Ambetter
5.4
Overall Score
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Rodney Kreinbrink Port Charlotte, FL
I signed up for Ambetter Sunshine health, and came to find out that none of the local hospitals would accept the insurance. The closest participating providers for my needs are around 30 miles away and into a adjacent county. Called to cancel the insurance, and they replied that they are required to give a 14 day notice and that I as an insured am responsible for the full months bill of that window period. Further the I.R.S may access a penalty fee of $642.00 or 3.5% of my Gross income. I feel that they should be sued for bait and switch- for not having enough participating providers within a specific coverage area. At the beginning of next month, I will send them a delivery confirmation letter that states that this will be the last month of coverage.
5 years ago
Andrea Mugnier Reno, NV
BUYER BEWARE!!!! I pay my premiums on time. Every month. But when one of my healthcare providers submitted her claim nothing happened. She is one of their providers. So I called several times. She called several times. We both verified that she was using the correct form, the correct numbers, the correct address to send the claim in. So she resubmitted the claim. After 6 months, still no payment. When I've called I keep getting excuses, usually they try to tell me that the problem must be with the postal service. I"m REALLY tired of their runaround. Today this provider told me she can't continue to see me because she's not getting paid. She said she won't even take people with Ambetter insurance anymore because they don't pay their claims. I filed a complaint with my state insurance commission. These people are horrible- I manage to pay my premium on time every month so I'm holding up my part of the bargain but they're not hold up theirs. They need to stop making excuses and FIX THIS!!!! I'm done being nice about it. I'm going to write negative reviews on every healthcare bulletin board I can find because people need to be warned about Ambetter Insurance- BUYER BEWARE!!!!!
5 years ago
Melanie Green Tampa, FL
Ambetter commits fraud regularly. First, they decided that $8,900 is less money than our $3,000 deductible so we owe everything. They don't comply with federal regulations to provide breast pumps to mothers. They then reprocess your claims to put some money toward co-insurance instead of the deductible so you owe more money and they owe nothing. This isn't how insurance works. They work the Better Business Bureau automated system, saying they're looking into it and then because you don't respond BBB closes the complain. They claimed because my deductible changed after my son was born that his deductible wasn't met. This doesn't even make sense. Ambetter scams health care providers, too, so it's difficult to find one that even accepts Ambetter.
5 years ago
Mariela Picon Dallas, TX
The worsest health plan that I ever had. Do not be accepted in any providers, pharmacies nor clinic or hospital. Irresponsible at 100% you call for help to find a provider and they always say the same thing "we'll call you back during the next 5 days" and never call back. They are #1 to bill you but not to pay for the health needs. Im was recently pregnant and I had been waiting for them to indicate what they are going to do to provide me an OBG cause theres not providers in the entire area of Dallas and nears city that accepted this insurance and nobody took responsible for that. Every time I called they said the same "we are going to evaluate your case and see to assign you a provider out of the network for your prenatal care" never they did it. So not choose this insurance for you or your family. Im not recommended to anyone.
5 years ago
Mandy E Las Vegas, NV
Ambetter by SilverSummit is by far the worst insurance We could have ever possibly chosen for my husband and myself. First of all, even after paying a deductable in full, I am still getting sent bills in the mail that I have to spend hours on the phone disputing, only to get dismissed and pawned off to unqualified people. They don’t have accurate book keeping at all. All their numbers were off. When I filed a claim with them to fix this, they only put one charge on thit claim and not all the charges that they promised would be dealt with. So I’ve had to call again, only to get on the phone with a slow representative that sounded unconfident in what they were doing.
