Ambetter insurance specializes in health insurance plans on the Health Insurance Marketplace in twelve states. These plans are also sometimes called Obamacare plans. Ambetter health plans are operated by the Centene Corporation. If you're looking for another kind of plan or don't live in an Ambetter service area, you'll need to consider other health insurers.
Attention: Ambetter is a very unpopular health insurance company.
It has received a 1.4/5 star rating from reviews left on Best Company. Roughly 88 percent of the Ambetter reviews on Best Company gave a 1-star rating. Complaints against Ambetter include poor customer service, difficulty with pre-authorization, and high costs for limited coverage. Most customers do not recommend buying healthcare coverage from this insurance company.
Ambetter health insurance's covered services include preventative and emergency care, therapy, behavioral health help, medications, maternity, and hospitalization. It is an on-exchange health insurance option in the Health Insurance Marketplace.
Health Insurance Marketplace plans offer comprehensive health insurance coverage. For health plans to be on the Marketplace, they must be a qualified health plan that covers the essential health benefits listed in the Affordable Care Act.
To enroll in Ambetter insurance, you need to apply during Open Enrollment. The Open Enrollment period for 2020 healthcare coverage runs from November 1, 2019 to December 15, 2019. If you missed the enrollment period, you may qualify for a Special Enrollment Period after December 15, 2019 if you have a Qualifying Life Event.
If you're looking to get an Ambetter plan, you can view their health plans by first selecting the state you live in and then selecting the type of health plan tier you're most interested in. From there, your options open up to several different plans with varying prices and benefits.
Ambetter Health Insurance Marketplace plan options include: Ambetter Essential Care (Bronze Plan), Ambetter Balanced Care (Silver Plan), and Ambetter Secure Care (Gold Plan).
Each plan offers insurance coverage for the essential health benefits listed in the Affordable Care Act, but the cost-sharing rules for medical expenses are different for each tiered plan option.
Members with Ambetter Essential Care pay lower premiums but have higher out-of-pocket expenses.
Ambetter Balanced Care, the Silver Plan, offers higher premiums and a lower out-of-pocket limit.
Ambetter Secure Care has higher monthly premiums, but the lowest out-of-pocket expenses of the three plan types.
For specific coverage and cost information, including the deductible, out-of-pocket expenses, and premium costs, you'll need to work with Ambetter directly. Depending on your income, you may qualify for a tax credit subsidy on your monthly premium.
Each Ambetter member has access to an online portal through which they can make all of their payments, view healthcare plan benefits, and take care of logistics like obtaining a member ID card. The member portal offers extra features, too, such as providing reminders for members when they are due for another doctor's visit or allowing them to take a health risk assessment to determine which steps they can take to live healthier.
Members can track their claims 24/7 through the online portal, as well as connect with member services at any hour of the day.
The subsidy estimator in the online account also helps members see how much they would receive for reimbursement for a treatment with their benefits. If you qualify, the subsidy lowers what you pay for the monthly premium charge.
Ambetter provides more than just logistical tools for members. Many of the extra features it offers also send the message that Ambetter wants members to get healthier and stay healthier. These tools include a 24/7 nurse hotline that members can access for questions and medical needs.
There are also health-promoting programs to support members with dealing with behavioral health and maternity and newborn care. Ambetter offers 24/7 Nurse Advice Line and integrated health management to enhance members ability to get the most out of their medical care. Ambetter also offers telehealth access with some of its plans. With telehealth, members can have phone or video access to in-network providers for non-emergencies.
My Health Pays™ is Ambetter's rewards program to provide incentives for members to live healthier with better habits. You can earn money for taking a survey provided by Ambetter, getting a flu shot, or having your wellness exam, and this money can go toward your next premium. Members can be reimbursed for gym membership payments as well. This rewards program promotes health and well-being among Ambetter members. While this program is great, it's only available in some of the states Ambetter services.
Dental and vision coverage are available with Ambetter, but the benefits and availability of each are entirely specific to the state you live in and the type of health plan you've signed up for. Dental benefits, for example, is not available in Texas, but vision insurance is. Dental coverage includes exams, cleanings, and screenings, overall, and vision benefits include yearly eye exams and glasses or contacts. Those seeking vision coverage and dental benefits in addition to health insurance can find options through Ambetter.
