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Ambetter

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5.5

Overall Score

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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..

5 years ago

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ambettersuck

Would leave zero stars if I could. Every single time I use my health care for anything covered, it is denied until I dispute it. They're even disputing the telehealth provider linked to on their own member portal.

5 months ago

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kasey riley Kansas City, MO

Repeated denials of a non narcotic treatment for chronic pain and migraine that three of my doctors have issued orders for—Ambetter denied it AFTER peer to peer reviews with two of my doctors. I simply don’t understand why…

6 months ago

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Marcus Conner Bentonville, AR

Absolute worst insurance company ever! Avoid at all cost because they’re not worth the cost…even if free! They deny everything when trying to get approved for a procedure and deny receiving info from my drs repeatedly! I cannot wait to get a different carrier. AVOID Ambetter-they are the WORST!!!

6 months ago

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Taa Reeq New York, NY

Where is the zero star. The Ambetter Value Silver 32 plan is the most useless plan. None of the provider showing up on my list by zipcode take value plan so not sure why they are on the ambetter website. You call customer service and they also read through same list of doctors from the website. Clueless now ????

7 months ago

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james martin

I have Ambetter, with dental and vision, problem is nobody accepts it. They gave me a list of providers but none of them accept it. Some of the providers they gave me were actually nursing homes. Then my payment of $624, which is on automatic payment, was taken out twice on February 28th, my due date, and good luck trying to get them to put it back into my checking account. When you call them they say wait 7 to 10 days and check back. Not everyone can afford an extra $624 to come out and then wait 10 days to get your money back. It has been 9 days and still no refund. WORST EXPERIENCE EVER.

8 months ago

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KateB Ashburn, VA

I have now spent literally 14 hours and 25 calls (I'm tracking them) trying to get a relatively simple problem resolved with Ambetter. I had no issues with them last year - I thought they were good. But I have a policy/billing issue with them now - WHICH IS ENTIRELY THEIR FAULT - and can't get it resolved. There are too many departments who don't talk to each other - and no way to get a manager assigned - you have to call into the helpline and start over every time. SOOOO FRUSTRATING. Take your business elsewhere - not worth it.

9 months ago

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Michelle Sutherland Dayton, OH

Absolutely incompetent customer service! They will read off scripts rather than try to actually try to help you. They hung up more than once when confronted with a problem that they didn't want to help with. They demanded we get an urgent care to call them about a bill that was supposed to be covered by their policy because they said it was out of network when their website clearly stated it was in network. Stay as far away from this shady company!!!!!

9 months ago

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Geannie Mitchell IA

Going into my second year, and not happy with Ambetter, I can't afford to pay high premiums, and need some physical therapy, but I have to pay 50% of the cost for each visit, I was told I could change my plan, but I explained that yes I could, but the monthly premium would go up, so it doesn't matter there's a no win either way you go, so I'm not getting physical therapy. Hopefully I can find something better next year

9 months ago

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Amanda Royal Oak, MI

Do yourself a favor and pay just a little more for better insurance. I've learned quickly that doctors who are supposedly in their network are not actually in their network! Not only that, but they aren't accepting new patients even though the Ambetter site says they are. The search feature for doctors is a nightmare to navigate. Customer service has been terrible. I've been "disconnected" several times and when I do get someone on the phone they seem to not have an answer for anything. I can't wait until this year is up so I can go back to Blue Cross.

9 months ago

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Bill Seattle, WA

Ambetter is totally worthless. Don't buy Ambetter insurance. If I could give 0 stars or minus stars I would. They have wasted hours and hours of my life waiting on hold transferring me around and generally not paying. I'm going to fight them tooth and nail. They make me so angry! I wonder how much (millions I'm sure) executives at this company steal from customers in the form of salary and benefits. They offer you some of your insurance payments back in pots and pans or other trinkets you pay for if you take a quiz.

9 months ago

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DocZemanek Ballwin, MO

Ambetter was authorized to take less than $200.00 from our account. They took almost $1,700.00 and are activity trying to keep the stolen money. We’ve called several times and are either moved from operator to operator or hung up on. Two of these overseas operators were caught lying to us about the situation. When a supervisor corrected the lie we were still given the runaround regarding the stolen money. They are an extremely frustrating and untrustworthy company regarding billing.

9 months ago

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Lisa Harvey Newburgh, IN

Beware! A pre-authorization that normally takes 24 to 72 hours has now gone on so long that I have had to file a grievance. Now I am waiting again on an estimated date for resolution. I have spent hours on the phone with “health care managers” trying to get answers to simple questions. They seem reluctant to help. I’m unsure if this is due to lack of knowledge/training or the language barrier with English as second language managers.

9 months ago

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Peter Tomczyk Fenton, MI

Same like most others complaints - network list not accurate at all. Isn't a SCAM to tell lies about provided services then charge money for it and then not taking the claims? We were looking for a podiatrist and out of 4 local ones listed in Ambetter network one only said that "they should be covered ,if are listed in the network list". Month later found out they were not. .... STAY AWAY FROM AMBETTER! We're out and being smarter with our choices of insurance for the future...

