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Ambetter

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5.5

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Britty Heather Houston, TX

I'd give zero stars. I was signed up without my knowledge or consent & found out when I went to my regular doctor to be told they don't accept my insurance to which I said what insurance? I had to pay put of pocket that day to be seen I'm order to get my meds refilled! Terrible company!

6 months ago

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Jedi Mc.Knight ! Cumming, GA

Terrible service. Can never get an appointment .Terrible service. Can never get an appointment with her primary care physician even want to telladoc appointment.!! Terrible. Terrible. Terrible runaway, runaway runaway. As soon as I can I’m switching my insurance to something different. This sucks.

7 months ago

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Mary Conyers, GA

Customer service people are not from here barely understand I had auto pay for some reason past 2 years my money only comes out when it needs too how funny . I go to explain this they have No clue how this happens & when I need major care can't get it due to cancelation !

8 months ago

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Marsha Lewis

I never signed up.. found out I was enrolled when I filed taxes. Paid out of pocket for all of my medical, dental and vision. They enrolled me, without me knowing. I am appealing. I have proof of paying all of my bills on my own, because I didn’t know I had insurance. One of their representatives signed me up, using my information.. without my permission. That is tacky and unprofessional! I’m absolutely, positive that I’m not the only one. It’s not right to try to get bonus checks if you’re not getting clients. Now my taxes are held up for nonsense!

9 months ago

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Tyler Mardis Tarpon Springs, FL

Functionally useless. Terrible coverage, expensive and pointless. Network is unbelievably small, with doctors that don't actually even operate where they initially claim. Customer service is somehow worse. 10 minutes to even get to a person and they just repeat scripted lines until you get so frustrated you or they are forced to end the call. Rewards program gives a visa card that works nowhere. A giant scam of a company. I was happier having no insurance at all and waiting 6 months for open enrollment than deal with this joke of a business and give them my money. DO NOT USE.

9 months ago

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Amy Baker Richmond Hill, GA

I briefly had Ambetter between employment when i needed to purchase insurance on my own. It was affordable and very helpful when i needed coverage.

9 months ago

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eliezer Ramos Thonotosassa, FL

ReallyThey are incompetent They do not help their members, they do not care about the needs, nor the services they receive, they only have excellent service and options to receive their payments and they also have a list of doctors and when the offices and doctors are called They do not accept the Ambetter medical plan It's like it's a fraud. Bad health insurance

10 months ago

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Ken Byers Hattiesburg, MS

I met my out of pocket maximum in January, yet Ambetter has yet to pay for any of my medicines (which are many). Customer service is a joke. Most CSR’s are less than total idiots, and the ones that know something are not that great. Even the email support sucks. I had to file a complaint with the state insurance commissioner, hopefully that will be a black mark on their record whereby they will be penalized.

10 months ago

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Millie Fernandez Gainesville, FL

This Ambetter insurance is not a very good plan. I have had such difficulty getting my son's medication and treatments approved for coverage, frustration with customer service not understanding my son's needs and being able to tell me which medications are covered. Unbelievable that my son has been diagnosed with Type 2 Diabetes and they have denied two medications - not covered and still he has no medications. With an over 300+ Glucose reading! Please rethink before you choose them. I will definitely be changing once the time is up with Healthgov.

11 months ago

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AmbetterIsTerrible Nashville, TN

This is the worst healthcare insurance I've ever had. Do not get it. Every PCP listed on their site that is supposed to me in my area is no longer accepting their insurance or no longer in service or actually dead. I'm not making this up. After calling repeatedly and getting my case escalated, I tried to get them to switch my insurance over. They supposedly did "an investigation" and sent a letter to me with the names of 2 radiologists! Does Ambetter even know which physicians do which kind of work? The customer service is obnoxiously terrible. Their knowledge base is extremely poor. As I mentioned their information on their site is outdated. Their network basically doesn't exist in Nashville, TN. They're basically stealing money by charging for insurance that they are not providing. DO NOT get Ambetter. It'll be a terrible mistake. In fairness, I will admit that my prescription drugs are cheaper on their plan than my previous one.

2 weeks ago

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Blink Drive Roanoke, TX

Ambetter insurance is not a scam. However, every phone call made to them results in an endless loop, typically lasting at least one hour, before you can speak with someone, and even then, there is no progress. Seriously, we called them for 10 consecutive days, averaging one and a half hours each day, yet nothing was resolved. I just want them to approve my Primary Care Physician (PCP) and assign me to any in-network specialist. Their call center is unprofessional. Even if you ask them something as simple as the current date, they still put your call on hold to get the answer from their manager. It feels as if they might as well hire stupid robots instead of real humans to work there. My wife got pregnant for three months. They are helpless since day one till now.

