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Ambetter

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5.5

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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 While Ambetter was a little frustrating to work with initially (info on the website is outdated, so multiple phone calls were required to find out which doctors/surgical centers to use), once I got the important info from them, I didn't have a single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

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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

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rick hearn

Government Bait and Switch backed company. The worse customer service in the world, reps not able to answer simple questions due to the fact they have awful English speaking abilities. Would not use under any circumstance

3 months ago

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Jack Black Toms River, NJ

The worst insurance you will ever find. Not accepted by most healthcare providers, people don’t even know who they are you will constantly be doing a run around. Customer service is terrible and horrible coverage biggest mistake please choose otherwise.

4 months ago

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Brittany

They have overcharged me 3 times it is a monthly occurrence and it impossible not to get customer service to be able to help with anything I had to file for fraud because they were supposed to refund me told me they did and they never did

5 months ago

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R D Catoosa, OK

While trying to find source of leg pain (Sciatica) via abdominal x-ray an Abdominal Aorta Aneurism was spotted. AMBETTER has fought tooth and nail to prevent this from being confirmed via a CT scan with contrast requested by my PCP. I literally have a less than 40% chance of surviving if this bursts and they do not feel it is life threatening - what a worthless company and should be investigated

6 months ago

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PMN

They told me I had to pay my first premium by August 4th in an email; then, when I went to pay, they told me my account was CANCELLED because it was supposed to be paid by July 31st?!?! Now I'm screwed out of health insurance until open enrollment. I tried to get reinstated, and they denied it! BS! Way to be disorganized and blame it on the customer! Imagine how bad they are with everything else if they can't even give you the correct enrollment information, and then you have to take the punishment! I wish there were more places to write bad reviews online so everyone could avoid them!!!!

7 months ago

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Cec Chicago, IL

I just got back from the pharmacy where, if I used my Ambetter insurance, I would have paid $172. But the kind pharmacist told me that if I pay out of pocket it would only cost $45. Ambetter is the very worst insurance I could imagine. They have denied most of the health care that my doctors believe I need. Ambetter is all capitalism, no healthcare.

7 months ago

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KH Roanoke, TX

I HATE THIS COMPANY AND WILL NOT SIGN UP WITH THEM AGAIN!!!! First of all, their crappy insurance isn’t cheap!!! Second, they aren’t set up to receive funds electronically, so I have to send a bill pay from my bank to them. Third, I GET SICK OF HAVING TO ANSWER FIFTY F’IN QUESTIONS BEFORE I CAN GET MY QUESTIONS ANSWERED BY SOMEONE IN A FOREIGN COMPANY!!! Fourth, there aren’t enough doctors, dentists or eye care providers in this plan. I CAN’T WAIT UNTIL OPEN ENROLLMENT! I WILL NEVER PICK A NEW, NO NAMED COMPANY AGAIN!!!

8 months ago

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David martin

Truly shocked that Ambetter has turned down an MRI request from a specialist and a cat scan from the healthcare provider both doctors specializing in female specific issues. My wife has been in pain for 6 months and having to take otc painkillers daily. Ambetter does not care whether a patient drops dead only if they cost money. Next stop with be ER which costs more for Ambetter but seems they prefer this. We recommend not using Ambetter.

8 months ago

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Southern Yankee Wake Forest, NC

Do yourself a favor and DON'T FALL FOR THIS COMPANY'S PLANS. They use overseas customer service reps who DON'T speak English well at all; you can not request a native English speaker - they just tell you to hang up and try again. I am of the opinion that there ARE NO native English speakers there. As well, their CS reps are not well versed in how to use the plan. I am currently signed up with their Gold plan with the virtual PCP - which, according to the website, there is $0 copay - until you actually make an appointment and guess what? It'll cost me $75 for an appointment. What a crock of crap! The plan supposedly gives me PCP appointments at $20 copay but guess what? Nope. You gotta pay full price and hit your deductible before that kicks in. It's a farce from Day 1. Can't wait 'til open enrollment to get out of this plan.

