Ambetter
5.4
Overall Score
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Quinn Ales Chesterton, IN
I'm from Indiana so I don't know if that makes a difference, but I've never had an issue with Ambetter. I had more headaches with BCBS. Honestly the only thing that has been annoying in the last 4 years was that they didn't want me to use name brand Vyvanse for my adhd but instead preferred adderall xr...not a big deal. I'm happy with them. Just sucks insurance is so expensive these days across the board. I pay $1300
2 years ago
Jason Walker LaFayette, GA
I have been with Ambetter as a patient / customer for nearly a year. While I totally comprehend the opinions and troubles of others and the number of one star reviews, I have been thoroughly pleased after leaving my workplace and losing excellent company insurance.
Ambetter fortunately had my providers on their roster and I've had absolutely no trouble with accessing care or prescriptions.
Perhaps I'm a rarity, but I'm really happy with Ambetter.
I'm a Georgia resident and acccesed my Ambetter plan through Marketplace during open enrollment.
2 years ago
William McNeel Columbus, MS
Its been pretty good for me on my first year of coverage with them in 2022, depending on your plan, I have a zero deductible plan and generally this pays in full for my doctors visits and I also like the $10 Urgent Care visits and it pays for medicines for like illnesses in full and lab work at my doctors office. I personally really don't get sick much or go to the doctor very often. I also like the teledoc call in doctor that comes free with this coverage basically unlimited call in visits. The only dislike(s) I have so far is that my doctor prescribed me Ozempic and they refused to cover it even with filling out PA (pre-authorization) and had me take their recommendations of other medicine for 3 x months only to still deny me. Also its not any good if you go out of your state to a doctor. so if you are from mississippi and get sick in Alabama or Florida and need medical attention you best get back to mississippi to be treated. Also not sure how good or bad it'll ever be for hospital stays or surgeries just yet, I know my sister is on this coverage, as am I and even our local hospital in our home city is not in their coverage network and she got hit with a $1,500 bill that they refused to pay for going to the ER... so you have to be extra careful where you go to make sure its covered and in network. I would recommend knowing in case of a medical emergency where you want to be taken to and treated at.. That also goes for specialist and dental work also. Be sure to call ahead in advance and verify with doctor(s) before going and do not trust what the ambetter website list as approved providers. I had an appointment with my long time (local) dentist and even noticed he was on their listed of accepted & approved providers only to find out on the day of my appointment that they do not accept ambetter or evolve dental coverage. Even told me it was a down right awful insurance that they don't ever pay claims is why they quit accepting it. I was able to find another dentist in my area that accepted my coverage but he wasn't nearly as good of a doctor as my long time dentist. Also I have noticed that specialist that do accept ambetter generally put you on the back burner. example I have had a bad ear ache called an ear nose and throat specialist and they booked my appointment almost a full month out!! I'm like i need treatment now not a month from now but ended up keeping my appointment.. I'm not sure on that myself that my dentist told me about them refusing to pay claims to doctors.. also my primary physician tells me its a horrible last resort insurance to have. He said I do not have insurance with this insurance, but overall I haven't had any issues with them not paying anything so far although I haven't had any XRays or much lab work done. Even the tech lady at Walgreens says I have good insurance so I'm not really sure who to believe on that. Also if having test as I've learned with united healthcare I would still call the insurance company to verify if the procedure, surgery and pre-surgical testing that needs to be done to verify if it needs to be prior authorized and don't trust hospitals or doctors or specialist to do this for you...
2 years ago Edited November 3, 2022
Smileeys Hattiesburg, MS
I wish more people would write the state and general area they live in for these reviews because it seems to make a difference. I live in South Mississippi and Ambetter has overall been a good insurance for me. I work part time and would be on disability or unemployed if I didn't have a wonderful employer who allowed me to go from full to part. However, I am no longer eligible for health insurance through work so I had to go to the marketplace. I actually have better insurance paying very little than my work family does. They have united healthcare and have had so many problems. I am one of the ones the affordable care act has helped tremendously.
One thing I really like about ambetter is they have a rewards system that is not hard to do. You get points for flu shot, answering simple questions, watching health videos, etc. I was able to earn $250 this year easily that I paid my electric with. There are only certain bills you can pay or they have merchandise you can get.
CVS quit taking my insurance this year but I went to another pharmacy that I discovered I like better. I pay zero dollars for my medication (I take 9 a day) and copays for primary and specialists. What plan you get depends on your income, though. We are a family of four with income around $36,000 for reference.
