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 While Ambetter was a little frustrating to work with initially (info on the website is outdated, so multiple phone calls were required to find out which doctors/surgical centers to use), once I got the important info from them, I didn't have a single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

5 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!

5 years ago

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AK Kilani Frisco, TX

many of the PCP listed on Ambetter value 32 site say they no longer accept this plan. Many other listed PCPs do not accept new patients even though the site mentions "accepting new patients"

3 months ago

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Brandon Feldman

Biggest scam insurance company ever. Tells you doctors are in network, they are NOT! Then They blame the doctor for not updating them. CVS does not accept this insurance. I can’t find doctors I want to go to. The worst company! DO NOT get this insurance!

4 months ago

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khalil Hamzeh Frisco, TX

I am still on hold and it has been 129 minutes now just shy of two hours what a joke? The government messed up again. Terrible company all the government subsidi they receive and still the service sucks doctors avoid accepting patients because they are not paid enough I think. The patients here are the victims.

5 months ago

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Missy Carter Mathiston, MS

Crap, crap, crap! I used to love this insurance, but since they have started using Envolve as their benefit & claims manager, it is nothing but crap. They force you to use specialists if you want your meds & devices covered after you jump through hoops. They don't cover any pen needles or syringes. Won't approve a lot of services... & the crapiest customer service by foreign speakers with heavy accents you can't understand! I absolutely hate them now. My health is steadily going down hill since 2021 because of theit stupid ways. All they care about now is the dollar!

5 months ago

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Smriti Abraham Chicago, IL

I would give Ambetter 0 stars if I could. DO NOT use the HMO Illinois marketplace plan. It looks like there are several doctors and many options, but every other provider's information is incorrect on the website. I have spent three whole days calling providers trying to get an appointment, and I have gotten through to ONE, just to be told the earliest availability is two months out. DO NOT USE.

6 months ago

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mark johnston Florence, SC

Worst customer service ever experienced. Put on hold for over an hour while the "escalated" to an escalation specialist who we never talked to. Had to call again while on hold to see if anyone was ever going to pickup. Still don't know if resolved. Just a problem with a copay amount. Hope you don't have a serious issue. will be filing a complaint with state insurance commission. Pick another insurance provider.

6 months ago

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John Cox Sunnyvale, CA

Absolutely the worst health care decision I've ever made. Terrible service, denied ER cost, prescriptions (made by my doctor), refused to pay for doctor requested tests, scans, procedures that my previous insurance paid for without question. As soon as I can change (open enrollment) I will go with another insurance provider. I will never recommend them. If you value your life find another company.

6 months ago

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Pam Erman Dallas, TX

Ambetter refuses to pay claims for routine mammograms and vaccines. My providers have repeatedly provided them with the info requested. Ambetter is a joke! They constantly have some excuse to get out of paying and drag things out too long. Pass this company by and get someone better. This company should not be allowed to participate in the Marketplace!!

7 months ago

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Deep' n tha south Hattiesburg, MS

Paying a premium every month but not able to use my insurance. Everytime they tell me "it's not eligible" even been told by nurses that I forgot to enroll. Just dumb. I need a life threatening surgery and ambetter is making it HARDER TO GET IT. Just might as well go to the e.r where it's free and give the e.r 5 a month. And this is insurance!!!???

7 months ago

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Brittany Maddux Fayetteville, AR

Worst company ever. Literally called 4 times and was charged double, after canceling. The lady answered the phone, “uhh hello” after being on hold for 10 minutes. I couldnt hear her over the child screaming and Still didn’t get my issue resolved. Spent another 20 minutes on the phone today to be told, we just have to wait for marketplace…. Like how are your companies not synced enough to communicate better. Worst service ever.

7 months ago

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Stacy E McGrath Rome, GA

If I could give 0 stars, I would. This is the worst insurance company I have ever dealt with, and that is quite a feat. I am paying for a plan that says it covers services that they are actually refusing to cover. If I had just assumed that my insurance did what it says it does without calling them, I would've been stuck with a $25,000 bill. The customer service at this company is outrageously HORRIBLE. I could write a book on how terrible this company and their customer service has been to me. I would even go as far as to say that Ambetter is a scam, a total scam.

7 months ago

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Maria Houston, TX

If I could give a 0 I would This is review for Ambetter sunshine Florida Has the worse physicians providing service , then not even preventative services like colonoscopy are covered . Is very expensive for people like me that is self employed with good earnings but I get the service like if a homeless .. Make yourself a favor and refuse to pay for this Personally I just cancelled

8 months ago

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anita aeverettconsolatore Ormond Beach, FL

It's a new insurance that hasn't gotten it together yet. I was hung up on 3 times yesterday within a 2 hour period trying to get a new neurologist since it took me 4 months to get an appt and 2 for an EEG they do not do on premises. All I wanted is where they're sending me so I can follow it up and get an appt.!!! The prices and benefits will be great if they can get enough doctors to actually provide Healthcare.