3 months ago

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Noel Abbott Avondale, AZ

Absolutely one of the cheapest “insurance” companies out there!! But! Only After I qualified for a discount on my premium after getting married last year! When I was paying a whopping $ 680.00 a month they paid for Everything! Every test! Every treatment! Everything! Now that I’m receiving the discount; they won’t pay for ANYTHING! And I’m not being ridiculous or dramatic; I have several autoimmune diseases and they paid for a particular medication for a year and a half, my doctor RENEWED my prescription for the same medication I was prescribed prior to the discount and now they won’t pay for it, if I want it, I have to pay out of pocket!!! What the frick do I even have insurance for??!!?? They are also denying nearly ALL testing from my specialists as well!! I used to believe they were one of the best; definitely NOT!!!! Stay away!!! I am switching as soon as I can!!!

1 year ago

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John B. Place

Arizona Complete Health by Ambetter should be shutdown!! They recently turned my wife down for an MRI of her back that she desperately needs. They said she needed to do Physical Therapy for 6 weeks, which she did. They turned her down again! You'll NEVER guess what type of Doctor reviewed her case to determine if she needed an MRI ?? You're probably thinking it's a Doctor with a background in Orthopaedics, Nuclear Medicine, Radiology, Back Surgery, etc. WRONG!! The Doctor who reviewed my wife's case has a specialty in Pediatrics! Can you believe it? All this, to turn down an MRI that costs $300.00. What I have just related is indicative of how they routinely treat their patients. It's also no wonder that many Doctors don't accept Arizona Complete Health by Ambetter. I'm sure they treat Doctors as badly as they treat their health plan members. Let this be a WARNING to anyone considering buying this Health coverage: DO NOT USE ARIZONA COMPLETE HEALTH BY AMBETTER!!! It's dangerous to your health, and a complete waste of your money. I could go on and on, but I've said my piece, and I'll leave it at that.

1 year ago

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Marisa Overton Stone Mountain, GA

My plan is great. The kicker is that my account is suspended for lack of payment and yet there is an account credit for 2 months. No one can get this resolved. The letter I received in the mail said I have 3 months until my account is cancelled and yet my daily breathing medication isn’t being covered during this “glitch” period. I cannot get anyone to explain this either. I have a case manager who hasn’t checked in with me. I was told someone would be calling me back today and emailing me about getting my prescription authorized. That never happened. I have payment confirmation numbers. I have reference numbers. And 3 weeks later, still no resolution. I will say I have had some great customer service (and some terrible). But if you cannot get IT to figure out why my PAID account is suspended, what good is lip service?

1 year ago

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LuvMy BrownSkin Tampa, FL

I enrolled in Ambetter Health Insurance (Florida) just this year. Ambetter lists practitioners on their website as being part of their Network, then when you ACTUALLY CALL these practices/doctors, they actually DO NOT participate in Ambetter's network at all. I called SIX different doctors' offices (one Internal Medicine doctor and 5 different Orthopedists) that were listed on their site and NONE of them participated in the Ambetter Network! Secondly, whenever you call customer service, you get agents from non English speaking countries who (a) have very mediocre command of the English language, (b) have limited communication skills and are often very difficult to understand and (c) are not very effective at assisting you at all. I had to call back FOUR different times before I could get my issues resolved. The only reason I got it resolved the fourth time is because I insisted that they transfer me to an agent in the US. Makes me wonder what kind of criteria they use when hiring foreign customer service agents. Overall, I am extremely dissatisfied with this Insurance and if I could give it a lower rating, I would.

1 year ago Edited March 13, 2023

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Jeff Bailey San Francisco, CA

Horrible.. horrible customer service and insurance provider. Switched to them on Jan. 1st 2023. Worst mistake I ever made. I have yet to have a single visits approved by Ambetter of North Carolina. I’ve called over 40 times and get someone overseas that either I can’t understand or hangs up on me. I’ve been on 3 way calls with the Marketplace and Ambetter and still nothing corrected. They claim it is, but it never happens. Their member website has invalid dates and entries throughout, so it’s worthless. I can’t even get them to email or mail me a bill. I have 9 more months to go with them and then I’m done. Please reconsider if you plan on moving to Ambetter. ITS JUST NOT WORTH IT!!!!!!