The bad is that they require pre authorization but that's any insurance. They have denied some but then approved it later all except for one. My neurologist really didn't like my insurance and kept telling me they wouldn't approve this or that and I quit seeing him. Probably should have stopped sooner really because that wasn't only problem.
I haven't had much contact with live customer service so I can't offer much insight there but I'm often called by automated service to check in with me or tell me about new info. It's equal parts annoying and helpful. They also keep calling to tell me they've noticed I'm not taking my heart medication right but don't say what it is. I don't take heart meds but do take blood pressure meds. Anyway, that's just mildly annoying.
On my plan they do not pay for pain management and regular doctors pretty much can't prescribe anymore so that is difficult since I'm in pain almost constantly.
They have telehealth and 24 hour nurse's line but I've never used it.
3 years ago
R. M. Boca Raton, FL
Overall, I like Ambetter 1000x more than past plans I've had, like Humana and BCBS, which were outrageously pricey AND retroactively denied coverage for life-saving treatments, leaving me over $30K in debt. Of course there are pros and cons to every plan, but I stick with Ambetter because the positives far outweigh the negatives. So, for the good: it's affordable, I've had good customer service experiences (once they accidentally denied a claim, saying it was out of network, but quickly corrected this after a phone call), my copays aren't bad (this is important as I'm chronically ill and frequently see multiple specialists), they have a free health coaching plan, and I absolutely love the providers I found. I noticed that the providers' actual billing staff cause most of the billing errors, not Ambetter. The bad: Providers are hard to find, and while copays (like $8 for a PCP visit) are low, coinsurance is NOT. While they've allowed me to receive stellar mental health care, the same can't be said for my back. They required 5 weeks of PT before authorizing an MRI, with me paying 40% out of pocket for each session (I met my out of pocket max, so MRI was 100% covered). Meanwhile, they denied a back brace and stopped covering the pain medication I need to function. The MRI showed a mess: disc bulges, stenosis, degeneration, and bone spurs (and I'm in my 20s). Ambetter initially denied epidural steroid injections. HOWEVER - I've had a LOT of luck with providers winning appeals. My pain med is covered. My injections are authorized as far as I know (they wanted 5 weeks of PT, but I told them I'd done that, so they fixed it). I love all my providers. Yes, some stuff is a real hassle, but I'm very satisfied with Ambetter.
3 years ago
Meagan Mueller Chattanooga, TN
This is my second year as an Ambetter customer, and I plan to renew my plan with them for 2021. The coverage is better than any employer provided health insurance I’ve ever had, and at an incredibly reasonable price. The customer service reps are always helpful and usually go above and beyond to help, most of my prescriptions and doc visits are 100% covered or have a super low co-pay, and there are plenty of doctors and nurse practitioners in their list of providers.. I don’t know what the complainers are expecting, but this health insurance company is doing a great job.
3 years ago
KAREN M HARRIS Kansas City, MO
I lost my insurance 3 years ago. Never been without insurance. Bad luck happened to me and I had to have eye surgery. The only good thing that came out of that bad situation is a girl told me to call ambetter
I did and I am very thankful. They have been wonderful. Had 2 more eye surgeries that same year that they paid really good. I'm low income so I qualify for a subsidy. I just can't say enough good things about ambetter.
4 years ago
Mata Marietta, GA
Ambetter has been a hassle free insurance company that was the most affordable out of all of them. I have never had issues with doctor visits, ED visits, or prescription drugs. They are always very pleasant customer service wise and I actually think the website is getting better. My only complaint is finding a provider is a bit difficult and obviously you are very limited on who you can see, but the cost of the insurance is so low that I am okay with that.
4 years ago
Gail H Cincinnati, OH
I have had a very positive experience with the ambetter insurance. I have been with many insurance companies in the past and they all come with some very bad problems due to people not want to do their jobs first of all. From what I see the company is trying to improve issues and I'm hoping that more people who are not having problems will post reviews because I feel that this insurance has been better than when I had United Healthcare , Humana , Blue Cross Blue Shield. All of these companies have their issues. Sometimes you just have to call back and talk to someone else because two different people would definitely give you two different outcomes.