Ambetter has received an overwhelming number of 1-star reviews on Best Company. These Ambetter reviews mention difficulty getting medication and treatments approved for coverage, issues with claims that were difficult to resolve, frustration with customer service, and difficulty finding an in-network provider.
With such a high number of 1-star reviews, you'll be better served choosing another company if you can.
It's somewhat difficult to access specific information about the types of health plans Ambetter has. Its website primarily just explains the metal tiers (gold plan, silver plan, and bronze plan) as well as how essential health benefits are covered by every plan.
To find out what kinds of plans these are, such as Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO), not to mention what prices and benefits you qualify for (like out-of-pocket expenses, copayments, deductibles, covered services specifics,and if you need prior authorization for certain medical services), you'll have to contact a representative.
Upfront, it's important to know that Ambetter is part of the Health Insurance Marketplace (HIM). It's Centene's option for HIM plans, which are intended for people who don't have health insurance and maybe don't qualify for typical plans.
Ambetter only offers Marketplace plans. If you are looking for another kind of insurance plan, like a short-term health insurance, Medicare, or Medicaid, you'll need to find another insurance carrier.
Ambetter plans are available in a some states. These include Arkansas, Florida, Georgia, Illinois, Indiana, Massachusetts, Mississippi, New Hampshire, Ohio, Texas, Washington, and Wisconsin. If you don't live in any of these states, then Ambetter may not be an option for you.
Even if you do reside in one of the states they service, make sure to check the location of their in-network providers (e.g. a primary care physician, specialist, etc.) for your state to ensure they have an in-network provider near you.
Unlike many of its competing insurance companies, Ambetter doesn't have a mobile app. Some companies provide this for enrollees to access their accounts right from their phones, making communication and logistics much easier. Ambetter hasn't provided this yet, making account management slightly less convenient than with other companies.
Call our recommended rep over at Ambetter below.
Ambetter has the worst website. I even checked with my insurance agent and he has the same impression. The log in process NEVER works. It always says: "Your Login information has been locked out". Even though I am using the same information. I have it written down in a folder. There is not even an option as 'Forget Password' and/or 'Forget Username'....even if I wanted to utilize it. Then one has to call them, be on hold for 20 minutes, and then they will reset it to the same one. Next time, the same thing will happen again. It happens EVERY time. Thank you.
They won’t listen to the doctors. Will always deny to save $. I am having an issue with my leg that is not explainable. Dr requested an MRI which was denied. Ambetter recommends 6 weeks of physical therapy. In other words Ambetter does not want to know what’s wrong before someone starts working on you. VERY concerning! Their recommendation was to use pain pills and booze to dull the pain!!! Great medical advice
Ambetter lies about their coverage in the ACA website. I picked Ambetter because it said a major, well respected health care provider near me was in network. When I went to get a procedure scheduled the Ambetter website informed me the closest in network provider was 135miles away!!!!!!
Erik D. Hamilton
This company is absolutely a trash. I called both the WAHealthPlanFinder and Ambetter to cancel my policy on last October. Today, they just sent me a bill saying they just renew my policy for the 2019. Because I forgot to turn off the auto-payment, they just come and take my hard-earning money. I don't even give a hint that I need their health insurance. After looking at the reviews, I find hundreds of people have the same situation as me. I really cannot trust to give their my bank account as well as personal information for them right now. I will call them back tomorrow to ask for the refund as well as delete any tie I have with them as soon as possible. Now I understand when people say I should read the bad review first before I buy something for me and for my family.
I cancelled my health insurance with Ambetter.They sent me a letter saying my portion for health insurance would be 75.00 a month . Ha Ha what a great Xmas i received 260.00 a month for Insurance. not the 75.00 they said it would be in the letter they sent me. So i have no insurance now trying to get on my husbands policy please wish me luck. Do not recommend them at all.Also i have a ongoing bill the they have not paid.
I cannot find any GYN within 200 miles. When I searched the availability pre-12/15/18 there were plenty of good ones. I guess that was to entice ACA enrollees to select their plan, because here on 12/24/18 there are none listed. One of the doctors they had listed earlier this month, Dr. Lauren M, hasn't excepted Ambetter in years. Do they really expect travel of 3 or more hours for appointments? $718 a month for what? I have 0 health issues. I just want the normal exams.