Also, even after you are done paying the deductable, you will die before they approve life saving procedures and tests like mri. My husband now has permanent nerve damage down his leg and foot, because our insurance refused to pay for MRI and pain/steroid injection at the time he could have prevented it. They insist that he has to do 2 months physical therapy first. So we took him to see a Physical therapist and they won’t even touch him because they were never able to examine an mri to know how to properly handle him and they could see that he was in a lot of pain. Huge waste of time and money. They will not pay for the healthcare on time. We think it’s because once you get mri, they know they might be having to pay for surgery so they will take forever just to even review your case - over two months of my husband in the worst pain of his life, just to get a denial. Also, top to bottom, they only pay for what they want to pay for. I was prescribed a medication that they would not let me fill unless I tried a cheaper one for 2 months first which was ineffective. They will try to avoiding paying for the healthcare your doctor thinks you need, and make that decision for you what u can take. We have been going through this so Long that we went broke and now qualify for Medicaid which will actually pay for an MRI. So we now live with regret for ever trusting Ambetter. But are thankful that Uncle Sam can help us out. Ambetter should be shut down they are the worst. You’ve been warned!!!
5 years ago
Tre laf Atlanta, GA
The market place first off mistold me the benefits of this plan. And will not change it. Ambetter can’t override them. So always check and confirm with Ambetter before choosing a plan. I am not at all on a plan that is beneficial to my needs. My other half is a pharmacist and we both know a lot of insurance plans. Ambetter is not clear on their plans, their representatives are long winded talking you in circles only to find out that they can’t do anything to help you. Read the fine print. For me doctors visits and specialists aren’t covered to meet my medical eductible. Only lab work and certain general doctors are. When you get a bill for lab work it’s then you find out that that’s the only thing they cover outside of a general physician after you meet a high deductible. READ THE FINE PRINT AND GO OVER IT WITH MARKETPLACE AND AMBETTER BEFORE YOU CHOOSE A PLAN!!!
5 years ago
Melissa Chicago, IL
Ambetter is health insurance like tying a string around yourself in a car is a seatbelt--it might resemble the real thing, but it's probably more dangerous than nothing.
I got Ambetter because I was sick, uninsured, about to travel and terrified. Suffice to say I am lucky that my health held up and I didn't need to use them at all.
1. They have no gastroenterologists covered in CHICAGO--so if you live somewhere less metropolitan good luck!
When I called to cancel they were polite and helpful, but you can be nice and still be a scam.
My advice if you are uninsured:
1. Go to a free/sliding scale clinic! My clinic gave me 3mo of medicine for 12 dollars that my gastro doctor was trying to charge me $900+ per month! https://howardbrown.org/
2. Call (don't use online) the Healthcare.gov. My online account was messed up and I fixed months of confusing letters and emails with just one phone call. 1-800-318-2596
5 years ago
Jon Low
Can I give less than zero???
My experience tells you to run, not walk, run from Amworse from Inferiorhealth. There are few doctors that take them (for a reason), and I'm in a metro area of about 300,000. The nearest Ophthalmologist is 45 minutes away, and the nearest Neurologist is over a hundred miles away. It takes FOREVER to get approval for procedures. In fact we had to complain to the state of Texas to get them to do the right thing causing my wife to be off work for 2 months when it should have been maybe a week.
We have now had 4 instances where we had a service date in 2017, but because they did not do the billing until 2018, they tried to make us pay deductibles that had already been met for 2017. The problem I'm working on now is my CPAP machine. It paid out in December of 2017, under the 2017 deductible. They have it charged in Jan of 2018 and want me to pay over $500.00 for a deductible for this year. Can you say fraud???
They more than doubled my rates from 2017 to 2018, and raised my deductible by more than 3 times. Because of this I can no longer afford to pay for my insulin, and my Xarelto. I was in the hospiltal for my AFIB and between my Cardiologist and my Primary Care doctor they are giving meds to try to keep m alive.
And by the way, last time I heard Ambetter is the most profitable medical insurance company. Not hard to figure. If you can afford a reputable company, do so....
5 years ago
Amit Sorojon Houston, TX
This insurance is a scam.
Your doctor list will be limited to homeless community services centers. Yeah. No joke. And I live in a big city houston texas.
Your doctors option to choose from will be between homeless aids centers to just homeless comunity health centers.
90% of specialists on their network doctors to choose from will tell you on the phone that you will be a cash payer because they are not really in network with this insurance company.
All doctors I called said they are booked for the next 4 weeks.
You WONT be able to see any doctor before waiting a month for an appointment.