9 months ago

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niccole rietveld McHenry, IL

It is so hard to find a provider in network with Ambetter. Their website does not have accurate up-to-date information on the in network providers. I have reached out to 6 of the providers and none of them are in network or are taking new patients. Also, Ambetter customer service agents speak horrible English and instead of transferring you to a supervisor when you ask, they transfer you to the marketplace where you can not get help. All in all, I feel like this is horrible insurance with horrible customer service and I would NOT recommend them!

10 months ago

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Tricia Cavanaugh Utica, MI

I was contacted by an Ambetter "rep" and told I could qualify for a $25/month plan. Of course I was interested in receiving more info & gave her contact info. She also gave ME contact info. Her line remains unanswered. Since, they have removed cash from my bank account. I NEVER gave them banking info! How did they do this??? Attempting to get legally-required Plan Documents, such as Plan Description and SBC. These reviews don't give me much hope...

10 months ago

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RiverPure Soap Company

I have been very ill and even though my doctor called and talked to the authorization "nurses", they still turned down my much needed CT of the abdomen and pelvis that was already scheduled. Now I have to wait weeks in a pandemic for an ultrasound. This is the second time that they have denied a much-needed medical test that my doctor insisted that I need. Worst insurance company ever. If you have any choice at all, do not choose Ambetter. Your life may depend on it.

10 months ago

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Josh Wilson Cambridge, MA

Just wrapping up my first (and last) year with Ambetter. Total amount paid to Ambetter in 2021: $3777.96 Total amount paid out of pocket for healthcare in 2021: $861.16 Total amount paid by Ambetter for healthcare (or anything else) in 2021: $0.00 Ambetter could have given me some solid gold ID cards to hand over with my cash every time I needed to see my doctor and they'd still be making out like bandits. No, not like bandits. They are bandits. This is theft. I've been robbed.

11 months ago

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Sloan Sells Michigan Portage, MI

I really don't give them one star. It's a racquet cheating the members! How they do it is saying a hospital or facility is IN Network.... HOWEVER the doctors in those facilities ARE NOT IN Network...therefore they won't pay. This coat me money. My husband's knee replacement was cancelled. And now, I can't even have a mammo this year because of this. Bronson Hospital that does the mammo is in etwork but not a single radiologist reading it is in network. So therefore if I had it done I would have to pay the radiologist. AMBETTER IS A SCAM.

11 months ago

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Lauren Woolsey Panama City, FL

The absolute Worst insurance provider ever! Family of 8 here. Paying $1260/month for what originally appeared to be good coverage. Long list of "in network providers". Turns out to be a Huge lie and i feel that my family has been scammed. Thankfully we are only 3 months in and Daniel with Healthcare.gov was able to help us on yesterday to have new coverage with BCBS effective 4/1 (25 days away) but i still cant help but being extremely angry with Ambetter for basically robbing my family of $3600 in premiums for the past 3 months. We hadnt used the coverage as we didnt need to until 5 days ago when my son broke his hand and i AM STILL TRYING TO FIGURE OUT HOW TO GET MY SONS HAND CASTED TODAY BUT CANT FIND ANYONE THAT TAKES THIS CRAPPY INSURANCE. There is literally no urgent care centers within 200 miles that take this insurance, NO Orthos within 100 miles that take this insurance, customer service is HORRIBLE when calling ambetter for help. They basically told me "Sorry, that is your problem not ours, you should have checked for providers before agreeing to this plan". The problem is that, I DID!! there was a list of all sorts of different in network providers. You call them and they say the have stopped TAKING AMBETTER because they are hard to work with. Also, because its ambetter, every provider automatically assumes that it is medicaid when it is not!! I paid allot of money for this plan. I am so angry and will get to the bottom of this. Do NOT FALL FOR AMBETTERS SCAM! YOU WILL PAY ALLOT OF MONEY FOR ALMOST NO COVERAGE AT ALL.... THEY PAINT THE MOST BEAUTIFUL PICTURE FROM START BUT WHEN YOU WILL TRY TO USE THE INSURANCE, NOBODY ACCEPTS IT!!! THEIR LIST OF IN NETWORK PROVIDERS IS FAR FROM UPDATED. AT LEAST40 OUT OF THE 42 PLACES THAT WERE SHOWING IN NETWORK ON THEIR SITE NO LONGER ACCEPTS THEIR INSURANCE. DO YOURSELF A FAVOR AND STEER CLEAR OF AMBETTER ALLTOGETHER. THEIR CLAIMED COVERAGE IS A LIE AND THEIR CUSTOMER SERVICE IS THE WORST I HAVE EVER EXPERIENCED!!!!

