the same time I receive another letter in the mail with an enclosed check of $121.03 telling me I have overpaid and they are paying me back. WHAT!?? So after several oblivious customer service reps later and being asked if I am related to Demi Lovato, which I did not appreciate I FINALLY get a supervisor who then spends another 40 minutes trying to figure this mess out. It gets figured out and then I am hit with the amount of ALL of the months I had tried to pay all at once which was a large chunk of change. I was told to NOT cash the check and that once I paid 4 months worth of payments my account would be back to active. I am LIVID that this is how things went down. I basically begged them to let me pay my monthly bill each month, was given the run around, had my insurance taken away from me and a check mailed to me, then was hit with all four months of payments that I had tried to make in the first place all at once. HORRIBLE COMPANY!!!! If you can get your insurance anywhere else DO IT!!!
7 years ago
Emily Ardolf
It took me 6 months to see a doctor and only after I went to the local news. This is because in Waco no one will take this insurance if you're a new patient. When I switched insurance, my dr office claimed that meant I was a new patient. After multiple calls from the local news, my dr office finally saw me. However, I can't now update my PCP to whom it is and when I search in their system not a single provider comes up in my zip code. However, magically they found me a PCP to assign me. This insurance has been a nightmare to use and I'm looking into private insurance which may cost me a significant amount long-term, but result in better coverage.
7 years ago
Lori Tampa, FL
This company is the worst insurance I have ever had. Online and with a telephone rep it looked like my primary was associated to them. He was not. I found this out AFTER I signed up and paid. When I went to make a vision appointment I found out the majority of options available were dropping the plan that had Ambetter attached to it. I was literally told there wasn't a vision option for me within 300 miles that would be covered with my plan. What? They drafted my account for a monthly payment too early and by 'accident', without my permission. Their customer care reps are clueless. I've paid for this plan for 4 months at nearly $300.00 a month and haven't used it because nobody takes this insurance! I'm dropping it. Such a mistake.
7 years ago
Andy Resende Savannah, GA
I HAD to get health insurance in the end of last year because of the Affordable Care Act. I chose Ambetter because it had a primary doctor that was covered under Ambetter.
I came to find out as soon as I tried to make an appointment with him that he is no longer with Ambetter and Ambetter refuses to take his name out of their site.
Along with this doctor, I learned that there is almost ZERO coverage with Ambetter in the Savannah area... and I am talking about: dentist, allergist, orthopedic, dermatologist, you name it! No one takes this insurance in Savannah!
I am now stuck with this insurance paying for something I can't use... If I cancel it, I will be penalized for not having insurance, but at least my fine will be less than what I have to fork out every month for no use... but that's the avenue I am going for because I contacted the Healthcare Marketplace and they said there's nothing they can do about that either...
7 years ago
Tinh Savannah, GA
None of the Drs. or health facilities accept Ambetter in the Savannah, GA area, yet, when we sign up online at the HealthMarket place, it shows that several family doctors and specialty groups accept it. Of course, when you show up with the Ambetter card, NO ONE accepts it in this city!!!! You will pretty much pay for health coverage that isn't accepted here. Pay for nothing!!!!
Representative at Ambetter was able to pull up one doctor in their system that accepts it, but it turns out, that doctor no longer is here in Savannah! That goes to show how slow their system is. It's not current or updated at all! This wasted too much of my time. It's April now and I still not have any health care I paid for!
8 years ago
Matthew Heller Coral Gables, FL
I have a catastrophic plan with Ambetter. I knew what I was getting into, but paying over $1300 a year just so I can go to a doctor for three health maintenance visits (no labs or prescriptions covered mind you) is too much. I have also found inaccurate information on their web portal (i.e. website says I owe an extra month's premium while agent on the phone guarantees I'm paid up--glad I didn't blindly pay online). All calls made to Ambetter take several minutes to reach an agent, which is the only option since repeatedly entering my Member ID#, SSN, DOB, or zip code in the automated menu are always met with a recorded "Sorry, there is no record for that information." The company is frustrating and a time suck, but tell me something about the US system of health care that isn't.