1 year ago

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Honest consumer Concord, NC

A NIGHTMARE!!! DO NOT CHOOSE THIS COMPANY WHEN YOUR LIFE DEPENDS ON IT!! We JUST chose Ambetter of NC for our healthcare and so far it has been HORRIBLE (to say the least) dealing with their customer service people! My son has needed a replacement for an antibiotic for a recurring strep infection that has caused him to miss numerous days of school. One of the bottles was spilled leaving us short. I had to call this company about 4-5 times and on only the 5th try did I FINALLY get someone that I could understand and understood me, and got the job done!! She told me there were no notes taken except for one time when I called. Unacceptable!!! And now we are stuck with this insurance for the year! :( Not off to a good start at all! I also want to add on my very first phone call the rep had roosters loudly in the background and a child talking during the phone call. I get people work from home but most of these calls went to people I could hardly understand or communicate well with (they didn't seem to understand me) and didn't know what the heck they were doing! I'm dreading dealing with this company's customer service when I have to again! Just avoid signing up with them!!! I wish we had! :(

1 year ago

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JustJJ West Plains, MO

Absolutely the worst insurance company I have EVER dealt with in my ENTIRE life. Switched to Ambetter and paid my first premium in December 2022. Had questions about discrepancies between Ambtter's website and Healthcare.gov. Ambetter customer service was USELESS. After hours spent in phone calls and being shoved from one operator to the next, we were basically told we'd have to wait until Jan 1st, 2023 to see the updates on Ambetter's website. January rolls around and NO CHANGES. Yes, bait-and-switch! Strike 1: HORRIBLE/unknowledgeable customer service that barely understands the English language. Strike 2: Ambetter NEVER sent my Insurance ID card nor a welcome packet. Strike 3 and my biggest gripe: Healthcare.gov showed a $0 copay for generic prescriptions before meeting the deductible. However, Ambetter changed the rules mid-game and decided that I need to pay my ENTIRE DEDUCTIBLE before getting ANY coverage for ANY prescriptions! YOU'RE OUT, AMBETTER! Thankfully, I caught on to their underhanded tactics before the second open enrolment deadline of Jan 15 and was able to switch back to Medica. Bottom line: Ambetter gives no indication of caring even a tiny bit about its members and misrepresents the actual benefits offered to Healthcare.gov. THUMBS-DOWN, NEGATIVE STARS, & a GOLDEN RASPBERRY AWARD for Worst Insurance Company.

1 year ago

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Brenda Campbell Grand Rapids, MI

Premiums are lower than most. But, you get what you pay for. Terrible customer service. I finally asked for a supervisor and she could not even get that. I called to ask why my claim was not paid in full. I had 100% coverage after deductible was met, and it was. They did not pay 100% of my ambulance claim and I wanted to know why. She asked several times what was the date of claim, what was amount, etc. Finally the last time she asked for the billed amount, I got mad. I’ve trained customer support staff for over 30 years in various positions. I skied what the problem was. She said her computer was having difficulty. I asked her why she does not write down information from the customer so she doesn’t have to keep asking. She said they re not allowed to use pencil and paper! I’ve never heard of anything so stupid. And, they need to provide ENGLISH SPEAKING SUPPORT PERSONNEL! DO NOT GET AMBETTER INSURANCE. WE LEARNED OUR LESSON AND WENT WITH BLUE CROSS. I believe Ambetter does not fully train their staff. Most likely they don’t train them because they don’t speak the same language. AMERICAN COMPANIES NEED SUPPORT LOCATED IN AMERICA. ENOUGH IS ENOUGH.

1 year ago

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Ivette Lago Hialeah, FL

IF I COULD GIVE THEM LESS THAN ONE STAR I WOULD! I'VE ONLY HAD AMBETTER FOR 11 DAYS AND I WISH I WOULD'VE NEVER LEFT MY PRIOR HEALTH INSURANCE CARRIER. MY SON HAS CROHNS DISEASE AND NEEDS HIS INFUSIONS VIA IV EVERY 8 WEEKS OF HIS LIFE, DOCTORS OFFICE HAS FAXED 7 TIMES THE AUTHORIZATION REQUEST, HAS EVIDENCE THE FAXES ARE GOING THROUGH AND YET AMBETTER STATES THEY HAVEN'T RECEIVED ANYTHING AND DO NOT HAVE THE AUTHORIZATION READY. I'VE SPOKE TO CUSTOMER SERVICE, SUPERVISIORS AND THEY ALL ASK FOR MY CALL BACK # IN CASE I SOME HOW GET DISCONNECTED, WELL GUESS WHAT I HAVE GOTTEN DISCONNECTED 3 TIMES A NO ONE CALLS ME BACK NOT EVEN THE SUPERVISOR! SO SAD....

1 year ago

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Larry Wood Springfield, MO

1-4-2023 We did our homework before choosing Ambetter for health insurance. However, we did not find out how terrible this company was until we were fully signed up. First, calling customer service is useless, you are put on hold and never gotten back to. You are given wrong,completely false, and incorrect information at every call, if you can get any information at all. Hours and hours of phone calls with no correct answers to your questions or concerns. Before signing up we checked on line and were told verbally that our family doctor was in network. However, after signing up we were told our doctors group were ALL considered SPECIALIST and we were not allowed to keep our doctor. MAKES NO difference what their website says or what you were told before you signed up. Terrible, Terrible company. It's not like they are a cut rate insurance company. For one person in our family, Ambetter was being paid around $1300.00 a month for health insurance. Not only that but the first $1500.00 of medical expenses came out of our pocket. Only then did Ambetter start paying for any medical expenses. How can such a terrible health insurance company be allowed to operate in the USA? We cancelled our policy with Ambetter and went to another insurance company. We are paying much more, out of pocket, for the new health insurance, but we felt like we had no choice but to do so. You cannot believe anything Ambetter says on their website or information they put forth. say or tell you.