8 months ago

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Holly Gutierrez Hamilton, TX

I wanted to try Ambetter out because they were a new company that I had never heard of and they were very reasonably priced and the deductible and out of pocket max were very low. My husband and I have a plan with them through marketplace. It was very easy to apply and sign up. I paid my 1st few months premiums and everything was going great. They even paid for the surgery on my shoulder, which had me almost meeting my yearly individual deductible. Around July, I realized that our yearly income was going to be higher than anticipated at the beginning of the year. I went into marketplace and changed it. When I did this, I still qualified for the same Ambetter care 12 plan, but I would be paying more for my premium, which I understood. I found out that my income change put me in a different tier, same plan different tier, I went from the 90% to the 80%, meaning what they would pay. I was fine with all that. But because I had changed tiers, they put me in a new policy with a new policy number. This reset all my deductibles. The 1st several times I called, either the person had no idea how to help me and would put my call into a supervisor, which I never received a call back. Two people spent over 2 hours each on the phone with me to try and get this sorted out. They were on the phone with their supervisor at the same time. At the end of the calls I was reassured by both of these people that my deductible from my previous policy would transfer over because it was the same policy but a different tier. I had also received a rewards card from them for doing different activities in the amount of $50. I had used it some to pay my monthly premium but still had a balance of $30. When my old policy was "canceled", my Visa rewards card on associated with thus policy was canceled as well and I lost that money, which I had spent the time to do the activities for. This escalated over 2 months. In all this time I never received a phone call from a supervisor. Finally, after speaking to someone on the phone and having to tell them for 30 minutes straight that they could not help me and I wanted to speak to a supervisor, they finally got me over to a lady who proceeded to tell me that I was lying about everything that I had been told because I could not provide her the conversation number. She told me she could see all the conversations that I had had but because I could not provide her with the number she could not verify that that's what that person said. She told me that they never transferred deductible that it was my fault I canceled my policy. And that if I wanted to use the rewards card I should have used it before canceling my policy. I tried to tell her that I did not cancel my policy, that it was changed by Ambetter because I had been put in a different tier. But she would not listen. She just kept saying you're right ma'am what can I do for you. And when I would tell her she would say we can't do that, we've never done anything like that before so what else can I help you with. When I ask to speak to her supervisor to her supervisor she denied this request. I did not have a problem with anything but their customer service. Their premiums were reasonably priced, they paid for my surgery with no problem, but the way they treat their customers is absolutely is absolutely uncalled for and unjustifiable. I will not have a plan with them ever again.

1 year ago

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Maddybaddy01 Des Plaines, IL

Terrible customer service. Extremely disorganised and I get different answers from nearly every person I speak with. They take forever to approve claims for treatments of chronic pain. I have terrible knee pain- waited a month for prior authorisation for an injection. Got denied. Never mind I am struggling to function. I was diagnosed with sleep apnea 8 months ago. Still not being treated because nobody wants to work with Ambetter and their process of getting treatment approved is ridiculously difficult. I was told by some medical facilities that they won’t work with Ambetter because it is Medicaid. Excuse me?! I am paying $341 per month, NO government subsidy- for this so called “Medicaid “. Had they disclosed this when they coerced me and basically pressured me into buying them this plan, I would have happily declined. They’re a rip off company who wants to steal your money. Don’t let the cheap benefits fool you. I’m looking into lawsuit options.

1 year ago

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Rachel Y Columbus, OH

I purchased AmBetter through the Marketplace. It was difficult to find providers who would take it and it was very difficult to get a medically necessary knee surgery approved because AmBetter kept denying it for no apparent reason. But the worst part about AmBetter was that I met my out-of-pocket maximum early in the year, so AmBetter tripled my out-of-pocket maximum right in the middle of my contract, even though my income did not increase. They also increased my deductible and copays. I called many times, trying to get a resolution, and AmBetter pretty much said, "Tough, we changed the contract." I have a hearing scheduled for later this month, with a Federal Hearing Officer. It is outrageous that in the middle of my year-long contract AmBetter would just be allowed to change the terms of the contract and put me in the position of paying thousands more than I had anticipated when I chose AmBetter at the beginning of the year. What good is an out-of-pocket maximum if they can just increase it after you meet it? I will never use AmBetter again.

1 year ago

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Kelley-Dan Young St. Marys, GA

100% worst insurance I've had in my entire life. Tiny network. Claims denied for legal modifiers. Have to travel an hour in two different directions for care. Most caregivers only in the covered office 1x/week to 1x/MONTH and are booked until we colonize Mars. Few specialists in network that have rights to any hospital also in network - so can't get emergency care because hospital doctors won't touch current meds and won't communicate with primary docs. Denying claims for random code errors that other insurances don't have a problem with, and refusing to contact the medical office to discuss the problem. Having this insurance is absolutely terrifying and if there was any other option whatsoever for our location we'd bail immediately. We've literally considered moving in order to get new insurance.

1 year ago

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SummerSpringWinter Smyrna, GA

My college age son has Ambetter Insurance in GA. I have Medicare as does my husband, his dad. He is a private pay customer as he doesn't work for a company full time that offers insurance (of course he is a college student with a part time job). My son goes to college out of state. He had an ER visit in FL, in CT, and some tests at a hospital in CT. He is an athlete so this is normal. Ambetter ignored these claims and haven't even recorded them on their claims page of my son's account. We have sent the claims personally, the hospital has sent them twice, We have called Ambetter numerous times and they don't acknowledge anything. But they bill my son $360. a month like clockwork and they never lose that. I wish we could choose a different insurance company but the only other option is Kaiser if you are private pay in GA which would not help as there is not a Kaiser Hospital where he was in school and where he is in school now. Also his pediatrician in GA is not in network with Ambetter. The insurance is worthless. I've never seen insurance this bad. I've never seen record keeping this bad. It is October and the claims have not show up for activity in April or May or anytime for that matter. Don't use Ambetter. GA needs better options.