9 months ago

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A. P. Alvin, TX

Absolutely terrible insurance company! They used to be better. The customer service department is poorly trained. It usually takes several representatives to answer any questions and the calls are long because the reps do not know how to answer questions. The network of health providers is small and the coverage has declined this year. Last year, a colonoscopy was covered yearly and this year it is covered every 10 years unless you are at high risk! The premiums have risen this year, but the coverage is lower. They do not cover some basic preventative care such as mammograms for younger women. I DO NOT RECOMMEND THEM!

9 months ago

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Phoebe Thomas Braman, OK

If I could give a 0 stars I would. They took a payment over the phone for 2 months then they took it out again 3 days later then said they had no record of it. Told me I had to wait 72 hours and call them back. Waited the 72 hours called back and they asked me to prove that that they took it out twice so I emailed them screenshots of the transactions while I was on the phone with her. She said she put in a refund for me. I canceled my insurance with them. Called back 2 weeks later and they are telling me I never requested a refund and would I like for them to. I asked if it was their policy to keep overpayments on customers who have canceled and she said no. I said well of course I want a refund. Said it would take up to 30 days. THESE PEPLE ARE THIEVES!

9 months ago

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Raymona Green Raleigh, NC

If I could select less than one star I would. AMBETTER is the worst! Do not waste your time or money. This company definitely has proven they are for profit only. They offer lier monthly premiums but you pay hirer cost for medications and Medical office visits; including, Tele- med calls. If you need specialty care ; you can just forget it. You’ll pay dearly. A day late with your premium and all cost are on you. Even if you have diagnoses that will cause you additional harm or risk of death, this company does not care. Customer Service Reps are incompetent, and reaching a English speaking person is off limits. I can go on forever telling about the greed and horrible service this company provides. PLEASE DO NOT WASTE YOUR HARD EARNED $$ WITH THIS ORGANIZATION!! YOU’LL REGRET IT! They do not care about providing better care or services to anyone. But they will gladly take your money.

9 months ago

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OF Clearwater, FL

Horrible! I had severe pelvic pain and had no choice but to visit an urgent care facility that wasn't in their network thus paying out of my pocket. No problem. The Dr suggested I get a Cat Scan "Stat" to figure out what was causing my debilitating pain. I decided to go through Ambetter in order for them to pay half the cost. I spent 4.5 hours total on the phone calling over and over again trying to get them to authorize the service. Nobody could even figure out how to get a Pre Authorization form to the urgent care office. It was insane! After all that time, I learned that Ambetter will not authorize the service unless I see their doctor first, even though the Dr at urgent care stated it was urgent that I get a Cat Scan. Needless to say, I was extremely frustrated and felt no choice but to go through with the Cat Scan without going through Ambetter and I paid the full price on my own. A month later, I decided to make a gyno appt. I called 9 doctors listed on their website. 6 of them are not actually in the network even though they were currently listed on the website, one was for emergencies only and one didn't work at the office listed. The other three weren't accepting new clients or had a wait time of 2 months out. Their website is incorrect. This has been a waste of time and money for me. I had my membership for 5 months and I wasn't able to use one single service.

10 months ago

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Bri Peterson Tampa, FL

I hardly write bad reviews, but I really dislike my coverage with AmBetter. The website is unbelievably glichey, same with the customer service. I've never gotten anything resolved on the first try, and have actually just given up on getting help multiple times. The rewards card doesn't work. I can't log into the site half the time. And I'm in the insurance industry and help people with their coverage, but I have a hard time finding answers to my own coverage. None of the doctors I want to see with good reviews are in network. They don't cover a lot of preventative or alternative care. Just don't do it.

10 months ago

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GGS GGS Umatilla, FL

I would rate this lower than one star if possible. Customer service is off-shored which makes communication difficult at best. I needed to know who in my area was In-Network as a Durable Medical Equipment provider and was given the names of four companies. This is after two seperate calls trying to explain what a Durable Medical Equipment provider was. I called all four providers and they all told me they do not work with Ambetter. I called back and was given another name to call. They explained they did work with Ambetter but only for members located in Michigan and I am in Florida. I am paying for insurance but cannot utilize the coverage, what a SCAM. Please do not sign up for coverage with this company, you will be sorely disappointed if you need coverage.