4 years ago
Jonathan Manchester, NH
I've had Ambetter insurance for 2 years and my only complaint is how frequently they call me to make sure I take advantage of all their wellness benefits. I've read the numerous negative reviews and experienced None of what others claim. I have a pricy RX and they cover all but $30/mo. That prescription alone is double my monthly premium so how could I complain? All preventive care is covered including all tests, many in the thousands. I haven't had any 'event' requiring non-routine care so I cannot comment there. I live in NH and I cannot find a Dr or practice/facility/hospital that ISN'T in their network. Overall very satisfied.
4 years ago
Brenda T. Byron, GA
After much worrying and warnings from others, I chose Ambetter off the marketplace. As newly self-employed I did not have much of a choice. To my surprise, most of my doctors, except for my primary care of well over a decade, are on the plan, and the plan has been wonderful. I have even had two of my doctor's offices express that they were well pleased. They company pays promptly and at reasonable levels. Whatever Ambetter Peach Plan is doing, please keep doing it. Now, if only my beloved primary care doc would join in...
4 years ago
CDan Miami, FL
I absolutely love this insurance. In Miami they cover a whole lot of top doctors, you could even go to the UM hospital and most of the doctors accept AmBetter. Been saving $250 every month, since it covers for my birth control. Even the pharmacist was surprised when it showed him that I didn’t even have to pay a copay, that usually no company ever covers my specific birth control.
5 years ago
lynn Springfield, MO
i live in missouri and have had ambetter from home for 2018. they cover both major area hospitals and doctors that are affiliated. they have paid all the claims quickly. the only refusal was when a doctor accidentally billed them twice. the plan is changing for next year but i hope it stays similar to what i have now because this has been the best insurance i have ever had. i have had to message them a few times and the always replied pretty quickly. they do not email directly so you have to check the patient portal for replies.
5 years ago
PATSY LEIST Bolton, MS
I have only good things to say about Ambetter. I am in Mississippi, one of the states Ambetter covers. My coverage is excellent. My doctors are please to provide it. I have had a minor surgery, my yearly PAP, Mammogram, pain management, etc. and the coverage provided, payment provided have been excellent. I am extremely happy I chose Ambetter insurance. I have recommended it to many of my friends.
5 years ago
VILMA MONTALVAN Miami, FL
From Miami FL Dade County I have never had a problem. When I call customer service they are always willing to help me in anyway. All my claims are paid. We have plenty of Dr’s and specialist to go to. My primary Dr is a private office not a clinic. I could also go to University of Miami which they have great doctors. I recommend my Ins with no problem in anyway.
5 years ago
Bronya Duhanova Tampa, FL
This is my second year with Ambetter from Sunshine health in Florida. In our state this is in my opinion the best option on the federal market place. I have Ambetter Balanced care 1 and I pay 40$ a month for me and my son, it is 0 deductible policy (after the tax credit). Copeay for PCP visit is 1$, for specialist 10$. The choice of doctors isn't the best, but if you are a reasonably healthy person, this is sufficient policy.
I was able to find a multi practice primary care provider near my home, meaning I have my PCP, OBG, bloodwork and allergologist in one building. I'm also happy with my son's pediatrician. All of the hospitals in Tampa bay area, where we live, take this insurance.
Added bonus is "My health pays" account, we get 50$ for each annual preventive visits, gym membership and other services, like HPV virus immunisation for my son. This are deposited to a credit card, what I can use for coinsurance and other health care expenses...
Customer service is always pleasant and helpful.
My life got significantly easier and less stressful thanks to Ambetter. I highly recommend this insurance plan for your basic health care needs.
7 years ago
kay molina Miami, FL
I've been with Ambetter roughly 2 or 3 years, the only complaint i have is sometimes they dont cover my medications, but normally is when itsbtier 2+ medications, as i have only tier 1 coverage and i believe they have 4 tiers. They do have prior authorizations doctor's can send in, to see if approved. But I've had very little problems with this insurance company. Im overall very happy, they have excellent coverage fpr vision and good doctors in network. The many times ive called concerning some questiond and occasional problem, they provide good service. The reps I've talked to have done all they can to help me sprt out what i need. I live in Florida and here its Ambetter with Sunshine Health.... Maybe its only decent In Florida, because these reviews are terrible and I've had little problems with them.