1 year ago

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Neville Mistri Berwyn, IL

My wife and I pay about $1500/mo for incredibly subpar coverage. I don't think most people could even fathom how bad this company is, so let me give a few examples: - Often when I try to login to my account it's locked on the first attempt. If I send for a link to unlock my account, the email rarely comes. A representative once told me they almost never do. If I call the number on my card I get a long wait time of course, but wait there's more. When you finally get to a representative, seriously probably 30 - 40% of the time they'll tell you their system is down, so they can't unlock your account either. I think they’re on Windows 3.1. So they cannot unlock your account, and you cannot look for a doctor in your plan. That's not subpar service that's literally the definition of no service. I've gone through this several times. - Twice now my wife has had to spend hours calling Ambetter and her doctor to try and get them to pay for a mammogram. Even initiating a conference call with them both. I believe both times it took 6 months plus to resolve that simple matter. - I’ve lost count of the number of times the phone disconnects on you after substantial time on hold, or it just throws you into voice prompt loop to nowhere where you’ll be repeatedly asked to enter your personal information. - Oh and even though we've been with Ambetter for a few years now and had the same primary care physician the entire time whenever we're talking to a representative they can't find her in their system. So don't forget to get your doctor's NPI number so you can give it to Ambetter. Anyone can look it up on the web, except for Ambetter apparently. I honestly can't even believe such a company exists. They make Comcast and AT&T look like superstars. I would really only use them for major medical coverage if it’s your only option. After the $15,000 deductible they may pay if you can get through to someone, and they can find your doctor.

1 year ago

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Mikieme Phoenix, AZ

Grievance after grievance .... nothing resolved .... then bang ... sir the podiatrist removed your female parts from your toe it has been RESOLVED your toe had female parts and a heart valve ..... Wow .... you cant make this s#$t up.... so what good is it to file a grievance... and oh yeah ... sorry but I cant find a grievance on that .... again WOW! Over a year and head of grievance to fix my account so I had my pcp and not a default pcp. .... Taiwamo not English no stateside you have no problem now ok ... yes I do you did nothing ... I fix problem for you you happy now ok and hangs up...or.... Supervisor call you ... never do... doesnt say that in notes ... well it says that in the phone recording... a Supervisor will call you NEVER HAPPENS... COMPANY IS A JOKE AND IM EMBARRASSED TO ADMIT THEY HAVE PLAYED ME SO LONG....

1 year ago

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Raymond B.

Signed up for Ambetter 6 months and didn’t have to use the dental option until now. My wife had an excruciating tooth ache and I needed to find a dentist who accepts the plan. Called customer service, after 20 minutes of trying to get through, and I get a list of dentist who take their dental plan. The representative says you have to tell the dentist office it’s billed under Envolve dental. Sounds simple until I call the list of dentist to make an appointment, of course either no one accepts the plan or the numbers are disconnected. Most of the dentist I talk to tell me they haven’t accepted that plan for years! At this point I log on to the Ambetter website and just start calling down the list, regardless of distance or reviews. Same results…….nothing. Finally into day two I call back to Ambetter and speak to the 4th representative and guess what? I’ve been giving the wrong information the whole time, the dental provider they use is not Envolve but another carrier. Which explains why, after countless hours of calling every dentist, I could not find one who took the insurance. What a waste!!!

1 year ago

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PSDTennessee Rogersville, TN

I've had Ambetter coverage for about 3 months now. Here's a typical experience for me that just happened today: Called to check the cost of a procedure (can't do it online as their website is broken and has been since I first signed up, when you search for the cost of a procedure, it comes back with the result "nothing within a 100 miles of your location" no matter what you search for). It takes just over 5 minutes each time for me to navigate the automated phone menu and talk to a live human. I finally reached someone and she had me review all of my information, including a phone number I could be reached at in case of disconnect. We, of course, get disconnected. I wait for a call back that doesn't happen. I call back, spend 5 minutes navigating the automated menu, finally get a human again, only to find that there's a really bad echo on the line. I ask the agent to call me back and she says that she's not able to place outgoing calls. Excuse me? She tells me she can understand and we continue despite me having to pause every time I say something to let the echo die down. I get the normal "please verify all of your information" questions even though I'd already answered them 4 times in the last 2 days. And then she asks "what number can you be reached at if we get disconnected?" I say "but you just told me you can't place outgoing calls?!!!" Her response? "Ma'am, it's just a field on my computer that I have to fill out before I can continue." That conversation sums up Ambetter perfectly: customer service reps responding by rote, no empathy, simply a script to follow, but no actual follow through, a computer system that's broken that no one bothers to fix and after all of my time spent, I still had the same unanswered question. No matter how cheap the price, this company will never be worth it.