1 year ago Edited January 5, 2023

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Michael J

Signed up with them through a healthcare .gov agent due to finding the low pricing attractive. Only to find out after calling around my area that same day that their website listings of practices who they stated would accept their insurance was completely fabricated and/or out of date. As almost every single of the 10+ ones listed in a 25 mile radius I made an inquiry to confirmed they would *NOT* accept Ambetter insurance, and/or hadn't accepted in quite some time. Filed a cancellation and refund request direct through both healthcare.gov and Ambetter, which on both ends was acknowledged and accepted. Followed up by a switch to different insurance company who's accepted location claims on their website was legit. After a very extensive information gathering session with an Ambetter rep on the phone I was assured everything was squared away, and that after confirming my cancellation with healthcare.gov (which I did) I could expect my refund in 5-10 business days. Fast forward 10 business days latter and with no issued refund. Called in to Ambetter again and was told there was absolutely no record on their end of my refund request. Proceeded to go through the extensive information gathering process again, including a direct 3 way phone call to a healthcare.gov rep who confirmed direct to their rep my earlier cancellation/refund request. After which i was again assured my cancellation was squared away and that I could expect an issued refund in another 5-10 days. Fast forward another week latter and I get a follow up email stating I was now eligible to sign up to their website to access my account. Found that strange so called back in to Ambetter a third time to inquiry about my refund status, and was again told for a 3rd time that there was absolutely no record of my refund request, but that they would be happy to file a request for one. Borderline criminal behavior experience as far as I'm concerned, and which basically forced me into having having to file a charge dispute with my credit card company to end the blatant run-around. Would give Ambetter a zero star recommendation to anybody looking to pick them up if i could.

1 year ago

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KMP Charlotte, NC

Please heed these warnings.. This is the absolute worst insurance company I have ever dealt with. It starts with their website and trying to locate a in-network provider. The website is constantly crashing or provides falsified information. I tried locating a Family physician which was advertised on their website as such and when I called, it was actually some mental health clinic in another city. Claims will be denied but there is no real way to no for sure if you are in or out of network as it seems its all arbitrary. Customer service is useless and lie over the phone saying a Dr. is in network. I know this because I couldn't verify anything on their crappy website which forced me to call and I was given false info about an in network provided and was charged 1K for a basic mammogram that they refused to cover. I cancelled them mid-year and got temporary insurance for the remaining year because I couldn't take the hassle and mistrust anymore. They should be banned from selling insurance and sued into oblivion. Please use Blue Cross Blue Shield instead. I've never had an issue with them and learned my lesson the hard way using Ambetter.

1 year ago

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ron Silver City, NM

Absolutely useless. No doctors or few in network, same with hospitals. May 22 my gp referred me to a cardiologist, August appointment. Upon checking not in network. After many calls to Ambetter's Philippine call center referred to cardiologist 55 miles away. Failed stress test and he referred me to 3rd cardiologist 125 miles from home who took ambetter. Scheduled angiogram but cancelled 2 days before procedure by hospital due to not in network. Got ambetter recommended 4th cardiologist, scheduled angiogram which was cancelled exactly as before by the new hospital. Ambetter reps are useless, waste your time and there is no one else you can call or get passed on to.

1 year ago

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Hannah Columbus, OH

Run away from this insurance. Filed an appeal for an over $20,000 emergency room visit for my then 5 day old son. Buckeye Health Plan promised a response by September 13th, I have heard nothing, and when called to follow up was simply told it was "in review" with no further explanation. I feel very foolish for having not read reviews prior to getting this insurance. If I could give zero stars a would. It is horrific to me that this insurance is offered through healthcare.gov, which is where I signed up for it. There should be some sort of vetting process for this government run program that is supposed to be helping people.

1 year ago

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Won’t Back Down Lemont, IL

One word describes Ambetter: horrific. Horrific network (very few hospitals or doctors), horrific customer service (they try to confuse you and/or deny everything, their people often barely speak English and it sometimes takes hours to get an answer on the phone, which usually is “no” ) and horrific coverage (if you need to use it, they twist the facts and take ridiculous positions and force you to fight them). I had to first file a grievance after they denied a claim, even though the claim was clearly covered. Had to go to the state department of insurance to file a complaint! They finally paid after the complaint was filed. It all took 2 years!!! I even know insurance law and pointed out specific policy provisions and legal theories as to why the claim was covered and only when I got an independent third party involved (department of insurance) did they react. Stay away from this place at all costs. You will have nothing but headaches and anguish if you need coverage for something other than a doctor visit. You have been warned.