7 years ago
AM
My previous insurance premiums were set to increase 40% in 2017, so I took a chance by changing my health insurance company to Ambetter. So far, I have been very happy. Yes, it was a bit of a hassle to find a PCP in the beginning. Some doctors who were listed turned out not to be PCPs at all. Before choosing Ambetter, I made a list of doctors in network near me, called to confirm that they were accepting new patients (some weren't) and visited several offices on my short list before choosing the doctor I like the best. Other than the first hiccups with choosing a doctor, we are very pleased. We have already completed our annual check ups and tests, had need to visit the doctor and got an appointment for 1 hour after calling, and have had prescriptions filled. This is a good option if, like us, you are relatively healthy and use health care mainly for check ups and routine screenings and prescriptions. I also like that they offer a program to incentivize you to eat healthy and take care of your health. You can earn $ to put toward premiums, co-pays and deductibles. Keeping my fingers crossed that things continue to go smoothly.
7 years ago
Jon Warneke
Arkansas Company do believe. Trying to edge into possible Government Health Marketplace with several reasonable deductible health plans. Effort in customer service response seems fine. Have fought very hard to stay out of hospital and E.R. so have not had any medical claims review. They were responsive with requested info I requested and their benefits info & summary of benefits were as good as or better than others. The Gov't Marketplace ecchange is a viable choice for many uninsured and underinsured families and those facing uninsurable criteria for the normal Health Insurance underwriting.
7 years ago
Mark Anthony Miami, FL
It took ,me a few months to get used to how this insurer works. I and my wife have a silver plan and we use the benefits routinely such as chiro and physical therapy, dental exam etc. Our doctors have said our plan gives us more visits per year than other patients plans. We have to spend a lot of time to find the health practitioners that we like but once we do, its great! The ones who are bad we call Ambetter and report the concern and or file a complaint(and believe me there are plenty of bad actors with licenses to practice medicine.) Usually they tell you that such and such a test or treatment that I need is not covered and charge me above the copay and when the visit is done I wonder was what they did anything beyond what is routine? That's when you need to call Ambetter to discuss what took place because there is plenty of fraud perpetrated on the ignorant consumer.
7 years ago
Tara Snyder Marshall, MI
I have alopecia, an auto immune disease where my hair falls out. This company won’t let me have a simple steroid, let alone a legitimate medication. Scam. Do. Not. Get. This. Insurance.
2 months ago
AuntyK _83 Kearney, NE
This company stole 525$ our of my personal account! They charged my work account also! It took them 1 day to mess my account up and up to 45 days to fix it! What a joke! I'm canceling as soon as I get my money back! I would never recommend them!
3 months ago
dustin opper Chattanooga, TN
OUTSOURCED CALL CENTER IN THE PHILIPPINES CANNOT HELP
I have had the worst experience with Ambetter, they canceled my policy for non payment even though I paid. Then it took two months to have my policy reinstated and all they did was apologize for canceling my policy in error.. It took two mangers who didn't even work directly for Ambetter and then another 2 months to get results. They still owe me $390.00 for doctors visits during my policy cancellation done in error... THE WORST INSURANCE YOU CAN HAVE.
4 months ago
Damon Rome, GA
This is the worst insurance company I've ever had in my 57 years! Do NOT ever sign up with Ambetter. It's one step away from being a straight up scam! They refused to pay "approved doctors " saying "oh we accidentally put them on the approved list" yet never remove them from the list. They don't apply money spent to the deductible. God forbid you have to call customer service. If you get someone who can speak English, they use a litany of canned excuses for everything. Shady company! NEVER, NEVER USE THIS INSURANCE COMPANY!!
4 months ago
Ivan Lieyeth Perolino Frisco, TX
They tried to scam my employer out of 880 dollars by creating a duplicate account and claiming they didn't pay, and then suspended the account. Who knows if they will try to send the scam amount to collections to damage my credit into order to force me to pay. If so, my lawyer is going to open them a new hole 1 mile wide. Easy legal win. Avoid like the plague
5 months ago
Don Rasmussen Issaquah, WA
Worked in Healthcare as RN/ARNP for 40 years and Ambetter is by far the worst healthcare entity I've even had the misfortune of dealing with. Non-English speaking "Customer Service." Escalation, and Grievance Departments that does nothing; don't pay claims. IT which screws up your web access to their preferred online pharmacy. No one ever has the authority to even look up phone numbers or email. Mail out 26 page denials of payment to credentialled providers. All they do well is take premiums.
5 months ago
Marmalade000000
They cancelled my auto pay without warning.
They overestimated the amount for treatment I was receiving, but when that amount turned out to be less, I STILL had to pay the balance out of my own pocket - for an ESTIMATED AMOUNT!! Furthermore, I received NO communication whatsoever about this - no letter in the mail, no email, no phone call - no nothing!