They never update their website. If you think that your doctor takes ambetter just based on the website think again. You need to call you physician because ambetter will never take that physician down and they trick you into thinking you’ll be covered. I went to a certain place for an eye exam but before we started they asked for my insurance and I gave them my ambetter card. The looked at me and said we do not take that. I showed them the website and they asked to call ambetter to see what was going on. Turns out they don’t have a contract with this eye place. SO WHY IS IT ON THEIR WEBSITE!!!! Luckily the people I speak with are nice but they can’t help you. It’s like ambetter knows not give there employees to much abilities on their webpage because then those people could actually help.
They are the worst, and so glad I am going to another insurance company. First they refuse to pay for medication and were acting as doctor for my father which they thought that could slide...but our family is well aware of what most insurance and health system is capable of ... they're bound to receive a lawsuit...
It complete bs! The coverage sucks. I ended up with $1800 in bills for my deductsble. Then when I reached that they began to deny my the exams the doctor ordered. Not one exam was denied prior to meeting my deductible. Total scam
I have used Ambetter by Superior before and it is cheapish and stingy when the doctor asks for anything special, but generally it is OK once 'proof' has been given that XYZ is needed. However, the place is run by malicious idiots who use helpess telephone minions to make false apologies about even the worst and most harmful malfeasance. In 2017, they double charged me for January 2018, and it took 2 months to get that straight. I let it go. It was a small amount. This time, they have surpassed themselves in malfeasance, tinpot-baron-robbery, and chicanerous corruption. Today December 17, 2018, Ambetter fraudeulently debited my family bank account for over $860 in advance for the January 2019 payment. This is fraud because the correct and contracted-by-the-US-government amount for the first month was less than $50. They have stolen the $860 only 8 days before Christmas. The funds were not all going to be spent on the Holidays, but some of them were, and they are now gone. Their telephone minion and his flightless bird of a higher-up just hold out their hands (figuratively) and say they can do nothing about it for some unspecified time of 5 to 10 days, which, based on past experience, likely will be at least as long as 10 business days. That's funny, as in a devilish joke. Their computer snatched the bucks out of my account in a blink of an eye, and so surely it could replace them as promptly. But no, that would require personal attention and the intervention of important decision-making and responsible persons inside Ambetter. I suppose Ambetter's MOUTH works when it's time to consume funds, but Ambetter's OTHER END does not, due to corporate constipation. Like a rodent, Ambetter is also unable to regurgitate that which it should not have eaten! The minion also told me what happened -which he should not have.. There were two figures for the monthly cost that showed up in their broken-yet-again computer system, one correct, and one incorrect at 71 times the rate, and instead of them investigating that obviously confusing situation, some other minion simply decided with no further checking, to have the computer simply withdraw the insane 71x amount. He said that this is a growing trend, this sort of "error". So they know about it! My family's custom regarding holiday and celebrations expense is that we do not to use credit cards for them. We put aside $ and use a budget, and we really do have very fine celebrations to which we all look forward. No debt. So you can see where this is going. Ambetter is "the grinch who stole Christmas", and indeed, most of January! However, we will not be put out of good cheer this Season, because we know what the Season is for. It's little comfor that Ambetter will be getting a switch and lump of coal and a whipping from Krampus. I had to call the bank and report this fraud. The bank has temporarily replaced the funds, so at least our plans won't be disrupted for now. All of the emergency worry placed upon us by Ambetter is not appropriate.
The Worst insurance ever. Where did this company come , who is the president of this company? these people need to be exposed for who they really are. They are ripping people off. I been trying to find a cardiologist in my area for almost a year, it's crazy. Something needs to be done about this insurance company.
They told me my ZIP and DOB info was wrong and I NEVER get that stuff wrong. I strongly suspect they lied. Then they put me in a run-around over that to delay and deny covering the hospital claims. TOTAL GARBAGE company
I am native American and the marketplace suggested this is the best insurance for natives that have health benefits from the IHS services. However after a year of having the insurance and it's coming to an end on December 31, not once did Ambetter assist in any payment of any service I received in the last year. All i ever received this past year was denial after denial I would never recommend this insurance to anyone, nor would I suggest any Native American to take this insurance. It was a money pit and not worth the cost I paid.