1 year ago

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Justin Crafton

Worst insurance . Nobody accepts Ambetter but when you ask them if there in network with your doctor they will almost always say yes. All Ambetter has done is made it were lower income families don't get enough money to help cover a real health insurance pain since they base how much you get on the lower cost plans. Ambetter has blanketed the Marketplace with cheap low cost insurance. The reason they can offer it cheap is because they don't have to worry about paying any claims when most doctors don't accept there insurance. STAY FAR AWAY FROM AMBETTER INSURANCE. NO INSURANCE IS BETTER THEN AMBETTER INSURANCE !!!

1 year ago

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Megan Maloney West Chester, PA

The worst. Both my Pennie representative and Ambetter are responsible for this sucky review. The rep asked if there were any doctors I needed in network, I gave them their name and was assured a bronze plan from Ambetter that cost about $320 a month would be my best option. Turns out my doctor does NOT accept Ambetter. I tried to call Ambetter prior to showing up to my appointment and was put on hold repeatedly and then they sent me to a Pennie representative without giving me any knowledge that they were patching me over to them. Obviously, they couldn’t help me. Horrific customer service. Also, no one I’ve spoken to has heard of this insurance so I have no idea who accepts it.

1 year ago

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Diogenes DeFawkes Warner Robins, GA

The provider listing website is useless. Literally had to call random doctors until I found one that took Amuseless. Finally got frustrated when the website showed no optometrists in my entire state, and called the customer service number. The gentleman with a very heavy accent and a limited english vocabulary had to escalate the issue. After waiting 15 minutes he gave me 3 providers, none of which accept Amuseless. One advised me that even though they keep getting referrals they stopped taking them after a few clients got stuck with huge out of network bills after being told they were in network. After my experiences and reading others horror stories I will be changing providers this upcoming enrollment cycle. These people are useless. Go elsewhere if you want actual insurance and not a scam company.

1 year ago

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SaneB4Kidz Leavenworth, KS

I've had Ambetter for several years and I was always happy with it.... Until recently. Lately I'm having issues with prescription coverage and my medical claims getting paid. Earlier this month I found out that as of October 30, 2022 my Primary Care Provider, my Orthopedic doctor and the hospital we use will no longer be accepting Ambetter Insurance and several other doctors, clinics, Urgent Cares and hospitals in the area are doing the same. I will definitely be changing insurance companies this year during open enrollment Based on my experience, I would not recommend signing up for Ambetter insurance. Your choices will be very limited when it comes to in network coverage for any type of service.

1 year ago

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AmbetterIsTheWorst Tulsa, OK

You're reading reviews right now to ensure you make the right choice. Back away. Now. I mean it. Go with that other plan. I don't care how cheap Ambetter is or what plan you're choosing from them. Expect full days on the phone with constant disconnects to solve account issues that arise and they will arise. Guaranteed. Expect hour-long waits on hold before you hang up, when the poor customer service person who has no authority or information you need inevitably has to escalate your issue to a higher-up who never answers. Expect ACA violations, Ambetter shirking their legal responsibilities for preventative care as they will never properly cover procedures as such even if required to do so. Expect a very limited range of doctors where necessary appointments take 3+ months to secure. Expect billing issues, overcharges and major out-of-pockets that Ambetter should be paying but finds a way to avoid, confident that you won't bother finding a lawyer and feel you're powerless to do anything about. Expect all these things, because they will all happen. Ambetter is the worst health insurance company in the United States, which likely means the worst health insurance company in the developed world. Based on the fees you'll be paying for the year, you are literally better with no insurance at all. Just. Don't. Do it. May they finally get sued into oblivion and

1 year ago

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ANPR Miami, FL

Horrible…!!! I have been in ciatic pain for a month and a week, they don’t care…!!! Authorizations that never come thru, 3+ hours to be in de scalating dept, nothing gets done, I even change the plan to a better one, paying more and nothing…. How can people live with pain and this people don’t care….. now they said that my Pain management company duplicate the request… IT’S THE SAME… just with an URGENT SIGN…!!!! If I go to an emergency room they will give me a shot and won’t help, I’ve been there 3 times….!!!!! It’s a joke…. No answer s, it’s like they are dealing with animals..!!!!! They tell you a different excuse every time…!!! Please help….!!!!! I can’t take this pain anymore….!!!!!

1 year ago

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Joan Castro Dallas, TX

The insurance is a the worse to pay for medication. It's almost impossible to get approve for medication. The always asking information from the primary doctor office and when they receive the reason the patients need that certain medication they still denied the medication finding another reason. And asking for more requirements. They insurance literally assume the doctors prescription is not vaillid and the patients is not sick enough even after the proper testing saying the pecient is sick. They are expensive and NOT RELIABLE when someone needs the medication. They're only good to collect payment but they put all kinds of barriers to respond financially for someone medication.