Their website is outdated. Most if not all of the doctors listed are either no longer practicing or don’t take Ambetter insurance.
Every year my premium has gone up considerably, but I don’t get what I pay for in the least.
Lastly, customer service is a complete and utter joke! Imagine hearing barking dogs and screaming children in the background while you try to get answers from people who clearly have no clue what they’re doing.
This company should be investigated for deception and fraud.
6 months ago
Haley B Bellevue, WA
Absolutely a scam. They appealed to me at first because they claimed to offer 'coverage' of the current providers I was seeing. Come to find out, not a single doctor that they claimed to cover was actually contracted with them. Not a single doctor of any, ANY, discipline, that they claimed to cover was actually contracted with them. Not even the literal PCP they assigned to me. Not a single clinic or hospital near me either. 100% a sham of an insurance company, misleading consumers either deliberately as a scam or accidentally out of monumental incompetence. I even spoke to a telehealth doctor for help, and they told me that Ambetter is notoriously bad for misleading patients. Never, ever, ever sign up with this insurance company.
6 months ago
Loren Ransome
My experience 1 month of having ambetter:
They will take your money. 540 USD exactly for my wife’s plan.
They will continue to admittedly deny you ever paid, and continue to send you the bill despite living in 2023 and being able to see a 540 deduction from ambetter.
You will get the absolute worst customer service representation you will ever experience in your entire life time. (Broken English, contradictory statements, and flat out lies about information that later turns out to be intentional)
For 500 and being brand new, how does the United States government have this business listed on the market place.
I’ve never left a review for a company in my life, but I felt I am morally obligated to make sure nobody else has to deal with this legal scam.
6 months ago
Ruiko Ame Tulsa, OK
I’d give zero stars, they treat you like your stupid and they screw you over, it feels like a scam, and their rewards card doesn’t even work, I would NEVER recommend them to Anyone, also they put a block or something on me refilling the medication that I need to actually stay alive, luckily my pharmacist is amazing and helped me to get them with good RX pricing without having to use Ambetter, this company has been nothing but rude and unhelpful, you shouldn’t be paying. For something that is against you when it’s supposed to be helping you major disappointment and they won’t even pay for anything even though I have already reached my deductible and they are supposed to cover 100% of it …. Stay away from them they clearly don’t care about you
6 months ago
Sharon Ciccone Lititz, PA
Be aware that when you sign up for Ambetter's autopay, they will inconsistently deduct your bank account. You will think that everything is being handled because you made the responsible choice, until you are refused service in your doctor's office being told that your insurance has been cancelled. It turns out that somehow it is my responsibility that Ambetter's autopay is not working. Ambetter did not make me aware that there was an issue, nor did they take responsiblity or fix the autopay issue. This happened to me 3 times! The stress and hassle is not worth the savings of a few extra bucks.
7 months ago
Tracy Harmon Dallas, GA
Ambetter is not cheap by any means but they always done what they said in the past. I paid our premium August 15, 2023. They cashed the check but they are telling me that they didn't receive my payment. I have the returned check in front of me. They are also saying that since my husband had an increase in his pay that we owe an additional $92. They are saying that this is for the premium from August 1-7...they have been paid for all of July and the check I sent in August was for our new monthly premium. They are just trying to double dip and get more money from us. I am cancelling them as soon as I can get someone to give me my premium back. I have done called 5 times trying to get this issue resolved and like all of the other reviews, I am trying to talk to someone in a foreign country. I am a cancer survivor and I have an oncologist appointment tomorrow and Ambetter is saying my policy is suspended. This is total BS. As soon as I leave this review, I am filing a complaint with the BBB. STAY AWAY FROM AMBETTER.
7 months ago
Lily Cutler Seattle, WA
No healthcare providers in WA state accept Ambetter. Some of them have never even heard of it. No mobile app and their website is a joke. "Find a provider" is useless - don't waste your time. If you start calling the doctors on Ambetter's "covered providers" list, you will find that they either don't take Ambetter or are no longer practicing. I have to assume the data is either completely out of date or false. I have their Silver plan, and I can't find a single doctor who can make a referral for any x-rays, specialists, or physical therapists, let alone the MRI my doctor thinks I need. My doctor called me after my visit to let me know that she couldn't even give me a referral in good conscience, because I would end up paying out of pocket for 100% of everything. I'm paying expensive monthly premiums, and the only thing they pay for is co-insurance on prescription medications. It's an absolute joke. Whenever I try to switch to a different plan, the health insurance marketplace in my state shoves Ambetter in front of me. Oh -- and they don't release any data, so you have no idea what they might actually cover. It's a guessing game. I don't know how it's legal for a health insurance company to offer zero transparency, but that's what you get with Ambetter. I'm switching to literally anything else as soon as possible.