1 year ago

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Sam Pennington Ada, MI

If I could give Ambetter ZERO stars I would do so. They delay, delay, delay paying providers for services that were given PRIOR AUTHORIZATION. I was billed the total cost ($9,100) of a procedure by my provider when, after 6 months, Ambetter was unable to tell the provider when they would receive payment. The customer service agents give conflicting information about providers being in network, or out of network. I have spent HOURS on the phone with Ambetter attempting to make sense of the information that I get via the website, or in the EOB'S I receive in the mail. I have filed complaints with the Insurance Board of my state, as has one of my providers. There is a reason that this company has the cheapest premium on the Marketplace.

1 year ago

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Mike Ungar Miami, FL

I would give them negative 5 stars if I could. After using their crap service, I finally switched over to another insurance provider. When canceling, I requested a refund for the month ahead I had paid in advance. They said no problem and issued the refund. I had requested the refund to be by check as opposed to the credit card the payment had been made through. I was told it's not an issue and would be sent in 7 to 10 days. Fast forward 4 weeks later and no check received in the mail. I called in to find out where it is and they informed me that they determined that day of refund request that they can not send out the check and the refund can only be returned the the credit card payment they received it by. So my question to them was 2 fold. 1: why than have you not returned the refund to my credit card if that's the only way you can do it? 2: why has nobody called me to tell me this after 4 weeks of waiting for the check? The response from the manager on the phone was that it was my responsibility to call them and ask them if my refund request would be honored by check. They denied the request by check the day they told me it was approved yet expected me to know that information telepathically and call them and tell them to send the refund to the initial card instead. 4 weeks later no phone call from them or email or text ot anything and I have to wait another 7 to 10 business days for my money to be returned when it fact we know they can easily return in the same day. And than to blame me and put the responsibility on ME for not calling in to find out? I lost it with these guys. Do yourselves a favor and stay away from these crooks. Better go find yourself a different insurance company. Litterally anyone else. Don't say you weren't warned

1 year ago

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Marty Novak Tucson, AZ

Ambetter is the worst. I have a very high deductible. I am not even close to meeting that. I need an MRI for a spine I already had fused, but is having problems WHEN I PERFORM MY DR. PRESCRIBED PT AT HOME!!. They will not authorize the MRI because they require 6 weeks of PT, the same PT that is causing me nerve problems, before they will authorize the MRI. They would not have to pay one cent for this MRI, as it is all out of pocket for me at this point, and are unwilling to negotiate an insured rate for me to pay out of pocket. A lot of doctors don't accept their insurance and now I know why. Don't waste your money.

1 year ago

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matt Seattle, WA

The worst part of getting food poisoning was having to deal with Ambetter. Sure, I experienced debilitating pain and frequent vomiting, but that was nothing compared to what Ambetter put me through. They repeatedly told my health care providers that my coverage had been cancelled, while telling me that it was still active. As a result, every time I sought care from Ambetter's emergency nurse line, I was refused help. It took repeated calls and hours on hold just to get taken care of. That frustration, fear, and helplessness was far more distressing than the intense pain that I experienced. Given the choice between food poisoning and Ambetter, I'd take food poisoning.

1 year ago

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John B Concord, NH

After losing my job and health insurance with the Covid layoffs I signed up for Ambetter NH Healthy families. It seemed to be a reasonably priced plan at $344 monthly. With the unemployment insurance when I did my taxes, and was declined the tax credit it came out to $794 monthly with a $6000 deductible and maximum out of pocket. I had met my deductible and maximum out of pocket by November 20, 2020. I had to go to the Emergency Room on December 24 by ambulance. My plan clearly states that after the deductible and out of pocket are met they will cover 100% of ambulance BOTH in network and out of network. On a $864 bill they paid 465 and said that the rest was my responsibility. I called to discuss this, they spoke with me for half an hour, gave me a reference number to refer to when calling back in a week. I called back and it was like I was calling again for the first time. The operator I spoke to kept communicating with her supervisor, who first said that I used an out of network ambulance and that was the reason for them not paying. When I explained that it didn’t matter according to my plan’s coverage, and says exactly that on my portal, they said “Well that’s the most the insurance company is going to cover for an ambulance. You have to pay the rest yourself”. They are completely dishonest, what the policy says totally doesn’t mean anything. I want to file a complaint with the Better Business Bureau. They should be put out of business. I’m not paying the bill, since I’m 100% right and have it in writing on my plan page. When the collection agency gets on it I’m saying it is not a legitimate claim.

1 year ago

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Kristy A. Cuyahoga Falls, OH

I would give 0 stars if I could. It is the WORST insurance I have ever had. They deny everything including a preventative mammogram which in order for them to be a part of the Affordable Care Act they can't charge for preventative mammograms. Customer service is horrible. No one ever knows anything and you can never get any answers as to why they deny the claims. And you will get a new reason every time you call and talk to a new representative. AVOID this insurance at all costs!!!!!! It isn't worth the low premiums because you will pay for every service and they will cover nothing. I got their best plan at $426/mo and they still don't cover!