8 years ago
Sabrina Diz Key Biscayne, FL
i signed up through the Marketplace on 11/2015 and on 02/11 I called to get my info packet and sign up a doctor. I had just gone through a death in the family and was a little late in doing everything, but still on time. The rep I spoke to fabricated a whole story, stated that my policy was cancelled due to non-payment, and when I asked her for more details, she said I hadn't paid the "Initiation Fee" or the "Start up Fee"...I was floored. I called Marketplace and started a new policy with Coventry Health - but Marketplace told me that their Health companies don't have any of those fees. So I called back Ambetter and the new rep told me my policy wasn't cancelled and that those other charges did not exist!!! Now I was in a pickle stuck with two insurance companies. I've been trying to get Ambetter to cancel my policy for 2 months now AND get a refund. They refuse to refund me because they say I had coverage!!! The following are my conversation notes:
FEB 11: AMBETTER REP SAID AMBETTER IS CXLED, GOT NEW INSURANCE CO WITH COVENANT, CALLED AMBETTER WAS TOLD NOT CXLED, ASKED FOR CANCELLATION AND REFUND $126.54
MAR 01: CALLED AMBETTER AND REP SAID SHE WOULD SEND THIS TO THE RIGHT DEPARTMENT, TO CALL BACK IN ONE WEEK
MAR 22: REP SHOWS THAT THE POLICY IS BEING CXLED; DOES NOT SEE A REFUND BEING PROCESSED - 1/1 TO 2/29 HAD COVERAGE; EXPLAINED TO REP I DID NOT HAVE A DOCTOR NOR PAPERWORK - 2 PACKETS WENT OUT IN NOVEMBER AND ANOTHER IN FEBRUARY; NOTATIONS IN SYSTEM - "PROBABLE LIABILITY MUST BE PROVEN IN ORDER TO GET REIMBURSEMENT, CONTACT MARKETPLACE REGARDING COVERAGE". CANCELLATION# FL20166193994950
***DO NOT TRUST THIS COMPANY OR THEIR REPS!!!!
8 years ago
Mark Hamlin Auburn, WA
This is company is the worst. Today is 3/8/16 and I have been dealing with them since 12/5/15 to pay a claim that they should have paid in November 2015. It was a routine preventative maintenance procedure that is supposed to be covered in full with no deductible. That part they seem to agree with every time I speak to them as well as the letters I receive from them. They just can't seem to handle the part where they are supposed to send a check to the doctor's office.
I called in again today and asked to speak to a supervisor in the grievance department to find out why the claims have not been paid. I am told they don't know how to transfer me to the grievance department but will give me their supervisor. While supposedly talking to a supervisor I get the same line as before. The only difference was that she said that it is not possible at all for me to talk to someone in the grievance department. They will send the information to the grievance department and I have to wait. So I ask for that supervisor's boss and get Jasmin who for all I know is just another person in the cubicle next door who's only job is to answer the phone and give pre canned responses like everyone else that I have talked to.
What a monumental waste of time dealing with customer service at Ambetter is! Nothing gets done. The doctor's office still want's their money and my credit score is at risk because the doctor's office is going to send the bill to collections. Ambetter gets my money every month on a timely basis and I get nothing in return. Ambetter is the worst insurance company but unfortunately I'm stuck with them until the next enrollment process. I'm starting to think that it would probably be better for me to just cancel my policy, pay the doctors with cash and accept the tax penalty for not having insurance.