7 months ago
Bill Hov Lakeland, FL
I DO like the coverage. The problem is for me to find a doctor that speaks some English. Luckily I found a good American doctor that is about an hour away from my house, but worth the trip. All the doctors near me, I can't even pronounce their name let alone spell it. Anyway, today I wanted to talk to customer service because the same plan has changed how deductibles are paid. I was paying $50 month for a certain prescription but this year they want all their money up front. So I've already met my deductible. MY Problem is customer service. After going through a dozen questions to verify my identity, it took over 10 minutes just to answer my simple question, "Do I need to pay my full deductible up front"? Even after I finally got an answer she proceeded to ask about other things like self help care and other junk. Coverage is great, customer service is really bad (and hard to understand).
1 year ago Edited January 23, 2023
anita aeverettconsolatore
Excellent for low cost however that means low quality and denial of necessary procedures they have already performed giving me excuses as to why that are redundant .
Spinal arthritis of lumbar ,thoracic and cervical is painful and treatment is exercise , diet , ibuprofen, ice and then injections when that doesn't work .
It transpires into a rhizotomy which kills the nerves of the spine so I can walk .
I can't get one two yrs ago then be satisfied with a letter explaining the injections when I've gone that route already so something is up with the company .
Everytime an overhaul of a company turns them into stupid leading stupid it's always money but healthcare to old people who worked all their lives should not be the victims
2 years ago Edited May 11, 2023
Lashawn Partee Arlington, TX
I have no complaints with them overall they have provided the needed care for My husband and I. Customer service has been good. He even told me that when he needed assistance with finding a specialist that they actually took time with him to call and find a Specialist that could see him. They have also covered all prescriptions. And my monthly premium is very affordable.
3 years ago
Hpalmer Marietta, GA
Maybe it depends on where you live. So far my experience with Ambetter in Georgia has been very good. I can't image how I would have paid for $400 plus a month health insurance right now. Plenty of primary care doctors and specialists here that take it at Wellstar and the quality has ranged from so-so to excellent. (I am in the surrounding suburbs of Atlanta). I haven't needed to get ahold of them for anything yet so I can't rate that accurately.
4 years ago
Sarah Barger Little Rock, AR
I think it must depend on what state you are in. I have Ambetter Arkansas and I love it. I do receive a subsidy so I don't pay a huge premium. I also don't have any major health problems, They are excellent for routine care, chiropractic, mental health etc. I do not have dental. So far they have covered everything without any issue.
4 years ago
Maribel Ruiz
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.
4 years ago
Mary Johnson College Station, TX
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.
4 years ago
Yolander C Henderson Merrillville, IN
Ambetter is a good company. They're prices aren't too bad, and they contact you personally to inform you when certain preventive care is needed. The only thing I have a problem is with new medications. I have severe migraines, and finally an injection that reduces migraine days to at least half of the migraines per month has been aporoved by the FDA, but it isnt covered. I can't afford to pay my Ambetter premium every month, plus 575 every month for the shot I need!
5 years ago
Gloria Etta Hamilton Waco, TX
Even though Ambetter did not approve of physician recommended Bariatric Surgery, because I have high blood pressure and in a pre-diabetic condition, I am still grateful to have the insurance. For the most part, it’s a good insurance to have. My copayments are low on prescriptions and office visits. I was badly in need of healthcare and couldn’t afford it before going to Healthcare.gov. I was in so much pain from Osteoarthritis wearing away at my hip joints. I felt like nobody cared even though I have worked hard most of my life. And I still work. Ambetter is all right with me.