11 months ago

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Liz F Ballwin, MO

I have had Ambetter for all of 2021, 2022, and now for 2023. Something has shifted over at Ambetter. During my first two years of coverage, I was amazed at how good it was and I raved to all kinds of people. Sure, I had to switch to some new physicians, but that part turned out very well. The problem in 2023 is that my prescribed meds are consistently being turned down, even after my physicians appeal the denials. We are not talking about expensive drugs here. If there is no generic available, Ambetter will deny it even if it's only a hundred dollars. I have a lot of conditions for which I'm on maintenance drugs. These meds, even cheap cheap generic ones, are now not allowed to be filled for ninety days. Why??? Now I feel like I'm at the pharmacy every week just to keep my meds on track. This makes me feel like a sick person, which maybe I am, but I like to pretend I am well. Another thing, which is a big giant thing, is that my premium went up 30-40 percent and my deductible and out-of-pocket more than tripled. TRIPLED! My out-of-pocket is now approximately 30% of my annual income. Not sure that part is exclusive to Ambetter because all of the companies seem to be even more costly. I don't qualify for other gov benefits because though my income is low, I have assets (retirement funds). I'm only 57, so this is not a good time to begin draining my retirement, but Ambetter is leaving me no choice if I want to do anything, like EAT. So much for "affordable care". I'd recommend choosing a different insurance company, but I am completely priced out of that option. Ambetter is the devil I know. Unfortunately.

11 months ago

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Tanny PC Phoenix, AZ

We just took Ambetter insurance for the year 2023, as we changed from Cigna (one of the best), and in the first month itself we understood that Life’s gonna be a hell now. Every time before our visit (or for my kid), I get a call from PCP’s office saying that “Their maintenance site is down.. so you need to pay from your pocket.” Or “Your status is inactive.” And so on… Horrible customer service and poor website framework. There’s no email ID even so that we can resolve an issue with proof of documents that both parties can attach for clarity. Knock knock.. AmBetter $800-1000 per month is expensive for a middle-class person. If you take the money, make your deliverables effective or lose customers. Thanks!

1 year ago

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Dave & Diana M Shawnee, KS

I've had a Silver plan with Ambetter from Sunflower Health Plan for several years. The insurance itself seems to be okay. The real issue for me is their customer service and website issues. I have the auto-pay set up. Every open season I apply through the ACA/Marketplace insurance. My income always changes slightly. This generates a different monthly premium tax credit from year to year and so a different monthly premium and a different member responsibility (actual member payment). Unbelievably, the way their software is set up, since the Auto-pay then is different, Ambetter will not draft a December EFT. This generates a "Notice of Termination Risk" notice on your account because they did not receive the January payment!! They don't "receive" the January payment because THEY did not process it!!!! Then the Risk Termination letter takes weeks to receive this in the mail, IF you have mailings set up. Otherwise, you only know this by noticing on your December bank statement that the payment for January (paid in December), did not process. So... this means you have to call Ambetter. You see on their website a "payment amount" that is ALWAYS incorrect/always more than the sign-up on Marketplace website. This amount is completely irrelevant! You have to go to the "Invoice" tab see the actual amount that SHOULD HAVE been drafted, tell the customer service rep this and make an over-the-phone (or online) one-time payment of the correct amount. Then you have to verify that the auto-pay is still set up and then log back in in a couple of days to make sure customer service rep did process the January payment. Then at the end of January, you have to log back in to verify that the January payment was drafted and Auto-pay still processing correctly! The customer service rep's explanation for this circus is always unintelligible! It makes absolutely NO SENSE! Really, what a messed-up system!!

1 year ago

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RenoHal77 Reno, NV

After a good 6 months trying to get my online account access in order with customer service, I finally figured it out myself. I was using the wrong email address to log in with even though it was the same as what was in my account. Apparently you can have a different login email than what's in your account for communications. That is so confusing. They didn't even catch that.