8 years ago
Jay Hoffman Round Rock, TX
I am 53 years old. Ambetter by Celtic is the absolute worst health insurance company I have ever experienced. They have challenged nearly every aspect of my care. My doctor's directions are irrelevant to them. They will not approve medicines that I have had success with for years. I have lost work due to illness waiting for them to ultimately deny filling my allergy medicine. Steer clear of this company. They should not be allowed to do business in Texas. In the next few days, I will file a complaint with the Texas Department of Insurance. I hope you will do the same if you are a victim of theirs. You will see this post in every social media avenue and online review site that I can find. Please share this to help your neighbors. #ambetter #ambettersucks #celticinsurance
8 years ago
Giselle Chang Hialeah, FL
This co. is horrible, my husband and I choose it thru the market place, after 2 months they cancelled his policy, however they been billing and receiving the payments, Market place been sending them reinstatements requests, we been doing conference calls, spoke with everybody there, no body knows what they are doing. there is not a supervisor who can give you a solution, every person we spoke with do an escalate supposedly to solve the problem, but nothing happen, meantime, insurance is no covering medicines, doctors appointment, been waiting for the reinstatement of his policy more than 30 days. this co. is a joke. but the take your money anyway that the only thing they do. no body do their job. there.
8 years ago
Aga Acworth, GA
Ambetter is THE worst company I have ever had to contact. Firstly, their automated payment system message is incoherent, and then cuts out. Then they make you wait on the phone for 40 minutes, then cut you off. I tried to register online, and it didn't recognize me as a member. No button to press for help. Then I call again, and try the phone payment... It just cut me off. I tried to get a human, and was then told after 2 hours dealing with this garbage that their offices were closed. Heaven knows what they would be like IF you needed to make a claim. Go with ANYONE else, but these people. It is literally, your life in their hands.
8 years ago
Gerard Jacksonville, FL
This company is ridiculous.
They have a listing on their website to show which providers accept Ambetter.
Literally 20 doctors later (all listed in their up-to-date list) I finally found 1 that accepts Ambetter.
Yes, I literally called 20 different offices that supposedly accept Ambetter(according to Ambetter) and only 1 said they did.
Scheduled an appointment as I was having some issues and they called me up a day before my appointment that they no longer accept Ambetter and I would have to pay everything out of pocket.
Since I am already paying for my insurance I really don't want to pay 100% of my health care needs as well.
About 3/4 of the doctors officers gave the same reason why they don't accept Ambetter: Ambetter does not pay them.
1 of the doctors listed is actually an acquaintance of ours and he told us from the beginning that he does not accept Ambetter and is unsure why his office is listed as healthcare providers that accept Ambetter.
When I called up Ambetter asking what nearest walk in clinic was available to see if I could get prescription medication for my breathing problems, they referred me to an office that's about a 4 hour drive away. Seriously Ambetter?
8 years ago
Mariya Seattle, WA
Please don't choose this insurance people!
I have never in my life encountered such a horrible company!
We had it for just a couple month and had trouble finding any doctor to take it.Their list of network is outdated, doctors that their website says take Ambetter told me they do not anymore and never will again and now I know why.One time I went to a doctor I got sent a 150$ bill even though it was a regular visit that I should only pay 1$ copay for. My husband is a diabetic.We ordered his medicine once and next order they refused to cover his syringes.A month ago we got fed up and requested to be disenrolled and receive a refund for the month we won't be using their services, since we paid ahead of time.They said we were disenrolled and will be issued a refund within 48 hours.We never did.Called again.The next person said it's not in the system but now it will be.You qualify for an expedient refund.Will get your refund in 48 hours.Nothing!Next person on the phone said we need to call Health benefit exchange to disenroll.That was new!Ok, we called them.Got confirmation for disenrollment. Same story. ..Nothing!Received a mail from Ambetter saying we have voluntarily disenrolled.But no refund still.Called again today.They say we are not disenrolled so no refund.I'm holding their letter in my hand that says we are and they say that we are Not disenrolled. Basically the point is they don't want to give us money back.
I have seen some mistakes done dealing with companies of all sorts, miscommunication, red tape, human error.But they were all resolved after a couple of calls. This however is Catch 22.
Not only they are the worst health insurance I have ever had but they also are playing tricks with those who want to exercise their right to take their money and walk away from a bad business.I'm not the kind of person to go out there and write a bad review based on my emotions but I would not want any other human being to get into this mess.Ambetter is a nightmare!