The only place I finally got treated after 3-4 days of fighting the system was a cvc clinic LOL Yeah . Sad. I was so mad.
I pay $500 a Month for this garbage insurance. $500 !!!!!
Do not sign up with them. Its a scam!
I canceled my membership a week ago. (May).
Had enough. Just unbelievable scam in daylight.
They need to be in prison. SCAM!!!!!!!!!!!!!!
5 years ago
constance vernier St. Petersburg, FL
Want to hold Ambetter accountable for the information posted on their website. The implied contract between the company and member is not being honored.
When choosing a 2018 insurance provider, I spent time making sure my doctors and preferred hospitals were part of the network.
In late January My primary care provider dropped Ambetter in 2018 but members were not informed this was happening prior to signing up for the year. Ambetter had amble notice (+3 months) from the doctor and time to remove her from their list. In trying to find another PCP, I've called numerous other providers listed on the website. The first five (near my residence) also no longer accept Ambetter. It's been 4 months and the list is still inaccurate.
Ambetter wants me to accept a random doctor they assign and that doctor is doing a residency. The one experienced doctor I did find is about 40 minutes from my home and was not happy to accept new patients. I searched for a doctor in late January and again in March. Today (April 20) I was told the website is updated but I looked and the provider list still includes doctors who are not accepting their plans. I spoke with their customer services and the lists they’re working from are wrong - Also listing many doctors no longer practicing or no longer accepting Ambetter.
After 4 months this goes beyond administrative error, Ambetter is lying to their members. They’ve been lying from the start and they should allow members who’ve been deceived to see the doctors they expected to see when they signed up and ‘eat’ the cost.
Also have spent a month trying to get a prior authorization on a med I've been taking for more than 5 years. Neither Ambetter customer service nor my DR's office will accept responsibility in seeing this is completed. Each blaming the other for lack of follow through, Stuck in the middle and can't make either side do their freaking jobs!!!!
5 years ago
Nicoleta Skokie, IL
Is the worst Health insurance. They let me die and do not approve of my oncological tests and radiation.Last year they walked through countless hospitals and did my adenocarcinoma surgery in my country.Now I have to do 3-4 brachycardy radiation sessions and I do not approve anything, the hospital is in their network and the type of insurance is agreed by the hospital.I pay them nearly $ 400 a month, the state pays another $ 1200 for me, and they do not approve of my radiation to stop cancer.The women who answer the phones send you to the hospitals without knowing where, they have no idea what to recommend and scream at me that I have to take the hospital in the network. I took hospital in the network and refused to pay for radiation and tests.I'm going to sue them and ask them for $ 10 billion in damages, because let me did.
6 years ago
Mike H Indianapolis, IN
Absolutely horrible selection of providers. I live in Indianapolis, which is the 12th largest city in the country. There are a total of two Physical Therapists in the city as options, and one of them answered the phone in a barely understandable accent with a "hello". I should have know better than to purchase my policy from Ambetter, aka "Crazy Bob's house of tacos and health insurance".
As mentioned in other reviews, there are many providers listed on their site that don't accept Ambetter. I made my selection this year based on the fact that the providers I've had for years were listed. Now I either have to pay out of pocket to see them or change to new specialists, which as everyone knows is a nightmare and takes months sometimes.
Had the GOP and Cheeto Jesus not gutted what they could of the ACA and made threats to stop subsidies that caused 2 of the 4 Indiana companies to drop out of the exchange this year, I wouldn't have to deal with this crap.
6 years ago Edited September 14, 2021
George Pompano Beach, FL
DANGER. Stay away. This company is basically a SCAM. They are taking advantage of the fact that health insurance is mandatory. So inefficient, nobody knows what they're doing. You will get different answers every time. Basically you will have to do their jobs and call the Dr office, Labs or any other provider. Finally they will deny procedures because they know more than your Doctor. Nobody wants to work with them so good luck finding a PCP. Not even the ER doctor wanted to take it so they made me wait until they found someone who will. You are basically on your own. They will wash their hands and give you an absurd excuse.