1 year ago Edited June 6, 2022

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Peter Morrison Nashua, NH

I signed up in Aug 2021 for a new plan. I have 2 medications that I take and get refills on a regular basis. Both were covered by the RX plan until now. I went to refill both and one was covered but the other was not? I tried calling the support line and spent 1/2 hour talking with someone in the Pharmacy that tried to tell me my deductible has not been met and was the reason. Also, she claim she saw that I didn't refill my prescriptions last year?? I got frustrated and got no real answer. I am now going to look for new insurance once again. This insurance is not cheap the difficult to see what is covered, how much, and what is not covered. Don't waste your money

2 years ago

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Regina Euless, TX

I've had Ambetter Superior (TX-DFW Area) since 2018. I chose them reluctantly (I researched and saw the bad reviews), but they were the most affordable of the very dismal options. The first year was not as bad as expected, but not great either. It was hard finding a doctor that accepted them, the doctor list on the website was grossly inaccurate and customer service was not helpful. By 2019 more doctors were available in the plan and my husband and I miraculously found doctors that we liked so we stuck with Ambetter for the next few years. Earlier reviews are definitely right about them denying claims though, especially for MRI's: I think it is their policy to deny all claims first. In 2021 I met my deductible very early in the year due to a surgery and I didn't have any problem with Ambetter paying for any service after that. However, the premium for that plan for 2022 nearly tripled and we had to downgrade. We chose Ambetter Value plan, after I checked to see if at least one of our doctors were in network. They were...so they said.. so I proceeded to enroll in that plan. Which was the worst mistake I've made so far this year. Our doctors are not in the network and I still have not found a PCP after searching for 3 days. 90% of the doctors on the list were in an Urgent Care facility. I called Ambetter for help, and they read from the same website list...that is, if they didn't hang up or have me on hold for 30 minutes wishing I'd hang up first. Finally spoke to someone today who actually spoke English as a first language and 1 out of the 5 names she gave me actually had a working number, but the earliest appointment was 4 months out. So we have worthless insurance that we cannot change and I, like the guy who reviewed above, will be contacting anybody I can find to complain because this is just not right.

2 years ago

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James Eason Fort Worth, TX

Ambetter must have an entire team devoted to finding ways NOT to pay a claim. I had several problems with them but the worst is this: In an attempt to feel confident in what I was told, I called Ambetter THREE times before my anti-skin cancer treatment (photodynamic therapy--PDT). All THREE representatives told me I only had to pay my $60 copay and NOTHING else. The doctor's office received a pre-authorization letter stating the same thing. A month later I get the bill and am told that I haven't met my deductible yet. For 1.5 years I fought this, going all the way to the Texas Insurance Commission. They ruled that even though Ambetter told me verbally AND wrote a letter to me (after they reviewed my claim) stating that they should indeed pay the claim, they still didn't. In case that wasn't clear: AFTER REVIEWING MY APPEAL, AMBETTER WROTE ME A LETTER SAYING THEY WOULD PAY THE CLAIM 100%, but they still didn't do and the Insurance Commission wouldn't / couldn't enforce it. Ambetter even went back and listened to the recorded conversations and admitted that I was REPEATEDLY told wrong information. Unbelievable!

2 years ago

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briasativa Dallas, TX

I had Ambetter in Georgia and it was great. I never had problems finding a doctor nearby, it covered my prescriptions, reasonable co-pays and deductibles. I loved it! Since moving to Texas it has gone down hill fast. The website isn't working properly. I can't see my Rewards information, there are hardly any doctors available. I live in DALLAS. It's not like a small town or something. All the doctors I did find (that didn't have their own horrible reviews) ended up being mistakes. When trying to make a first appointment they all informed me they no longer take Ambetter. When I called customer service they couldn't get any better results than I could. What happened?! I'm going to have to change plans just, so I can find a doctor to go to. I have no complaint about the actual insurance but if you can't find a doctor it's worthless. Ugh.