8 years ago
Jess Atlanta, GA
Ambetter overcharged my bank account over $500, and with overdraft fees from my other bills coming out, my account is overdrawn. They first told me it would take 30 days to get my money back. After calling the billing department numerous times and waiting on hold for about 2 hours total, now they are saying 3-5 days. That was Friday, today is Wednesday, and i still don't have my money. I requested a refund confirmation email so that I can give proof to my bank so that they will refund my overdraft fees. I was told it would take 3-5 days for the email too. And i still have not received an email. In the time it took the manager to notate my request, he could have sent me the email himself. I am HIGHLY dissatisfied with the way AMBETTER'S HUGE MISTAKE is being handled corrected. It has negatively impacted all of my finances and bill payments, so I hope anyone reading this will rethink using Ambetter. More like AmTERRIBLE.
8 years ago
mary Shannon
OMG, this company is the biggest headache you'll ever encounter, all the complaints listed here I have experienced! !! Every single one !!! Lucky I did find a Dr that felt sorry for me & treated me ! His staff called this NOBETTER ! I paid on 1st every month, was suspended every month, after 3 to 4 hours I'd be reinstated! I feel for anyone that gets on this plan !!! I was told to Call Obama! ! Once told they were to busy bn 1st excepting payments, they didn't have time to deal w complaints, call back middle of month !!!!!!! Grrrrrrrrr, I switched paying triple premiums, but peace of mind so worth it !!!!!!
8 years ago
kevin Helotes, TX
Ambetter should change it's name to AMWORST! Last year i experienced a mass in my nose that was possibly cancerous. It took two months to finally see an ENT because there were none in my area that accepted the insurance, even though their provider list shows several.
This year we signed up with them again but with a better plan hoping for better results. Two and a half months ago my wife was referred to a specialist by her PCP but again the ENT does not take Ambetter. Almost 3 months later Ambetter has not been able to find her an ENT that accepts the insurance.
I told Ambetter last year that it is deceptive to provide a list of providers that is inaccurate when they are aware of his fact. But this year they have the exact same list of providers. STAY AWAY FROM THIS COMPANY. We are canceling them and starting with AETNA in March.
8 years ago
Lucy Atlanta, GA
Terrible customer service. They tell Yoi one thing then do another. The billing department is the worst I have ever seen. They send the wrong bill for 3 months. I called and questioned it twice. I was told it was was correct so I paid the amount they were asking which was lower than my monthly premium. When they finally get their act together, they bill me for their mistake and tell me I am late on my payments. I can't say anything good about this company. I thought I was done with them. We did NOT select them for our insurance for 2016 yet they have sent us our cards and say we have paid through February. We have not paid them this year. The people here are incompetent and their computer systems do my work. On top of the billing issues, they raised our premium 3 months into the year. Are they even allowed to do that!? Stay away!! The price is too good to be true. Pay a little more for a better company. The lower price is definitely not worth the stress and hassle.
8 years ago
Gilbert Arriaga TX
Worst decision I've ever made in my life. There is not a single Dr within 100 miles of me that takes this health insurance. Before I paid they gave me 3 primary care providers one of which I had to choose for them to cover my medical expenses. After I paid I called the 3 Dr's they gave me and NONE of them existed at the numbers provided and when I tracked one down I found out they don't take this health insurance at all. It took this company more than a week to activate my coverage and they refused to cover the $100's of dollars of medications I had to pay for in the interim. Because no primary Dr's within 100 miles of me take this health insurance I am also being denied coverage for the specialists I need to see. In other words they took my money and gave me NOTHING in return and cosy my health to suffer in a way I can not begin to explain. I am laying here with a herniated disc, a torn disc, 7 bulging disc and spinal cord compression and because I paid Ambetter to be my health insurance company I can not see a Dr or get any treatment at all. I would not wish this on anyone. Please don't make the same mistake I did.