1 year ago

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Reno Dog Reno, NV

Company should be called AmWorse. Do not get insurance from this company. They will find any reason to deny coverage. My back doctor referred me for an MRI of my upper spine due to chronic pain which I had gone to physical therapy for a year before with no significant improvement. Ambetter denied the MRI and said I needed to do physical therapy (again). I started the physical therapy and after four sessions at $100 out of pocket per visit, I learned that Ambetter denied payment for physical therapy because it was not pre-authorized! My PT had checked when I started the therapy and at that time, pre-authorization was not required. They changed their policy a few weeks after I started PT and refused to grandfather me in. This was not the first major issue I had with this crappy company. I changed to a different insurer as fast as I was able. DO NOT INSURE WITH AMWORSE!

1 year ago

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Laura Schott Philadelphia, PA

I "only" pay $62/month for this insurance due to a tax credit but the plan I have is typically $250/month and it doesn't cover ANYTHING. It should be illegal. I have been trying to find a primary care doctor so I went to the Ambetter website and all these doctors came up as "in-network" but when I actually call the office to schedule an appointment it turns out I'm actually not in-network with them. I have been unable to find anyone in Philadelphia, PA that accepts this insurance through their portal. When I signed up for this insurance I chose a primary care provider (at random since I didn't have one) OFF OF THEIR WEBSITE, and when I went to schedule an appointment with her she didn't accept this insurance. I don't know how they can legally claim that all these doctors are in network with them when they're not. I would rather be uninsured than give Ambetter any more of my money. I will be getting different insurance next year.

1 year ago

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Nabrin Noor Ellenwood, GA

So my grandma was required to have surgery to remove an infected toe and after we were sent home we couldn’t figure out why we couldn’t have home heath come in. After calling the nurses, the hospital and then the insurance I figured out there was a balance due. There was no phone calls or anything to let us know that the referral wouldn’t be approved unless that balance was paid so I spend 8 hours talking to people for no reason when it could have easily been sorted if someone from insurance would have notified me. Now we are on day 3 after discharge with an old dressing on a wound. Does Ambetter wanna pay for amputation of the whole leg instead of focusing on helping us prevent further infection?

1 year ago

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Laura Langford El Mirage, AZ

If I could give Ambetter ZERO stars I would. It has been over three months, more than 3 hours of phone calls and still no-one at AMBETTER seems even slightly aware of the policy that they created for all of the state of Nevada. In Nevada, despite my reading of my benefits, I found that they do not have any idea that on April 1, 2022, they installed a new policy for specialists. These doctors are not permitted to see any Ambetter patients without a "Authorized Referral". Ambetter, however, has "Authorizations" and "Referrals". They do not have anything called an "Authorized Referral". Hmmmm. The office manager at the Gastroenterologist informed me (as well as the Ambetter representative, who I had on the phone) by reading an email sent to all Referring Doctors in the state of Nevada - Ambetter will not pay visits of any kind (including initial consultations) without an "Authorized Referral". So let's just hope that my 3.5 hours and ticking away are not wasted and I can FINALLY figure out what Ambetter means by an "Authorized Referral" and I can teach every referring doctor and specialist in the state of Nevada. But wait, there is a new development - I may not even be covered for at all to see a Gastroenterologist... Curious indeed. Seriously, what good is health insurance that doesn't cover your GI track? Okay, but I still can't see the doctor because the CATCH 22 of "Ambetter Health Insurance". They sure don't care about making making me BETTER, just themselves.

1 year ago

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Adrienne Wissa Phoenix, AZ

Was not able to reach a representative for MONTHS. Finally reached someone today. Spoke with them for 20 minutes and we're disconnected, they never called back. Spoke with another representative for 40 minutes and disconnected, never call back. Now waiting 40 minutes to speak with supervisor. Last year paid for my daughter's birth and prenatal visits out of pocket. Had an ER visit in December for her, they didn't even cover 20% despite deductible being met. No one is able/willing to answer why. Tried to get her an audiology appointment, no one would answer when I tried to find an in network provided. Finally gave up. Exhausting and worthless.

1 year ago

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robert lee Little Rock, AR

Ambetter is basically a type of legal Scam...to scam people who cant afford health insurance. If you dont get pre-approval, nothing is covered. Whenever providers call Ambetter to get preapproval, they find themselves either unable to get through or on the phone with someone who barely speaks english and who only gives you a web address to send records and authorization requests to. Ambetter never gets back with you. Then you call again and you are sent to the "provider relations" call center (wierd that it's a call center right?) but all you get almost every time you call is a recorded message telling you that the system is down and telling you to call back. If they do answer they tell you they need more information. Trying to collect is a massive dead end. Basically, in most cases they make it virtually impossible for the provider to collect payment, which throws the bill back onto the insured member. And since Ambetter usually never even processes the claim, the member is left with a giant (unajusted) bill.