1 year ago

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Jessie B Chicago, IL

Working with ambetter customer service for almost 3 months was the worst customer service I have ever experienced in my life. The employees take your number in case you get disconnected, however they do not call back if a disconnect occurs. On more than 5 occasions, I explained my situations and got hung up on by customer service because they seemingly didn’t want to deal with the complexity of my situation. This was not a disconnect, they had my number to call back, they sounded unpleased and you could hear a phone click every time. At times it was me asking to speak to a supervisor, as soon as I asked to speak to a supervisor, they would hang up the phone. Never was my situation ever handled by the same person, which made this a hundred times more difficult. I spend so much time retelling and retelling this story to new employees who had to be caught up on the situation, only to try the same thing that the last employee tried and then to say good luck and part ways with nothing changed. I was a huge inconvenience trying to get my money back for the time period in which I could not use my card, not to mention the time I took every day to try to resolve these matters. No reimbursement was ever given. To top it off, most the doctors listed on the ambetter website are fake or old listings. I paid additionally money for a ambetter dental plan, I was unable to ever go to a dentist because the dentists listed on their site either don’t work where ambetter says they work, they don’t actually take ambetter insurance, they work in an entirely different state, or they are no longer in business. Please see the examples below. These fake listing are not just in the dental. They have occurred in PCP, physical therapists, and chiropractors. Filed a BBB complaint, and when they did get back to me they investigated everything 3 months after. I could not use my insurance all of January until the 28th when they finally gave me the card numbers to get my meds at the pharmacy. Since I finally could use the card on the 28th they said I had to pay for the full month of January and they would not reimburse me. Not to mention still never being able to see a dentist when I paid extra for a dental plan with them because of the fake doctors listed on their website. Over 20 dentists in my area are all fake listed and DO NOT TAKE AMBETTER. Save yourself money and stress and do not ever get this insurance. They do not even pay for basic labs that other insurances do. If you get normal physical blood work done it is gonna cost you 300 dollars. Even my pap smear cost money (a service that is something to be covered but ambetter always finds a way to make you pay something). They will never care about their members even if you are on tears on the phone crying because of the damages done to your health when your insurance was "active" but they wouldnt let you use it for 28 days. I could have died and their response was well you used it on the 28th so we will not reimburse you anything.

1 year ago

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Katie Spring, TX

My husband went for annual wellness exam. He received a bill charged to his deductible. Contacted the provider and she said that she correctly submitted the preventative codes. Filed a complaint with Ambetter since Oct 2020 until now ( March 2021). Every time we submitted the complaints and we received back a letter saying that " we will mail the answer to your complaints within 30days" ! Nothing happens but just some random person gave me different (verbal) answers. I spent so much time to work with this issue and no solutions yet. This complaint/Grievance department service is really horrible. Stay away from this company if you don't want to receive a surprise bills and no-one seems responsible for complaints filed.

1 year ago

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Cayamarie Springfield, MO

Had no issue with ambetter the first like 3/4 yrs I had it. It was somewhat of an issue finding a provider. Come this year, I went to pick a prescription up to which I had to pay in full. I called ambetter, just for them to say that I was missing a payment. A $350 payment! I had absolutely no clue where it came from. Then I got February's bill and it is $400. I called once for them to tell me that my account was terminated then again that same afternoon (their system went down and had to call back later) for them to tell me that the $400 is what I pay a month. I should have reviews before getting it. I'm just gonna be canceling it. Hopefully I can, but seems to me I will have issues with it (from reading other reviews)