8 years ago
Jere Houston, TX
I have had nothing but bad experience with this company. When I called to get help with going to see a dr which shingles this month not a single dr would help me would of had to wait for 3 days before being seen. I even called on a Saturday to see if there was any dr or urgent care I could go to and I was on the phone over 2 hours with a rep that was no help at all. Then I called to cancel this plan by the 15th and was told that it was done even was transferred to health care gov and again told was done. Then last week get an email thanking me for being a member I called again and was guaranteed it was cancelled and not to worry. So guess what no it wasn't and they pulled out the funds from my account and was told it takes 7 to 10 business days to get the funds back. This is BS they sure are good at taking your money but worthless when it comes to helping you out when you need to use the plan. Never been so discussed with a health insurance plan.
8 years ago
Peter J Hall San Antonio, TX
The real problem with this company is less than 20% of the doctors in my city will accept the insurance. The ones who do take it complain about Ambetter not paying them, having to spend hours trying to collect from them and in one case taking litigation against them.
This is the same for blood work and imaging, the places Ambetter tells you accept their insurance do not. I personally believe that all of these places did at one time but got tired of not being paid so they stopped accepting patients with their insurance, one office staff member actually confirmed this to me.
Emergency room visits, that is laughable, you can only go to the hospitals that they cover. I live in San Antonio TX, with 15+ hospital brands. ONLY one accepts the insurance. Absurd.
Bottom line, if you live in a smaller city think twice about using them, odds are that you will not find a doctor that accepts their insurance, if you live in a big city and are pretty healthy you *might* have some luck. Caviet Emptor...
8 years ago
Miguel Gonzalez
My biggest complaint is that I have with ambetter is that for over a year and yet I am unable to find a dental provider that covers this insurance. It was a pain finding our current providers, the directory claims many available doctors, dental, and optical but 8 out of 10 do not accept Ambetter. By the way our zip code 78664 which in no way is a small remote city.
8 years ago
Jean Curran Alpharetta, GA
• Copayments are fixed dollar amounts (for example, $15) you pay for covered health care, usually when you receive the service
• Coinsurance is your share of the costs of a covered service, calculated as a percent of the allowed amount for the service. For example, if the
plan's allowed amount for an overnight hospital stay is $1,000, your coinsurance payment of 20% would be $200. This may change if you haven't
met your deductible.
• The amount the plan pays for covered services is based on the allowed amount. If an out-of-network provider charges more than the allowed
amount you may have to pay the difference. For example, if an out-of-network hospital charges $1,500 for an overnight stay and the allowed
amount is $1,000, you may have to pay the $500 difference. (This is called balance billing).
• This plan may encourage you to use in-network providers by charging you lower deductibles, copayments, and coinsurance amounts.
8 years ago
Review Source
Roxana Perez ,
I used Ambetter three years ago and I have no complaints. The prices were affordable and the network was easy to navigate. I had no issues connecting with the right professionals or to access any medication.
3 years ago
P. Palmer El Paso, TX
We just started using ambetter this year and have been very happy with our healthcare coverage. The only negative is that not as many providers take it in our area so it has taken us awhile to find new healthcare providers that we trust.
6 years ago
wendy perrier Palm Beach Gardens, FL
The customer service is over seas and it is impossible to communicate with them!! You might as well speak to a raccoon. It would probably have better communication skills and knowledge.
5 months ago
Halle Carl Carson City, NV
This is the ABSOLUTE WORST insurance. Thye lied to me, took my money, will not refund me and have canceled my plan. I havefought with them for 6 months and I am over it. I would not get insurance through them.
6 months ago
Anna A Mobile, AL
AmBetter is an absolute joke of a company. I am a pharmacist, and every single representative I speak to at AmBetter is either lying, incompetent, or both. They are only interested in making money--not helping patients.
8 months ago
Mary Conyers, GA
Customer service people are not from here barely understand I had auto pay for some reason past 2 years my money only comes out when it needs too how funny . I go to explain this they have No clue how this happens & when I need major care can't get it due to cancelation !
9 months ago