They don’t care about you in the least. I had them last year. My bank card number was stolen and used for $12,000 in phony charges. I stopped the card and ordered a new one. Visa said my bills would transfer. Ambetter didn’t. It skipped 1 payment and they cancelled my policy. I called and asked if I could back pay them they said NO. I asked if there was anything I could do. They said, NO. I said this sucks. They said, I know it’s compam policy, it happens all the time. Goodbye.
I wasted many hours with them on the phone. It appear that their strategy is to wear you out by wasting your time trying to find 1 actual provider out of the many providers that they claim that are in network according to their website. During a call, Ambetter might help you search for providers, keep you on hold during their lunch break, waste 4 minutes on every call to run you through a long menu before speaking with someone, give you a list of providers that do not take their insurance, refer you to somebody else and finally RINSE AND REPEAT. START VERY EARLY IN THE YEAR, IF POSSIBLE, WHEN SEARCHING FOR A PROVIDER. Don't waste your time trying to pick the best provider yet. FIRST, just confirm that the provider actually takes Ambetter insurance AND that someone has successfully filed an Ambetter claim with them for what you need to have done. Talk to the person that handles the insurance claims at the doctor's office just to be sure. And then, ask them again 2 more times to be sure. If you are lucky, they are correct. Record all calls to Ambetter, if possible, and use an internet phone service that keeps track of all calls numbers and call lengths. After wasting months with them, I filed a complaint with the Texas Insurance Board. Two weeks later, THEY CALLED ME BACK TO HELP FIND A PROVIDER. The provider I chose was one that was on their website for quite a while, but they only recently signed a contract with them. Surprise. My health problems have all been taken care of by a very good provider. I was very lucky! Best of luck to you! Hope this helps somebody!!!
My husband and I live in North Las Vegas and we are very satisfied with AMBETTER.
I'm on Affordable Healthcare Act in which I have a premium and the government kicks in $1,300 a month. I can't even get an ID card to go to the doctor. this is an Arizona I was in Montana before and had great insurance. This insurance company is a joke
I still got high bills, they charge you for being over weight, and high deductible that i had to pay towards at prenatal appointments, this is not a good insurance for expecting mothers.
If I could give it 0 stars I would. There are no doctors in the Dallas, Texas. They won't let me go off it and pick another insurance provider.
This insurance company is so bad they hardly cover anything and they deny most claims even though it’s expensive. And most important of all only few provider accept this plan in Houston,TX and sorrounding counties and most of them start rejecting it after a while
Having Ambetter has been really frustrating. I can't do a number of things that they say we can easily do. Some of these include...1. getting a hold of them on the phone when needed. 2. finding a provider online. Whenever I search it says that there is no one in our area even though there is. What I liked about Florida BlueCross was that it was the exact opposite and they were very reliable.
No urgent care providers in-network withing 50 miles. Run!!! Better off putting the money paid in premiums in the bank. They'll deny your claims. Denied MRI for my hip (that was fractured) and wanted pain meds and PT for 8 weeks first. Because I was unable to access care, I requested a refund of premiums. They agreed and then kept my money. Reported them for consumer fraud in TX, but they lied and I would have had to fight the determination and by then, I was worn out. They are the WORST! So bad, that I didn't get coverage this year because I felt so scammed.
Ambetter is a huge headache when trying to help a parent to at the very least enroll. Ambetter sent an invoice that was not received due to being out of state and mail was not collected properly. Ok...our fault. Then sent another invoice that included the first invoice and a new total that included a price difference for a new health bracket that he qualified for. Ok... no problem. The invoice was mailed with a ck to cover the total right away. A couple weeks later a letter is received stating that the application for the ins. was not processed due to the lack of payment of the first invoice. Umm...the first invoice was paid with the revised invoice. A week later another letter comes stating that the coverage that was applied for is not longer available, so if you don't contact us then we will just enroll you automatically into something of their picking that will actually be better for him. Okay no problem. 2 days later a ck and a letter stating that the actual ck that was received was an over payment of the invoice and because you didn't pay that first invoice that was not received, you get no insurance and have to start all over again! I spent several calls and hours on the phone between Ambetter and Marketplace in reference to just getting him enrolled and why the ck was sent back and denied all together. One pointing the finger at the other and it's beyond words that I can actually post on here. So if you are helping a parent or trying to get this insurance yourself look elsewhere or if you have to go with them keep a close eye on them and write down everything you can about your call if you have to talk to them. Oh and for those trying to help out a parent or member, they say you have 24 hours of authorization from the member. Nope. You have until 10pm central time that day. As for question #4 below, It shouldn't matter if you are a paying customer or not.