5 years ago
Christopher Primosh Little Rock, AR
Benefits are terrific but, the rewards pays card... I had my hip surgery October 2017, I was going to use the card for my electric bill and November, after 8 months I was finally able to activate it. Between October 15th and January 21st I Must Have Spent at least 3 hours on the phone with these people until I finally gave up just this morning I thought hey I'll give it a shot. I finally got my benefits, the people on the phone with ambetter their representatives had no idea how to activate the card put me through multiple people and then finally hang up each and every time although they did ask for a call back number in which they never called back they were very uninformed
5 years ago
KMS Overland Park, KS
I'm the medical proxy for a friend who had a stroke on 1/8/2018 and his Ambetter policy has performed beyond my expectations. I'm not sure why it's totally subsidized but he pays $0 for an exchange bronze plan (HMO) with a $6800 deductible. Any HMO is going to have fewer providers and more restrictions, but the main problem seems to be that it's new in the market and the provider list changes constantly. Having met his deductible on day one of his hospitalization, the plan is paying for home therapy, nurse visits, and has a decent drug plan. I don't have any problems with the website which is every bit as informative as my own BCBS plan. No major complaints from us.
6 years ago
Jack Lewisville, TX
I'm very sorry to hear the negative stories from other members. I have been fairly pleased with Ambetter. True, they are very picky about who you can see and what they'll pay for. Thus, you definitely have to do your homework up front. You can't just go see the doctor you like; verify they're in Ambetter before you go.
In mid-2017 I became a cancer patient. This included chemotherapy and surgery in 2017, and we had no significant problems with Ambetter. I say no significant, as there were times that we received bills from someone "out of network"; for example, the hospital is under plan, but perhaps the lab they use isn't. However, that isn't strictly an Ambetter issue, as we've underwent that through the years with both Blue Cross and Humana.
Three stars because it could become a bit tricky to find a doc you really feel comfortable with. I like my primary guy, and the oncologists have been great. On the other hand, there isn't a physician out there that my wife is comfortable with.
To conclude: Ambetter isn't perfect, but it's not bad. Do your homework before charges, and even be prepared just in case there's an emergency.
6 years ago
Maria Alvarado Harlingen, TX
All the folks that gave a 1 star need to learn to read to take advantage of the benefits. Just follow the rules . I'll bet this year of 2017 they have paid about $200,000 in benefits with a $600.00 deductible!! Just pay attention to your account on line. Learn to use the online resources . They have several very good providers on network!!! I signed up again for 2018!!
6 years ago
Tamara Canton, GA
I will tell you they are great however-- warning-- you must use their in-network dr's. I was diagnosed with Thyroid Cancer had to get a total thyroidectomy - radiation, etc. They were awesome. I did have to drive about an hour into Atlanta for the right care. They do have some local PCP. If I have an emergency visit to an ER- meaning my local hospital - NO COVERAGE. I have to drive an hour as there are only one or 2 hospitals in the entire area closest to me i troublesome. Just hope no emergencies pop up.
6 years ago
Glad to have insurance Boerne, TX
I have had a good experience with Ambetter, after I digested the fact that the provider directory on the web site is inaccurate & the customer service reps are pretty dumb. I apologized to my GP for being paid poorly and he said Ambetter pays him fairly. They seem slow to approve referrals: my GP had to telephone a few times to get approvals, but the MD staff in referral department was very helpful once my doc talked to them. The plan I have gives $$ incentives for taking their exercise/lifestyle quizzes, for getting a flu shot, having an annual checkup, and the money is transferred to the Ambetter credit card promptly. I am glad to have coverage and I have had no other problems. The monthly bill and the Member Explanation of Benefits is straightforward.
6 years ago
Clair Melton
I've been buying insurance through the ACA for 4 years, after almost 20 years of going without. I get what I can afford, which isn't much. But hey, I'm used to how capitalism works. Normally, I require only basic maintenance services, so my experiences have been fairly uneventful. But this year I broke my arm down at the wrist, which required surgery. While Ambetter was a little frustrating to work with initially (info on the website is outdated, so multiple phone calls were required to find out which doctors/surgical centers to use), once I got the important info from them, I didn't have a single problem with their providing coverage, and doing so at the expected amounts. That's how insurance is supposed to work, so I'm quite satisfied with that aspect. However, I just got notice that my network physicians have terminated their contract with Ambetter. When I look online, it says my nearest gynecologist (for example) is several hours away. So that's a problem. I'll be calling them to see if there are actually some in my city to choose from. Wish me luck!
6 years ago
Bart Harrison, AR
I've been reading all these bad reviews, I have only been on Ambetter since Jan 1 2017, but have had very good service.
I was wondering about Meds I was already on being included, no problem whatsoever.
I'll keep you updated. Happy in Arkansas!
7 years ago