3 years ago

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Colleen Sheahan ,

I use AM Better for doctor visits, preventive screenings, and medication only. I have had no issues, also get great customer service help. If you pay your monthly premium, stay in network, and do not need surgeries, this plan will work for you

3 years ago

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Lizzy Puentes Tallahassee, FL

Ambetter is a great insurance for where I resided in South Florida. They have lots of perks that you can gain from a point system they have. They also have a great reward system where you get money back if you have the debit card. That money back can be used to pay any bills you have which is so convenient!

3 years ago

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Jay Cole

There Customer Service is Wonderful I've been very pleased anytime I have needed help in the past there has always been someone to help me on the first try. And for that I am Thankful For

4 years ago

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hem n sah Irving, TX

I was very worried about the negative review. But All the claims for emergency room was processed properly. It was a seamless experience and we had no issue at all. Just follow all the network networks and no issue at all.

4 years ago

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Ken Greenwood Austin, TX

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

4 years ago

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Esmer McAllen, TX

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.

4 years ago

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Olha Auburn, WA

I use Ambetter from coordinated care second year. I have a problem when I want click my login, I haven’t access to my health pays rewards. Every time when you visit your doctor must check information about your doctor work with your insurance or no.

4 years ago

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Yous Ibra Richmond, TX

You guys are scaring me. I just joined AmBetter and had my first doctor visit with no issue. I found a doctor about 5 min away from my house and got my 3 months prescription medication fully covered. May be it is too early to say anything about the company but my first impression is okay.

5 years ago

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John Fort Lauderdale, FL

I live in Broward county in FL, and all the very negative reviews are surprising to me. True, their website is not great, but other than that I have had zero issues. Many doctors to choose from, great prescription coverage, even urgent care. I am sorry to hear the problems people say they have, but again, I have had no problems at all with them.

5 years ago

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Virginia Young Cincinnati, OH

Absolutely the best health insurance I have ever had!I like it so much that when I turn 65 in March I will be using them for my medicare supplement plan. Kudos to your great insurance and service!

5 years ago

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NobodySpecial Temple, TX

I wasted many hours with them on the phone. It appears that their strategy is to wear you out by wasting your time trying to find 1 actual provider out of the many providers that they claim that are in network according to their website, or any other way possible. During a call, Ambetter might help you search for providers, keep you on hold during their lunch break, waste 4 minutes on every call to run you through a long menu before speaking with someone, ask the same 2 questions on every single call, give you a list of providers that do not take their insurance, refer you to somebody else and finally RINSE AND REPEAT until you drop. Call center employees work cheaper than specialists. START VERY EARLY IN THE YEAR, IF POSSIBLE, WHEN SEARCHING FOR A PROVIDER. Don't waste your time trying to pick the best provider yet. FIRST, just confirm that the provider actually takes Ambetter insurance AND that someone has successfully filed an Ambetter claim with them for what you need to have done. Talk to the person that handles the insurance claims at the doctor's office just to be sure. And then, ask them again 2 more times to be sure. If you are lucky, they are correct. Record all calls to Ambetter, if possible, and use an internet phone service that keeps track of all calls numbers and call lengths. After wasting months with them, I filed a complaint with the Texas Insurance Board. Two weeks later, THEY CALLED ME BACK TO HELP FIND A PROVIDER. The provider I chose was one that was on their website for quite a while, but they only recently signed a contract with them. Surprise. My health problems have all been taken care of by a very good provider. I was very lucky! Best of luck to you! Hope this helps somebody!!!

5 years ago Edited September 14, 2021

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Rebecca a Cecil Hernando, FL

THE ISSUES I HAVE WITH AMBETTER IS THEIR IN NETWORK PROVIDERS ARE FEW AND FAR BETWEEN. AMD WHEN I CALL MY SUPPOSE TO BE AGENT HE SOUNDS LIKE HE WORKS FROM HOME AND JUST ROLL OUT OF BED EVERY TIME WHETHER IT IS DAY OR NIGHT. THEN HE ENVER HAS ANSWERS FOR ME SAYS HE IS NOT MY AGEENT THEN GIVES ME HIS SONS NUMBER WHO IS SUPPOSED TO BE MY AGENT ACCORDING TO THE DAD BUT THE SON SAYS HIS DAD IS. SO CONFUSING - I JUST WANT ANSWERS AND GET NONE.