This is the worst insurance company! Invest your money somewhere else. Horrible costumer service, they laugh at you, and they won’t resolve anything, and won’t leave you speak to the manager or supervisor. They deny claims , and would also take money from your bank account to renew your policy without your authorization. Run away from this company!!!
Yolander C Henderson
Ambetter is a good company. They're prices aren't too bad, and they contact you personally to inform you when certain preventive care is needed. The only thing I have a problem is with new medications. I have severe migraines, and finally an injection that reduces migraine days to at least half of the migraines per month has been aporoved by the FDA, but it isnt covered. I can't afford to pay my Ambetter premium every month, plus 575 every month for the shot I need!
Every interaction with Ambetter has been a nightmare. You have to contact customer support anytime you need to do anything online because their website is so bad. It seems that anything that might cost them money is burrowed deep into the darkest corners of their site where you would never find it without guidance. In addition, customer service does not respond in a timely manner and is never very helpful. Right from the start I knew they were shady when I signed up for one price and SURPRISE, next month my bill is 20% higher! Not to mention the health providers covered are poverty status. This company preys on people that don't really have any other options. That way they can charge whatever and treat you like garbage. DO NOT USE AMBETTER!
Ambetter told me to have a mammogram for prevented health maintenance. They said it’s free to me. I got it done by a provider in Ambetter network but Ambetter has yet to pay the provider and it’s been eight months. The provider said they have thousands of Ambetter patients that have not been paid on. I’m switching to Oscar Insurance.
Absolute trash. Have been trying to appeal coverage for prescription and have made 20 phone calls totaling over 7 hours or phone time with them and no resolution. It has been 22 days of trying to get my medication covered and they claim that an expedited appeal only takes three days.
Complete waste if money every month. Living outside the perimeter of Atlanta there are only 2 insurance plans available. Kaiser HMO and Ambetter. Refered to as AmGhetto. Our premiums are what a typical mortgage payment would amout to. Nothing is covered and no top rated providers are accepting it...not even the Walmart Care Clinic will take it. We consider ourselves "self pay" in order to get a reduced rate to see quality docs. Thankfully nothing catastrophic has occurred because I have a feeling our local hospitals would not accept the plan. Soooo.... forced to buy an expensive and useless plan through the marketplace that no one accepts, where we would have to spend nearly $12k in premiums and deductible per year before they pay the 1st $1 in reimbursement. Yeah that makes sense. I want my individual plan prior to Obama care back that was reasonably priced, that everyone accepted, and covered everything.
My daughter had emergency situation and joined her in the near by emergency room, ambetter have contract with emergency which is more than 100 miles. We have called ambetter for pre-approval since its out of network and more than 100 miles, she is agreed. Later I was by customer rep that I need to pay deductible then rest of them they will cover. After hundreds of followups (almost 2 years) surprisingly they don't cover anything with strange disclaimers. AMBETTER IS A FRAUD.
Why aren’t the specialists or all participating providers not updated? Why is old information still in the out of date system ? Why are there different tier systems for the member vs Ambetter locater ? Why don’t I have access to the same information in the member system? Why do I have to call to find a provider When it takes a minute on line if updated ? Why do I have to work so hard to find a provider and continue to pay for this insurance ? I answered my own question.....
I have a medical professional within their network and they keep denying she's in their network. When I first called, they said she was in the network, so I went to see her. Then I got a letter from Ambetter saying she's not in my network and they denied the claims. So I called again and they said she is in my network and refiled the claims. Then I got another letter saying they denied again, not in network. It is now the end of the year, the plan is expiring and they still deny these claims.
If you want to have your tests, procedures denied....ambetter is the perfect choice. Ohhhh and pain MGMT..they approve then re nig and deny pre auth Oh and the best part... getting repeatedly hung up on.... Be. Sure to get the agent name at start of call.