1 year ago

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Disgusted Lincolnton, GA

This company is breaking the law and getting away with it. Under the Affordable Care Act they cannot cancel insurance except for non-payment or fraud/misrepresentation. Cancellations require a 30 day notice in writing so that the usered person can obtain another plan through the Marketplace as a special enrollment. In my case, as of January 2021, they have deon neither, and I am now out of the blue, in the middle of a pandemic without health insurance. I had coverage with them in 2020, and used it for vision, dental and general doctor checkups. Finding anyone would that take this insurance proved a challenge initially. I paid for a new similar plan (with increased premiums and increased co-pays/deductables of course - pay more for less as always) via the Marketplace in November to start January, 2021, and paid by credit card my firs month's new premium in December. All seemed ok, Ambetetr sent me a new Welcome 2021 pack with plan and new insurance cards with Coverage Effective from 01/01/2021. On january 17th I presented my new card to my pharmacy for my refoill for high blood pressure medication, and was told my coverage had been 'cancelled' - so I had to pay in full for them. I have never missed a monthly payment or co-pay or anything, and have copies as proof from their statement/billing on their website. The following day it took 3 calls to Ambetter and 3 calls to the Marketplace to get NOWHERE. The Marketplace says I have a plan that Ambetter has cancelled but no reason has been given, so I can't simply enroll in a new one, they also say I have to deal with Ambetter about this. Ambetter, of course, tell me I have to deal with the Marketplace. The worse thing is that each of the three different customer service agents I spoke to at Ambetter eithe lie, do not know whatt ehya re doing and ALL refused to pass me to a Supervisor when they admitetd there was nothign they could do. One stated I didn;t have any insurance for 2021, and denied I had a new card for 2021 from them wheich I had in my hand! One said he'd speak to a superior and put me on hold and after 20 miutes of loud call waiting music the call was, surprise, surprse, terminated his end. He said he would call me back, but did not. The final customers service agent was downright rude and evasive, and said they would transfer me and actually only sent me back to the Marketplace. Ambetter has 'cancelled' my new policy for 2021 for no known reason whatsoever, which was purchased through the Marketplace but did not notify me, they returned my first month's paid premium online halfway through the month as if by doing so this made the customer just disappear. I have now had to make appeal through their system which I doubt will result in anything, and one through the Marketplace. I recmooned anyone having trouble with this company do the same, perhaps even lawyerup as their breaking the law as regards their requirements under the Affordable Care Act, 2010, might be worthy of a class action suit - I am sure they are doing this to others all over the country. I have written to the CEO of the company as below, again, I recommend anyone do the same. Point out their own words, which is the very opposite of how it seems Ambetter treats its customers. I suspect they are an Obamacare mohey-grab set-up to pocket as much of anyone's tax credit they can get + premiums paid whilst providing almost no true health care to their insured. This must be the end result of the Affordable Care Act, a clever ruse to transfer tax dollars and pooer people's hard-earned money to the already wealthy. Nothing changes, does it...

1 year ago

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Penny ,

Giving 1 star but the company doesn’t even warrant that. This is the worst company I have ever had. In the 40 + years of dealing with health insurance companies they are the worst. Since our health care system has been ruined I have been stuck with this company, no other companies participated in the county I live in. High cost over $1500.00 monthly w/ 16k deductible. Customer service is terrible, cost is high, I have been trying to resolve an issue of overpayment for more than 60 days and get the run around, am told first person dropped the ball, I am taking care of it only to have the ball dropped again, 4 people no resolution no return calls from anyone. It’s no little matter either. Do yourself a favor and avoid this company, if you have a choice any other company would have to be better. Next step fling a complaint with the dept of insurance at state level.

1 year ago

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Paige White Kennesaw, GA

Getting pre approval has been a nightmare. 15 bus days to approve all procedures or care has left me in immense pain for over 2 months because each new procedure has to go through a 15 day process. Office staff confirmed only ambetter has such terrible requirements. I wish I had stuck with Kaiser because I would not be living on meds daily while I wait for the procedures I need. Also don’t believe them when ambetter says the delay is because the doctor office doesn’t file correctly. Ambetter told me this about multiple different providers and after being on hold for over 2 hours a rep finally told me the only way to bypass the 15 day approval wait period is in the case of life or death.

1 year ago

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Michelle Hefner Cedar Creek, TX

Do not choose this company!!!! They are completely inept. They charged me for insurance for 6 months and when I went for a checkup, I was told my insurance was inactive. There was never any communication and they continued charging my credit card each month! After many hours of conversation, they refunded my money in November. Today, I received an email saying, "Thank you for your payment." They had charged me again! When I called, the woman said the confirmation number that accompanied the email was wrong and there was nothing she could do to help me. I told her that was the confirmation number on the email from ambetter! This is insane and totally unprofessional. What kind of scam is this company running?!

1 year ago

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Tracy Bridgeview, IL

It’s the worst insurance ever. The lists of doctors and hospitals in their website as “in net-work” are all lies. I’m pregnant but there’s no OBGYN accepts this insurance. After calling 3 pages of “in net-work” doctors according to the website, I finally found a OBGYN doctor who’s 45 mins away from where I live (Chicago). I was bleeding a lot when I was 14 weeks pregnant and went to the nearest emergency. This insurance only covers if I used an ambulance or emergency room but all the tests I had to take including ultrasound, they did not cover. The doctor prescribed me medications but this insurance didn’t cover either. My OBGYN doctor transfered me to a different hospital for another ultrasound which also says “in net-network” in their website. This insurance also denied this coverage so I called them and they don’t know why i got denied when it says “ in network” like wtf? She told me to call the hospital so I did, she said called my insurance. I called my insurance and they told me they would call me back, it’s been a week already and haven’t heard anything. I’m so sick of this insurance but it doesn’t expires until the end of this year. I don’t understand why I am paying this insurance every month for monthly payment when this insurance doesn’t covers anything. Stay away from ambetter.