5 years ago

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Tefft Crystal City, MO

I live in Missouri and have had no problems with coverage, copays, payments, or finding a doctor. This past year, I needed several tests, infusions, procedures, and medication. Never had an issue. Hopefully the coverage and copays do not go up next year. I will keep it .

5 years ago

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Tom & Misty Mathein New River, AZ

While I have good health care with Ambetter, their customer service is terrible. I have now been sitting on hold for over an hour and counting.... Trying to get answers to questions is one of the most difficult things I find with this company. In addition, when you send your payment, they do not credit your account right away. So even though it is in their possession, as confirmed by my bank, you can still get a late notice in the mail, threatening cancellation. The processes overall leave a lot to be desired.

5 years ago

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Amal Sweis Little Rock, AR

I wish there is an email address to contact them instead of the useless customer service people that keep answering my calls. I needed a proof insurance for all my family for the year 2017 and I had to call them more than 20 times until eventually I received the papers for all my family except my husband whom they denied he had insurance with them, I found my husband's receipts for most of the year and I want to show them that there is something wrong with their system but how can I do that?! they don't even have an office to visit in my state! Me and my family where unlucky in 2017 because someone in the marketplace referred us to ambetter !

5 years ago

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Harold Ferris Atlanta, GA

Ambetter misled me on 4 occasions, saying that they would cover my child when playing sports for her school. The team coach revealed, in a 3 way call with Ambetter, that they in fact DO NOT COVER my child. The school has secondary insurance ( not primary) and Ambetter will not pay anything unless the secondary (backup) insurance pays first. Even talking to a supervisor (Cathy A. ) at Ambetter did no good. Why lie, Just tell me the truth! You know you don't cover. Don't waist every ones time!

5 years ago

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Sandra Pharr, TX

Don't get this insurance Melissa supervisor in customer service is horrible and won't help you with anything the WORST customer service Ever if you don't want to be ignored and a 0 priority stay away from getting An better coverage

5 years ago

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Rhonda Petrukitas

I have no problems with ambetter in Indiana. My questions get answered correctly. It seems they pay the provider quickly. My husband had to have MRI and brain scans approve. We received in a timely matter. The only complaint I havevisbthr selection of providers are very limited. You have to do a lot of searching find doctors.

5 years ago

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ALVIA TOMLINSON Miami, FL

I have no problems with this insurance. I went to the ER in 2017 and they took take of my bill .I only had to pay a few dollar out of pocket. The only draw back is that my PCP is not in there network .

5 years ago

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Marsha Moore Indianapolis, IN

I was pleased with Ambetter and appreciated my experience with them.I think they are one of the better choices.Thanks Ambetter moving to Medicare.Wish there was as good of choices as your company unfortunately All well didn't meet my needs

6 years ago

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Liss Austin, TX

We had ver little issues with coverage but we also never went to the dr. We only did our yearly exams. What’s upset me with Ambetter is the offered money back rewards for Wellness checks, forms to complete which took 20 mins each, flu shots, etc. We earned $100 and they never sent to us. They told me they sent twice and that my address was my old and that it’s my responsibility to update. Which I had already. They had 6 months to get to me and continued to say because I didn’t update my address. Needless to say all of our monthly bills made to us just fine! Lies from them regarding the address.

6 years ago

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Lillian Thomas

I am so happy that I have Ambetter really didn't have no insurance.. very affordable and very good network provider... I am very please... customer service do all that can to help you find the best provider..

7 years ago

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Kara Ralston Belton, SC

Absolutely awful, I was in a head on collision and wheelchair bound they refused to pay for my wheelchair. Now they're trying to come take the wheelchair I'm literally sitting in. It wouldn't let me leave ZERO STARS

4 months ago

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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

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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.

5 months ago