1 year ago

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Darlene Tucker Scotts Hill, TN

I would give zero stars if I could. Ambetter: lowest cost plan in my area, because Ambetter has the benchmark plan. Makes other carriers unaffordable even with tax credits. Getting prescriptions filled is a nightmare unless it's a $4 generic. For brand name RX you have to get prior authorization(PA). If the rx has a lower starter dose in the beginning, you will have to get prior authorization again to refill the normal dose! My 1st one took months. They decline it the 1st time and you have to appeal. Meanwhile, you go untreated so they can save a few hundred dollars during the delay. Expect to spend 45 minutes to an hour, minimum, if you have to call them to get assistance.

1 year ago

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Donna Reeves Charlotte, NC

This is my experience this evening. My first phone call—at 8:30 call disconnected before anyone answered Second call—someone answered, I gave my info and even gave a call back number, but the phone call was disconnected—no one ever called me back. Third call—someone answers. I give my name, date of birth, Member ID, name of the medication and the dosage. I explain that I am calling because I didn’t receive a reimbursement that another representative told me I would receive if I paid the $529 for farxiga. The rep states, “I will have to transfer you to that department.” The transfer does not go through and the call is disconnected. Fourth call—someone answers; I give my name, dob, member id, name of medication and the dosage. I get transferred to the customer relations department, but in order to speak to anyone I have to have my NCPD number. A number that I do not have so that call is disconnected. Fifth call—get representative; explain the reason for my call; then the rep takes my name, dob, member id, name of medication. I explain that I need an NCPD number and I don’t have that info. I ask if they have it and then I am put on hold. The rep comes back and says that they don’t have the NCPD, and I will have to call my pharmacy in order to get the number. I know that my pharmacy closes at 9:00 p.m. It is now 8:55. I spend two or three minutes going through the CVS phone tree and finally contact the pharmacist who gives me the NCPD. I then call the number for member services that the rep gave me. The rep gave me an incorrect number. I hang up. Sixth call—get the rep I had on call number three; give her the same info as my previous four calls. I explain the purpose for my call. She then tries to transfer the call, but the office is closed and won’t be open until Monday at 8 a.m. This could have been told to me on any one of the previous five phone calls. This company is just...the worst.

1 year ago

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Elizabeth Conard Philadelphia, PA

Ambetter is literally the worst. I signed up for my health plan because, at the time I signed up for the plan, it listed many doctors and hospitals as in-network in my local area. Upon the start of my health plan, I discovered that almost all of the doctors listed as in-network on the Ambetter website are actually out of network. I had to drive 45 minutes out of my major US city to get to the closest urgent care, and I still got a $150 bill from the urgent care clinic. I was unable to obtain the mental health counseling I needed through my insurance because the VERY FEW offices around my city that took my insurance were not taking new patients. None of the other major hospitals and clinics that I’ve gone to for blood work, ultrasounds, etc knew if ambetter was in-network, meaning that I had to obtain services without knowing if I had coverage, resulting in several large and unexpected medical bills. I also could not trust the information I got from the ambetter portal or from customer services because the offices and doctors listed on the portal had proven to be inaccurate. I’m basically paying $100 out of pocket plus hundreds in healthcare credit from the government per month to get no benefits besides my $25 prescription refill. I literally want a refund for this insurance.

1 year ago

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medrevur Elmhurst, IL

For Ambetter / Buckeye Health in Ohio My opinion.. STAY AWAY AT ALL COSTS. Literally the worst health insurance company I have ever dealt with (worst company of any type in fact)... some of the people are nice to deal with but they can't save you. The moment a dispute of a claim is sent to the back office to review, it goes into a black hole with no hope of resolution. They deny appeals through their process, appeals that have been well documented by their own reps (with their own reps saying this absolutely should be paid), and the denial reason is a couple words that make no sense whatsoever. They run out their own self-defined clock on the appeal process by taking months between responses and then refuse to examine the issue further. This company has cost me thousands of dollars I absolutely should not have owed. Why stay? I was over a barrel, this was the only company in healthcare. gov that covered the doctors I had found for some serious health concerns and did not want to use other doctors. The stress this company added to my life through their horrendous billing is criminal. Even today, as writing this, I am getting a bill from a procedure 11 months ago that for a preventative procedure that is 100% covered under my policy EOB, which they paid and THEN pulled the payment back from the provider with no explanation. I thought I'd gotten away from these monsters and they still creep in a year later. Criminal.