They are criminals. They prey on the sick and desperate. They will take your money and the government's money and will deny coverage of procedures without a valid explanation.
6 years ago
Alex Chicago, IL
Awful, this is embarrassing. The first five PCP options listed in my zip code are from a health center that moved TWO YEARS ago. When I called to get assistance from a representative, she was looking at the same screen that I was and offered no help what-so-ever, other than blindly selecting names from the list, which I am going to need to call myself in order to verify that they still exist. She asked no questions about my preference or about my healthcare needs nor did she offer any useful information on the PCP's themselves. The whole thing is a sham and this company deserves to go out of business.
6 years ago
Rebecca Watkinsville, GA
Like so many others, if I could give zero stars or even a negative star, I would do. Ambetter is a horrible company. My children, due to divorce, have to receive their insurance through the Marketplace and Ambetter was the only choice I had when choosing a plan. Since January, I have attempted online and through telephone calls to assign a PCP to my children. In November, 2017, when I had to sign up for insurance, the pediatrician they had been seeing was listed as a provider. Through February, she was listed. Today, however, when I went on line to pay (the only part of Ambetter's website that consistently works), I discovered that my youngest had been assigned to a doctor whose main office is almost two hours away (I live in Athens, Georgia and the office is in Austell, Georgia). The doctor does, however, also work at the local health department. When I go to the website of the health department, it clearly states that it's mission is to serve children living in poverty--that is is for the uninsured and the underinsured. Am I to understand that I am paying over $231 a month for my youngest child to be assigned a doctor that he can actually go to FOR FREE? Is Ambetter, by assigning him to this doctor, admitting that is is a subpar insurance company? It would actually be comical except that if my children become ill, we are in serious trouble. If an insurance company can't handle easy tasks like letting members choose their own PCPs, I fear to think what will happen if we actually ever need any type of medical care.
6 years ago
Kyle O'Malley Tempe, AZ
If I could give AmBetter negative stars I would... What a terrible decision I made signing up for health insurance through them. I also partly blame the sales consultant who sold me on the this insurance. I have an infection/abscess that is imperative that I get it worked on immediately. Even though my deductible is an astronomical ($7500) and they won't actually be paying for anything, they have to authorize the surgery and have made me cancel the surgery I was supposed to get today and wait for them to authorize it which may never happen. Also, during this whole process I had to middle man everything between them and my Dr's office. Being put on hold for hours at a time. I'm really confused as to how that's my job... I thought that's what I paid this company $350/month for. On top of it all finding a Dr who takes this insurance was almost impossible and from the looks of it seems like I was extremely lucky I actually did. What ever you do STAY AWAY FROM AMBETTER.. I will be looking into legal action against the company for forcing me to postpone this urgent surgery.
(by the way I am a very active and healthy 28 year old male who never has health issues. This is the first time I have had to see a specialist/needed surgery and have been paying my premium for over 15 months)
6 years ago
Ben Auxier Chicago, IL
I wish I could rate this 0 stars.
This company is literally useless.
I am kicking myself for not looking into customer reviews while choosing a plan. All the details in the marketplace looked great. Reasonable, affordable, nice coverage.
It's only now, as I attempt to make my first in-network appointment, that I realize this network is basically non-existent.
Don't let their website fool you. They have this great, handy page where you can look up lists of "in-network" physicians. There is a 90% chance the person listed doesn't accept Ambetter at all. Maybe never did. It's just a straight up lie.
Run. Run away as fast as you can.
6 years ago
Susan Bohannon Martin, GA
I do not have Ambetter insurance. In fact, I have no insurance at all. I was looking at my options, and from everything I've read, it sounds like everyone should run as fast as they can in the opposite direction from this insurance company. Never before have I ever seen any company with nothing but negative reviews. I never did see a positive review. Isn't there an agency with the government who oversees this sort of thing? If so, then they all need to be fired for not doing their job.
I feel bad for everyone who bought insurance with this company. It is a shame and a disgrace that you now find yourselves at war with them - just to provide the service that you paid for and expected in the first place.