Rebecca a Cecil
THE ISSUES I HAVE WITH AMBETTER IS THEIR IN NETWORK PROVIDERS ARE FEW AND FAR BETWEEN. AMD WHEN I CALL MY SUPPOSE TO BE AGENT HE SOUNDS LIKE HE WORKS FROM HOME AND JUST ROLL OUT OF BED EVERY TIME WHETHER IT IS DAY OR NIGHT. THEN HE ENVER HAS ANSWERS FOR ME SAYS HE IS NOT MY AGEENT THEN GIVES ME HIS SONS NUMBER WHO IS SUPPOSED TO BE MY AGENT ACCORDING TO THE DAD BUT THE SON SAYS HIS DAD IS. SO CONFUSING - I JUST WANT ANSWERS AND GET NONE.
I am in Missouri and have had excellent health care coverage and customer service provided by Ambetter.
This is the worst insurance You can find I live in the suburbs & they sent me to Doctors in the south side of Chicago (the hood ) 11/2 hr from my house just to see a doctor then a problem to pay the providers then when I go get my medicine the card isn’t active I’m not in the system .the list of there providers when I call them none of them take ambetter. This is the most sleezy insurance I have ever come across if u want an insurance that doesn’t pay that u have to call then also call the market place over and over again and fight all the time this is the insurance for you
The worst insurance experience ever! Unable to get a person on the phone. Only thing they were worried about was making sure you paid your premium. When my wife turned 65 and went on Medicare, we quit Ambetter verbally and in writing, but still received past due notices for four months after! One arm does not talk to the other at that company!
Ambetter insures me and I went to an in network hospital emergency room. Problem is the ER Dr. was out of network. Even though I have 2 separate copies of my plan and my insurance card issued by Ambetter, all stating zero$$ after deductible with exceptions =-NONE- for IN and OUT of network they are refusing to pay the full bill. I would give Ambetter — stars if I could because they are deceptive and DO NOT pay legitimate claims that are supposed to be covered as found in writing in black and white. I would never recommend this company to anyone.
My daughter has Crohn's and has had 8 remicade infusions this year at Dayton Children's, all were pre approved and it still shows no payments made, all payments are pending. First treatment was in February, When asked, they say they are still in negotiations, in negotiations since Feb?!?!?! They also refused to pay a bill to Cincinnati Children's (out of network) By the way, Cincinnati Children's is the number 1 children's hospital in the country, but they are out of network?!?!?! I urge everyone to bombard their advertisements on Facebook with their complaints and concerns, I did that and was messaged right away. Their member services contacted me, it was obviously no help, but social media is one way to let the world know about them and also maybe get them to act. Another fun fact, they have to give the Ohio Department of Insurance's phone number on their website, when you call that number you get a survey company that wants to give you a "free" cruise. I dialed a couple times and so did my wife to make sure we didn't misdial.
My experience with AMBETTER for the 2018 year has been GREAT. My husband has been to the ER three times and hospitalized one time. All the bills were paid promptly. We both have had a lot of doctor visits and several diagnostic procedures without any problems at all. All of these extremely negative reviews are terrifying and scary as it is time to pick a company for 2019. I only had two choices form 2018, either Ambetter or Kaiser and Kaiser is a true HMO so that was out. The reason I pick AMBETTER is that All the hospital systems in the Atlanta area were included: Emory, Piedmont, and Wellstar. When I have searched for doctors, there any dozens for each specialty. I don't know if my great experience is driven by my location and the fact that we are in the metropolitan Atlanta area or not. Good luck and Good health to all.
I am a healthcare reimbursement professional with may years of experience, I file claims for various physicians, code medical records and perform physician credentialing. Currently, I do not qualify for AmBetter health plans but anytime I have needed to call to verify patient benefits, check health claim status or get an authorization for services or just so I that can help redirect a patient appropriately, every customer service person I have spoken with at AmBetter has been helpful, courteous and professional. Answering all of my questions with care and great attention to detail. As a patient, its better to allow your doctors office to handle things for you but try to be clear when attempting to get answers from your insurer. But it is the insured parties responsibility to personally understand their own insurance like what's covered and what is not, and how much will this cost me? before you leave the doctors office. For physician offices you really should let the right people handle credentialing, people with experience. AmBetter is a great payer of claims and fast; as they keep accurate records and when they recoup because someone made a mistake in claims processing its always been accurate without the chatter like some others, "because we can". Thanks AmBetter you are doing a Great job and you are easy to work with.
Terrible service, terrible policies. They refused to pay legitimate claims, resulting in Collection agencies filing claims against me and ruining my credit rating. DO NOT trust Ambetter with your health insurance.