8 months ago

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Gloom Bunnie Fort Worth, TX

They don't deserve a single star. Let's start from the beginning: All of their website information as far as providers is inaccurate. The numbers aren't in service, the Dr's don't even work at any of the offices anymore, and none of them are taking new patients even though the website says they do. So,I call them about this little hiccup.. as far as I'm concerned, stuff happens. I get it. Except, the employees don't even give accurate information. I am on call #6 trying to resolve these issues and getting put on hold just for the calls to drop 15 mins later. They'll try to "fix the issue" so you don't escalate but it's a lie, they don't get you accurate info to fix the situation. Disgusting company, liars, scammers as far as I'm concerned. None of them know anything, none of them fix anything, and I've wasted over $200 in 2 monthly payments alone and still have 0 healthcare because I wasted the entire first month waiting for an appointment just to find out they can't actually take me!!! SHAME ON YOU AMBETTER!! Do NOT get this insurance!!! I'm doing everything in my power to cancel it and not give them another dime, and this is coming from a very tolerant, kind person.

8 months ago

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Heith Gay Las Vegas, NV

Ambetter charges high rates but does not provide even basic care. I signed up for care under the Nevada health exchange and then used their "find a doctor" to set up a physical. I spent 6 hours calling different numbers. The list is so out-of-date that it is a serious burden trying to find a general practitioner. And for those you do get in contact with, no appointments are available for 3 or 4 months. I finally called Ambetter and they told me that I could get an appointment in the next city sooner probably and I should start calling people far away from where I live. I quickly canceled before the policy was to go into affect and Ambetter assured me I would receive a full refund in 7 days. It has now been 3 weeks and there is no way to contact billing. They simply put you on hold for more than an hour waiting for you to give up. Ambetter is a common thief. Avoid at all costs.

9 months ago

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Sharon D. Winter Park, FL

Avoid Ambetter! I did not re-enroll in 2022 because 1) They dropped my primary MD, hospital and others without notification, new providers are not close to my zip code. and 2) Admin. is terrible, the negative reviews are spot on. We had to routinely "appeal" for accurate benefits payments because Ambetter routinely denied stating "out of network", which was not accurate. I had major surgery end of 2021 and can't access 2021 Evidence of Benefits processing because I'm no longer a member in 2022, nor will Ambetter mail. I'm receiving provider co-pays but met the member out of pocket for 2021, and providers should be paid 100%. Customer Service puts you on hold for unreasonable periods, e.g. 1+ hour and often disconnects you. The appeals process is equally dysfunctional. I've contacted BBB and Florida Customer Services.

9 months ago

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Anonymous Chicago, IL

Discontinued membership after being enrolled in a Vision, Dental, and Health Plan. For reference, I live in Chicago and per their tool to find a dentist, I reached out to all 27 listed providers within my area to schedule a check-up. Each of them confirmed that they do not accept Ambetter and do not know why their practice was listed on the website. Members of their practice also called Ambetter requesting information on why they were listed, requested for it to be removed, however, months later it was noted they were not removed. Ultimately, paying $336 a month for vision, "dental", and health seemed like a waste and so I decided to cancel my membership in December 2021. I called to request a cancellation and was also provided a refund in January. In February however, $668 was deducted from my bank account by Ambetter. I called to inquire why and rightfully request a refund. 8 calls later and close to 8 hours of call time, my request was denied because the "pay through" date on their system was February 1st. I pushed back on the call I made in December and it was noted to me that I had to cancel my plan with Ambetter as well as the marketplace for it to fully go through. I called the Marketplace and they confirmed it was canceled in December and their system shows no record of me receiving coverage in 2022. I called Ambetter back and this time it was noted that the call log in December shows that I called to request account cancellation and a refund, however, no cancellation request was submitted (by the representative). I was then told that I should have received a letter in the mail in October noting that I need to take action to cancel my plan and if not, I will be re-enrolled in 2022. They backed out of their initial reason by noting that because my plan was started under"on-exchange", the marketplace would have no record of my coverage (basically their initial reason was incorrect). Finally, I asked what further action would have been required by me to make sure my plan was canceled beyond giving them a call in December to request to cancel it and receiving verbal confirmation that it has been cancelled and I can expect a refund. Furthermore, I was not charged in January and on February 2nd was charged for two months. They could provide no explanation other than my plan was set up to be re enrolled in 2022 regardless of calling to request for it to be canceled in December 2021. I then asked for a copy of an application to re-enroll into Ambetter in 2022 after canceling my plan in December 2021. They were unable to find one. I have still not received my refund and nobody seems to understand the reason for it. They have "escalated" my case twice but I have not heard back and frankly, I have given up on trying to get a refund. Ambetter of Illinois is a scam that misrepresents information on their site from dental providers that offer coverage to lying that a plan was re-enrolled (without having supporting documentation to show the account holder requested for it) and charging bank accounts. Please avoid using this service if you are in Illinois and stick with a larger provider.

9 months ago

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pooh nani Kingsport, TN

Ambetter is literally the worst. I dont know how its legal what they're doing. They'll charge you for plans you didn't sign up for or use, you'll pay for your plan and they'll say they even got your payment but they wont give you credit. They'll take your money, Bill you again, and not give you your insurance. Theres no way this is legal and im looking into fixing this. Getting my money back and making sure they never do this again. They are horrible. They literally hang up on me. I cant even contact them. I have to call marketplace and stride health and talk to them. Ambetter is worse than no insurance. Seriously.