Please remember that YOU paid them for a service, which technically means that they work for YOU - not the other way around.
Stand your ground, and never give up. You hired them, and you can fire them. Ambetter is by no means the only insurance company in existence. Sometimes companies have to be reminded of this fact.
I am really sorry that you are having to go through this nonsense. I wish you all the best. ?
6 years ago
kathy moran Smyrna, GA
Terrible! Excessively expensive. Most doctors do not accept this insurance. I had to obtain all new doctors except my primary care who got added to their program.
They DENY everything! The refuse the information provided on the pre-authorization.
It's a scam. They require you to "try 3 other medications", even though you have provided proof from your previous doctors (not in the AmBetter network). This is so they can charge you MORE . You have to pay for those medications, that don't work and could potentially cause you harm because they do not work. Their customer service SOP is to repeat their mantra. Please explain what I am paying for? I cant go to my doctors, the cost is outrageous and they deny medication so that you get sick and they can charge you for unnecessary medications. My doctors HATE this insurance. Unfortunately, there is no choice in this state due to our republican led congress, senate and so called president.
6 years ago
Paula Mock Conroe, TX
I had to give it one star only because there is not a negative selection. I chose this insurance through the healthcare marketplace because it seemed to have a lot of providers. I have contacted over 25 of the physicians on the list, only to find they do not accept this insurance. In my opinion this is fraud, since they misrepresented information. I am 49, have had a heart attack, am diabetic, and have other issues. I am simply trying to find a primary doctor for a simple checkup and refill basic prescriptions. I contacted a nurse from this group and was basically told that to get my blood pressure medication I should check into a hospital and complain of chest pains. I would highly recommend that everyone avoid this healthcare provider at all costs. The customer service reps are courteous but they are limited on their assistance.
6 years ago
C Nordy Greenwood, MO
If I could give 0 stars, I would. Ambetter is THE WORST health insurance I’ve ever experienced! I’ve been on the same medication for years and suddenly when I have to switch my health insurance, now they won’t cover my medicine. Instead they want me to try the cheapest option out there that has already caused me severe gastrointestinal problems to probe that a higher dose of that won’t work before they’ll let me use my standard medicine.
Meanwhile my blood sugar is now out of control because I can’t get the meds I need. So I’m essentially paying hundreds of dollars a month to a company to feel like I’m in a 3rd world country:
6 years ago
Bernie Johnson Spring Branch, TX
This is by far the worst insurance company I have ever done business with. From not covering knee injections (that were never a problem with my previous insurer) to basically denying virtually every claim you make and forcing your Doctor to jump through hoops to get coverage - they are the worst. I think they have a standard business practice of denying claims. Now...they apparently have a new plan to screw consumers regarding specialty drugs that have loyalty programs to help cover your deductible. According to my specialty pharmacy...Ambetter is fighting allowing the loyalty cards as covering your deductible. They are a horrible company.
6 years ago
Joy Roach
Horrible insurance. My husband has narrowing of the aortic heart valve. He is supposed to have a yearly echocardiogram but Ambetter refuses to cover it. Ambetter is the only health insurance we can afford, so my husband hasn’t had an echo or seen a cardiologist in years.
His primary doctor said he needs to be on a specific heart medication but Ambetter refuses to cover it. The doctors office called Ambetter and explained the situation and told them that it’s legit, he really does need it. But Ambetter refused. He never got the med. I hate this company but it’s the only one on the ACA exchange in my area in Georgia. I have no choice.
6 years ago Edited September 14, 2021
Joel Mitchell Boonville, IN
Good luck getting medication if you happen to be allergic to the "standard" treatment. For six days customer service repeatedly lied to me (and the pharmacy) about never having received prior authorization from the doctor for my prescription. The customer service representatives' job was clearly to make me shut up and go away without doing anything to resolve the issue.
When the doctor called to find out why they had not acted on her prior authorization they finally admitted to having received it but denied the claim anyway (with different people citing different, contradictory reasons for doing so). If you can afford any other health insurance go with that rather than Ambetter!