2 years ago

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Dewana Gray Morman Little Rock, AR

This company horrible they stopped my surgery that i had to opinions from 2 specialist stating that there is a need for this so u can walk this is a surgery that is needed they canceled my surgery less than three hours before I was supposed to have it I pay for all the things that I need to have surgery renting equipment and everything out of my pocket just to be told that they felt like I need to be in pain a little bit longer before I could get my hip fixed I tried to explain to them if I got my hip fixed then I could work and I wouldn't have to be on Social Security but they don't care I can't pay my bills or do anything I went from working as a nurse for over 22 years to not being able to work at all or stand and now I'm on a walking cane if I get my hip fixed then I will be able to walk work and take care of my household and I won't have to be on assistant I would think this is what you would want you would not want your customers or clients to be sick or sitting at home hurting when they don't have to be for you to sit in the office and tell me that I am not in pain and that I should be in a little bit more pain than this so I said maybe I should go outside and fall hard on the concrete and then they said they would fix my head really so I have to go outside and hurt myself for you to fix something that should be fixed anyways this is horrible this is supposed to be a company through Obamacare it sucks what's the point in having insurance if something's really wrong and you have went through all the precautions it took 3 years for me to get approved for surgery spine specialist because I did every other alternative that I could do besides surgery to help me now I'm in chronic pain constantly they say they don't want people to take opiates or get addicted but I have no choice but to take these medications because my insurance will not fix the problem so that I can get off of medication ridiculous

2 years ago

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SBM Albuquerque, NM

I am new to Ambetter, and I have never in my life experience the frustration of having to deal with them. I have been trying to sign up and absolutely no one in their sales department knows anything about the plans or any benefits that the plans provide. I don't understand, how you can work selling something and not know anything about it. All I wanted to know is what benefits does Ambetter offer HSA accounts? no one new what an HSA account was or what it was used for. I was transferred 4 times to different people in sales that might know more than the other. The conclusion was that I didn't know what I was talking about. I have worked in insurance for years, I know exactly what an HSA is, but each individual insurance company has different benefits. This company desperately needs to invest in actually educating their sales department including the member services. Think of the hassle you will go through I they can't even answer a simple question of " what benefits does this plan provide?" pretty pathetic. I would NOT RECOMMEND

2 years ago

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Victoria C West Palm Beach, FL

I purchased a plan with vision and dental. It was not worth having the vision and dental. The dental only had one provider that would accept the plan in my area and they are so bad I walked out, and will pay out of pocket. Division benefit barely covered the eye exam and gave me nothing towards a new pair of glasses. Even trying to change my primary doctor It has been impossible to find providers who will accept ambetter. Not just primary but that happens often with specialists also. Ambetter's websites are never updated, and even their employees will give you names of providers who don't even practice anymore and or don't take ambetter. I had to have foot surgery this year so I had to meet my out-of-pocket. I don't even have a job and I'm disgusted at how much I had to pay including the premium. I only chose this plan so I could keep one particular doctor, but it is by far the worst health insurance I've ever had. Really sad that you can pick based on your ZIP code and there weren't many good plans available. I hope I don't get stuck with them next year because they are pathetic.

2 years ago

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Arielle D Duluth, GA

Terrible in Atlanta. If you need an x-day half of the places listed in their network online DO NOT do x-days or do not accept Ambetter. They only accept it for the ER. Which needs to be listed. I've been in pain over a month barely able to use my left hand & the only place who accepts the insurance and actually do the x-rays says it can take 2 additional weeks to get an appointment because it takes so long to get the green light from Ambetter 🤨🤨🤨 so you'll continue to be in pain after calling tons of places to be turned down. They need to take them off their networks or specify what they do and don't cover.

2 years ago

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emad serry Houston, TX

Actually , i lost right ear hearing , then after visiting the primary care doc. transfereing me to ENT doc. then the problem started with Ambetter . The Ent asked for MRI on th brain , Ambetter did not approve the MRI . I had to pay the whole amount out of my pocket just to find out why the sudden hearing loss. The ENT transferred me to a neuroglial doc , which ordered 2 more MRIs and a some kind of special test And here it comes the tragedy. As usual Ambetter did not approve, the reason is i don't have a medical history that requires MRI - the sudden hearing loss is not enough reason and also they said that the doctor did not submit enough docs to get the approval , so its not approved. i called them and they advised me to apply for an appeal , Then i did that appeal. the result is the usual denial and the new advice was asking the doctor to do a call ( Peer to Peer call ) it means that the doctor must call the authorization department and ask for the doctor that gave the denial trying to explain to him the reasons for the MRI . after this scenario we got the first approval for the first MRI. It took 4 months to get the first approval. Then another month to get the 2nd approval. Now with the another neuroglial clinic , i am suffering from the same scenario because , the doctor asked to redo one of MRIs we did. By the way , i paid the hearing aid without Ambetter help and the first MRI completely out of my pocket. don't waste you health with AMBETTR

2 years ago

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Michael Main San Antonio, TX

I found it hard to find doctors. The company web site listed doctors (in my case I was looking for an ENT) but when I tried to make an appointment I was told the docs didn't accept Ambetter. I called Ambetter and asked them to find an ENT locally who accepted their insurance, they never called me back. I changed insurance

2 years ago

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RVM Lubbock, TX

THEY WERE REALLY WONDERFUL. THEY HAVE TOP DOCTORS. THE COVERAGE HAS BEEN A LIFESAVER. I WOULD STILL BE WITH THEM, BUT THEIR RATES WENT UP ON THE OBAMACARE MARKET PLACE.

2 years ago