10 months ago

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Elle A Atlanta, GA

I've been a customer for nearly a year and I would never choose Ambetter again. Know the overviews represented on the Marketplace website aren't accurate in terms of cost, in network providers, or cost of coverage. Customer service is insanely inept, they will just read the brochure version of your coverage for you with no ability to answer any problems. The in network providers listed on Ambetter's website aren't necessarily in network (please contact your current doctors directly before signing up for any insurance on marketplace). I pay a high premium for insurance that covers nothing. Every time I tell an office what my insurance is they either grimace, laugh, or contemptuously cut me off. Please only treat this disgusting company as a last resort. I am deeply suspicious of any review left here that is 5 stars as it was likely someone compensated/employed by Ambetter.

10 months ago

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Hal F. Berkeley, CA

The worst customer service I've experienced in a long time. Currently on the 5th call today. I can't connect my account with my login on their website. So far, ticket sent 2 weeks ago and still not fixed. Got a rep that said he "activated" my account, not fixed. Called again and got a phone number to Nevada Health Link, this is not my problem. Called again and was put on hold. Got transferred while on hold then call dropped. Called back, on call for 7 minutes but there's no one on the line. This is where I'm at right now. Got a bill to pay, but not sure if that's happening. Absolutely the worst.

10 months ago

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Maria Tajman Fayetteville, NC

Please be aware this is the worse insurance I’ve ever had. If they had a minus star that’s what they would get from me. Now why I understand most of the doctors in my area do not accept it. Had to drive 2 hours for mammogram, 1 1/2 fir colonoscopy ( which by the way they are trying for me to pay 500+ out of pocket because supposedly it’s not preventive, did I understand correctly? Colonoscopy after 50 is to prevent colon cancer, right ?? They refused to pay for an MRI that I needed for approval on a epidural shot I needed which I had to pay myself out of pocket and they still did not approve it!! Nevertheless I changed to United Healthcare at beginning of this year and after seeing my MRI and X-rays approved it right away. Never ever again I would use their services

10 months ago

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Steve D Overland Park, KS

Jan 2022: I'm a brand new customer with Ambetter - Kansas and... Dropping them already! In Dec 2021, before signing up, I confirmed by calling Ambetter Customer Service, that my physician was in plan and my daughter's pediatrician was in plan. I was told they both were. Yeah! Now 10 days into January, I cant assign either of our physicians as the PCP using my online account, can't even find them in plan. Called Ambetter C/S and was "escalated" to the Resolutions Dept. I was informed both physicians are "Specialists", not PCP's and unable to be assigned... WTH? Nice to have known that about 1 month and a over $1,000 ago.

10 months ago

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Michelle Coatesville, PA

They charged my credit card twice and never gave me a member number or account. When I called multiple times to try to resolve it they said they could not find me in the system. The foreign customer care couldn’t understand my name despite me spelling it many times. He gave me a number to help me, which I found out after dialing it was to healthcare.gov. I didn’t purchase through them so that was pointless. The next person transferred me to a number that hung up on me immediately. At this point I had to dispute the charges with my credit card company because I could find zero person to actually help me. Needless to say I won’t be moving forward with Ambetter, this felt much like a scam.

11 months ago

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MAXINE POWELL Riverdale, GA

Ambetter is a rip off. I have been paying over 2 years for my sons. I just happen to call Market Place and they informed me that I was that I was not supposed to be paying a premium for the past 2 years. I reach out to Market Place to update information and this was when I found out. I have tried calling Ambetter 5 times and they hung up on me, when I explained reason for call. I did ask for legal department to discuss reimbursement and they did not have number. Still cant get help so I will be reaching out back to Market Place see if they can help me get over $1000 back that Ambetter took from my account each month. At least $40 month.

11 months ago

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Bri Dee St Louis, MO

By far the worst insurance I've ever had. Moved states, and literally zero PCPs available. Cannot get in to see ANY doctor. The few doctors that do take this insurance are low-income clinics where you're getting the worst quality care... But like I said, haven't seen one of those in months because NONE OF THEM ARE EVEN TAKING PATIENTS. I'm paying for insurance I can't even use. I get sent an explanation of benefits I didn't ask for every two weeks in the mail, even though I'm signed up for paperless everything. No one can seem to figure out how to get them to stop sending it. The site never works, customer service is a joke and they will hang up on you if they can't figure out what you need. Lost coverage for a couple months and lost access to my therapist because Ambetter screwed up a billing issue. Never paid late once. Please, if you care about your health, don't bother with this company.

11 months 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!

1 year 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.

2 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

2 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!

2 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

2 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.

3 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

3 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.

3 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.

3 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.

3 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.

3 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!

3 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!!!

3 years ago

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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.

4 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 .

4 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.

4 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 !

4 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!

4 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

4 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.

4 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 .

4 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

4 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.

4 years ago