6 years ago
Jay Fort Myers, FL
Please note everyone who has written a review here. Klafter Olsen & Lesser has a class action suit against Ambetter's parent company covering all the complaints we have all experienced. Please call and inquire about signing on to the suit. Ambetter customer service does not exist. They channel you through multiple depts where no one has the authority or the desire to help you with your issues. They lie about timelines when prior authorizations were submitted and deny claims for no logical reason. They do not have adequate providers for skilled nursing, It has been 45 days since they received my Rx for my infusion and I still do not have nursing to administer the drug. I have spent over 30 hours with Ambetter and their two specialty pharmacies with no resolution. The company is not trustworthy and customer service is not qualified to handle any logistical problems.
6 years ago
Rhonda Athens, GA
If I could have given Ambetter zero stars I would have! I was forced into using this company because it was the only option I had for insurance on the open market in Georgia. My first experience was needing an Gynecologist so I went on their web site and it listed 9 in and around the area I live. I called everyone of the ones listed and NONE of them accepted Ambetter!!! Some even wondered why they were on the list, as they had never agreed to accept Ambetter Insurance. So basically this company lies and is deceitful. Shame on you!!!! They charge basically the same thing I was paying last year to BC/BS but their services and provider options are way below par. I'm so angry and frustrated. If you can avoid using this company do so....find something else if at all possible.
6 years ago
Ale Marietta, GA
"POS", and that doesn't mean point of sale either. I will let you figure that out. Worst company I've ever dealt with. I was automatically signed up in December of 2017 for the 2018 calendar year (previously was covered by Blue Cross Blue Shield). Also received a notice from Am better stating I was covered as of January 1st 2018. Went to the ER and personal physician and gave them my insurance information. All was good until my doctor's office called and said the insurance company denied my claims. I called Ambetter and was told they hadn't received a payment from me. I immediately told them I hadn't received an invoice or payment request and agreed to pay immediately for January and February 2018. They accepted my payment and told me I was still covered from January 1st 2018. I specifically asked if my policy would cover my doctor and ER visits from January and February and was informed by an Am Better Rep I was covered and to ask the Hospital and Doctor's office to refile the claim. THE CLAIMS WERE DENIED AGAIN. I called Ambetter, just to find out they cancelled my policy and transferred me to The Market Place so I could resolve this matter which was Ambetter's responsibility. Have now called several time and Ambetter keeps claiming policy is cancelled, however was initially told payments were made and I was also covered from January 1st, 2018. Made payments, haven't received any information other than it's being revised via The Market Place. Sounds like a used car dealer that takes your money and screws you by giving you a piece of crap. Wow, Ambetter the used insurance dealer!!!! P.S Have almost $13k or more in healthcare bills that have to be paid. My luck never have to go to the doctor but when I do my insurance wouldn't cover me. In the Market Place's defense, they are working to try and make Ambetter pay. Hoping it works.
6 years ago
Dafni Lustig Orlando, FL
IT IS TRULY BEYOND BELIEF HOW BAD THIS HEALTH INSURANCE IS.
First off, they do not update their provider directory on their website (which they're so proud of!), and as a result, I spend at least half an hour whenever I call a doctor to make an appointment, just to be told that they are not working with this insurance any longer! This has happened to me 3 times.
Last time I called a phone number that the lady at the member services gave me for an ear doctor, only to hear on the other line:'Sorry, it is a facility with eye doctors here.' Great!
And since I have chosen my PCP over the phone with them, they have failed 4 times so far to put the specific doctor on their system (instead they have a name of a doctor I never chose!), so now that I have an appointment with my PCP tomorrow, I will not be able to see her, because they have put the wrong name of a doctor on their system!
STAY AWAY FROM THIS HEALTH INSURANCE IF YOU CAN!
6 years ago
Natalie San Antonio, TX
When I first got Ambetter, it seemed alright. I got my pair of glasses through Ambetter, and went to the clinic once with no hassle.