I have been trying for 3 weeks to find a neurosurgeon with Ambetter, all the ones listed are no longer with Ambetter. I was told that I was referred to a member advocate to find a neurosurgeon that would take my case, my neurologist suggested a Dr. in his area but he would not work with Ambetter. I have been on the phone for 4 hrs. today with supervisors trying to find out why no one has followed up on this. When trying to follow up on this for the 3rd time today. I reached an advisor who told me that open enrollment started today and I should switch insurance. This company should not be allowed by the Florida Insurance Agency to sell insurance in the state of Florida.
Billing and coverage is always problematic. If this were a car brand it would be a Rambler, obsolescent and unreliable. Big mistake going with Ambetter.
Ambetter couldn't consistently provide access to healthcare for my two year old son. Earlier in 2018, I was prompted to alter my current plan to include my 2 year old son. The process to include him was fraught with error and employees who meant well but really couldn't help. I spent hours on the phone with membership services and enrollment, bouncing back and forth because no one knew the number of the appropriate department that handles modifications to existing accounts. And I really mean NO ONE. Not the membership/customer service reps, enrollment department, managers, supervisors, and not even the director. Well at least I'm sure that is what they are trained to say. To give you an idea of how bad it actually is, I spent over 3 hours on the phone today because my 2 year old son's coverage was mistakenly voided, without any notification, even though all bills were paid on time. YES, THIS REALLY HAPPENED TO ME TODAY. When I called and pressed the issue asking why was he dropped from coverage, the membership service rep claimed that they can't drop anyone without that change coming from the Marketplace. Thus, I contacted the Marketplace to see if any new direction came from them. Nada, NOPE, ZIP. That was and outright lie. According to the Marketplace, their last communication was dated, May of 2018 and it informed Ambetter to include my son in my current balanced care plan via a completed escalation. It clearly laid out retroactive starting dates, insurance rates, who should be covered, etc. That information was transmitted to them on more than one occasion, dating back as far as March of this year. Nothing indicated that my son should be dropped on Oct. 30th, as the customer service rep suggested. I contacted Ambetter membership services again but this time I did so via a three way call. A supervisor from the Marketplace accompanied the call. This Marketplace supervisor actually said and I quote, " We've been getting nothing but the run around for nearly 2 hours." Eventually, and perhaps by error or overwhelmed by the complete drudgery of it all, she quietly disconnected as well. This is all truth. I don't have a history of any particular bad luck and I am by anyone's standard a good person. Personally, I don't bear any malice to the folks that work there. They really tried to help but they weren't given the appropriate venue to succeed. That's what Ambetter is. The part that really doesn't any lick of sense is that the only person who was penalized by all this was a 2 year old boy. Prior to this fiasco and by fiasco I mean my experience with Ambetter, I never had any problems like this. If you have kids ... don't walk away, run.
My rating would be zero stars of i had the option. TERRIBLE. My recommendation is to avoid it at all cost. I recently had to look for a specialist. I called 3 separate imes. Each time they would give me contact information on two to three doctors. When I called each one of the doctors in the list, the doctor would do not accept the plan or the doctor no longer worked there. When I lost my patience and called a fourth time they transferred me to another office where they said they would find a doctor and would make a contract with him/her to take me. I waited for a day and a half and finally went to see a doctor and paid out of pocket. This insurance is the same as not having any.
Horrible coverage in Central Texas! They list a lot of Dr but if you really look, the are pediatricians not accepting mew patients. Meanwhile the primary care physicians that do accept it are the bottom of the barrel in quality. This company should not be allowed to exist. Terrible customer service and they deny everything. Total joke .
They seem to have a policy of rejecting preventive care claims for which they are 100% responsible to cover under EVERY health plan. They blame the providers and the truth is that both parties are responsible yet ambetter's claims department does nothing to rectify the situation
Almost none clinics accept Ambetter insurance including convince clinic. This is the worst health insurance I met.
The worst insurance company of all time. Everything I read here is true. No one takes it, even if they say that do on their website when I call them, they say they do not take the plan. I am paying an insane amount for my premium each month and they don't cover anything. I just gave birth to my baby, and if I had gone through the hospital without insurance I would have paid 1/2 the amount that I owe now. This insurance company is a fraud.