1 year ago

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Kimberly L. Houston, TX

Their customer service is absolutely horrible to deal with. Not only are they extremely rude but I've been flat out hung up on and/or disconnected on purpose by them numerous times. Their customer service reps continuously give you false information and the runaround. I've contacted them about a simple issue multiple times and every single person I spoke to gave me completely different information. I've caught some of them in complete lies. They seem like none of them know how to do their jobs. They could stand to get some customer service training and skills. And maybe learn about their company instead of constantly giving customers wrong advice and information. I dread every time I have to call these people, because I know how difficult it's going to be, no matter what the issue is. The worst customer service I've ever dealt with.

1 year ago

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Irritated Counselor Olathe, KS

I am a mental health counselor GETTING OFF AMBETTER AS A PROVIDER! After I see a client a few times, they begin to harass me for records. Currently, I just found out that they have been faxing me for records of a client UNDER ANOTHER COUNSELORS NAME and on. RANOM PUBLIC FAX. Not even my fax number, somehow, the owner of the fax machine was able to trace the faxes to me. Total HIPPA violation. No idea how they found this random fax number that is not my fax number. Totally irritating to deal with them! Goodbye AMBETTER! Have fun finding new mental health providers that love to work for free.

1 year ago

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DJ Bruffett Wichita, KS

I would give no stars if that was an option for Ambetter. I think I ambetter off without this insurance! I had to get marketplace insurance, so I poured through all available options. This one seemed ok at the time. My last insurance was less money on premiums and they covered much better. I have to pay for preventative check ups out of pocket with Ambetter. They get 619.84 per month for my individual plan and do not cover squat!!! So I pay 619.84 plus my check up visit of 200.00. I am a healthy person and dont require much medically other than 2 prescriptions for hormone replacement, and daily vitamin, which is pretty common these days. I am so disappointed with the corruptness that comes with price gouging people. It has become the norm and acceptable practice that we are just suppose to sit back and allow.

1 year ago

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Tyler McCoy Owasso, OK

Tulsa Metro. Ambetter is beyond abysmal. They took 2 months for me to receive my insurance after paying early enough it Jan. 1 When I requested a psychiatrist in my area they sent me a number for a place 90 minutes away. I reluctantly called them....... It was a phone number for an Elementary School. The Elementary school was familiar with this problem and knew which office to transfer me to. Neither DR at the office was even a Psychiatrist. Same names as I was told, just completely different specialization. Finally I payed out of pocket for my psychiatrist, got a medication prescribed, got hit with a prior authorization, got declined, the DR office and I were given 2 different reasons from the insurance company for why it was declined. The incompetence is so strong with Ambetter, I honestly wonder if it's intentional malice. I cannot wait for open enrollment so I can get a real insurance company.

1 year ago

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Golf Forlife San Antonio, TX

Garbage insurance. Deceptive practices in terms of listing providers on their website they say are within an exact plan, but then do not honor claims. THAT IS CALLED FRAUDULENT PRACTICES, AND BAIT AND SWITCH to give the consumer the impression they have more doctors in-network than they actually have to get them to sign up. Once you sign on, you're locked in for a year and unable to see the doctor you thought was in their Network. I will file a complaint with the Texas Insurance Department, as well as the State's Attorney General's office to force them to clean up their act. I will also try to have them removed from the Marketplace because they're bilking the government for payouts while lying about the doctors they have in-network to patients, and refusing to pay. Ambetter is acting like an unscrupulous insurance company as long as they falsely give the impression they have more doctors in-network than they actually do to get consumers to sign up.

1 year ago Edited April 26, 2022

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Angela Bell La Marque, TX

OMG! Wish I could have rated them a -0- star rating, and certainly wish I’d seen this prior to purchasing their policy. BUYER’S BEWARE! Horrible service; they basically deny every physician requested procedure, then request peer to peer conferences for basic, necessary medical interventions. This is a horrid company, that lacks compassion for people in need of medical attention. They must be operating on a reward for denial system. Talked to a disgusting customer service representative who was offensive, insensitive and down-right malicious. I’m so through with this agency; I’ll pay a penalty to drop this monstrosity. I get free enterprise; but these people should be shut down permanently.

1 year ago

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Ryknow777 Wichita, KS

This insurance is an absolute scheme and extremely deceptive. My wife and I signed up for one of their private health insurance plans and found out that barely any providers are willing to take this trash insurance. Customer service agents are hilariously incompetent and without resources to answer the simplest questions. They cover basically nothing. DO NOT SIGN UP FOR THIS INSURANCE. Trust me, the stress that follows is not worth anything. My wife and I can no longer afford our meds and NOTHING goes toward our deductible. We had to change several medications because they don't want to cover anything but the very few medications on their formulary, which are all the cheapest meds on the market. We can't wait to finally be released from this hell when next open enrollment comes around. Do yourself and your family a favor and avoid this insurance at all costs. Despite all the lawsuits brought against them, they've changed nothing and they do not deserve your business.

1 year ago