Suddenly, Ambetter is no longer used at the same places I went for my glassess. I asked around, and basically nobody uses it! So, I cancelled my insurance since it's useless...but the cancelling part is why I am giving Ambetter a one star review. I called to cancel my insurance numerous times, yet I am still getting letters and emails about making payments. Not to mention, the newer premiums are ridiculous.
I'm not paying for insurance that is useless and way too expensive.
6 years ago
James Hall Phoenix, AZ
I don't know where to begin and I'm not going to spend more time here other than to list mwhat I've learned from 3 years with this "health plan" and too many hours ospeaking with "customer support:
(1) they are trying to rebuild their computer system and it's a mess. They have 3 different member IDs as they migrate to the new system yet the system does not always "know" about the legacy IDs -- worse yet, some cust support people are unaware. The result is you will often have no way to actualy discuss your account with them.
(2) Their online website is a total mess. Links are broken, data is incorrect, provider listings are out of date. They even changed their domain without telling members - or even providing a forwarding link. omfg.
(3) The billing system is FUBAR. I received a bill for hundreds of thousands of dollars (montly premium!) and -- they will have difficulty just figuring you latest balance. They've actually sent me cancellation notices due to the fact that theyir system simply has no idea what your balance is -- or: has it mixed up with previos policies that you may have had with them.
(4) the "provider directory" is insanely out of date. They claim it's updated but I've called so many of these doctors only to be told that they've left the plan months ago. When this is pointed out they will blame the doctos for not updating their own profiles in the sysrem. It's a joke.
6 years ago
Shari Glendale, AZ
This company is the worst!!!! They keep sending me the wrong ID cards and every time I call they say the new card is "in the mail". Every card I've received in the mail has the old information from last year. In addition, the cards I've received only has my son listed and not me (I am the primary policy holder, he's only 4 years old). I have also had to call about questions I had regarding my schedule of benefits. Everyone I speak with gives a different answer. Some tell me I need a referral to see a specialist, others say I don't need a referral as long as the doctor is in network. Which one is it??? I also find it incredibly irritating that there are only two Pediatrician's on my plan and neither is close to where I live. WTF? I do not at all feel confident about this insurance plan and strongly dissuade others from signing up with this horrid company.
6 years ago
jessica Bentonville, AR
I am trying to figure out how to file a grievance and complaint. I have had Ambetter for 3 years and have never had a problem until now. I was told a couple weeks ago that I would need to make a payment of $91 to get my insurance renewed for January 2018. I did not have the money but I went ahead and over drafted my account so that I could get my insurance back. Come to find out, the agent did not realize that I am with Ambetter through my state and that I did not need to make that payment to get my insurance reinstated. The state of Arkansas would do that. I was upset and sent an email in. I received an email back from them on 1/16 that they requested a refund for my account and I would get that money back since it was their error. Well, I called to check on it that day because I was worried they wouldn't do it and come to find out, they had not. That agent said she would put the request in right away and it would take 2-4 business days to have it credited back to my account. She said it will be there by Friday. So Friday rolls around and it is not in my account. So again I call back and this agent tells me the request is open and they are working on it so it should be available in my account next day. Saturday rolls around and it is not in my account, I cannot call because they are closed on the weekend. I called this morning, and the agent says "Sorry I see a note in here that you are not going to get a refund" I said I need to talk to a supervisor because that is not what I have been told. I am on hold for thirty minutes, I never got to talk to a supervisor and the agent came back and said the original request for my refund was not done correctly and that is why it never happened. She said she would request it today and it would take 7-10 business days!!!! I said you need to talk to whoever you need to talk and request that this gets expedited because this was Ambetters mistake and they need to make it right. She placed me on hold for another 10 minutes to tell me "sorry but they said it takes 7-10 business days and there is nothing they can do" I asked her for a number to file a complaint and she gave me the 1877-617-0390 number to call (this was the number I was on the phone with!!) Someone needs to look into my account and make this right and get this expedited immediately. My state lets me pick which health plan I wanted for 2018 and I picked Ambetter again. I am trying to figure out how to cancel this request and choose another plan.I would rather pay more to get treated fairly! It is never OK to do people this way. You were quick to take my money but you sure as heck will not give it back!!!!! I have worked in customer service for 10 years and there is ALWAYS a way to put issues at the top of the "Que" especially since it is your companies fault.
6 years ago
Jay Carmel, IN
They suck. Some doctors they list as being in-network are not really in-network. Be careful.
Around the middle of this month, I got insurance through my job and I then canceled my Ambetter insurance (hooray!). For the past week, my wife and I have been trying to get a refund for the 2 weeks this month that we won't be using their insurance. We've made at least 10 phone calls, and only 2 of them ended up getting through to a human. One day, the phone system at Ambetter was down. One day, I got stuck in a loop (I pressed 7 for 'other issues', and then they repeated back the menu I had just heard). Another day, I just didn't have enough time to go through the menus and wait for a human.
6 years ago
Brianne Royse City, TX
Ambetter worked well for me when it came to treating my depression. I paid $1 per visit, my prescription was cheap.
Move forward two months and I discovered I was pregnant. Here's where it got extremely messy. I was unable to see a doctor until I was 20 weeks along in my pregnancy. My child has hydronephrosis band cerebral spinal fluid on the brain, something that would have been noticed if AmBetter had been capable of helping me locate an OBGYN. the list of doctors in my area (Dallas, tx) was full of wrong information, wrong numbers, they didn't accept AmBetter, weren't taking new patients or they were "high-risk" doctors only. I called AmBetter numerous times to get help locating a doctor, and they found one... Two hours away. I live in a large metroplex, how do you NOT have doctors!? I couldn't afford the four hours of driving it would take, especially if there was an emergency.
For weeks they tried to find me one, and they did. I went to my first appointment to be informed it would be my last, they were no longer accepting AmBetter insurance. More embarrassing, the physician told me that many women were in my position because AmBetter was not ran properly so many OBGYNs would no longer be accepting it.
So the struggle began again to find another physician, at about 20 weeks they found me another one, this physician wanted my deductible upfront immediately and wanted to charge me fees for my appointments and ultrasounds as well as my deductible, because he doesn't report the v deductible as paid until after the delivery.
What was the purpose of this insurance? A monthly fee of $160.00, a high deductible, no doctors, paying full price for procedures after meeting the deductible... It was ridiculous.
6 years ago
Terri Las Vegas, NV
Is this company a scam??? I paid premiums for my whole family and still have not received cards. However I did receive bills from them for the second month of premiums. I cannot log into my account online because when I click on "log in now" a "Not Found" page comes up. When I call, I either get a busy signal, or go through the waiting process only to be hung up on. I have never been able to reach anyone on the phone. I can't find any doctors in Las Vegas that accepts this insurance and I can't log into the website to find providers that I can go to. Again, nothing can be resolved because I can't get in touch with anyone. I initially signed up with automatic payments and since I can't log into my account or get in touch with anyone I am unable cancel this bogus coverage. I seriously think they created this company to scam everyone out of money.
6 years ago
William Hale Atlanta, GA
Ambetter is one on the worst companies in existence. They say they want to help you yet instead the employees and supervisors argue with you about everything., They blame the marketplace on everything but the marketplace tells a different tale about what occurred.
They are useless. They never back down only argue with you. Customer service is a misnomer with these folks.
Stay clear they o them they are re not your friend. They refuse to listen to your concerns and denigrate you on the phone.
They argued that i owed them a monthly y premium of about $82.00 from April 2017 although they never sent me an invoice telling me that. I asked to make payments and they refused. They are ridiculous - $82.00 ? for a national insurance company? Really? Wow the marketplace told me Ambetter cancelled the policy and told me to call them back. I did. They argued with me that the marketplace cancelled the plan not them.. They accepted no responsibility. for the policy being cancelled.I had to go to Kaiser to get a better insurance company and I did thank God.
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Do not enroll with Ambetter they are sharks and not in your best interest by far.
William Hale
6 years ago
Alan Palider Chesterton, IN
The worst health insurer ever. This POS was borne out of the disaster known as obamacare. Very few doctors and hospitals take this insurance (and for a good reason). They do not review and discount; so, since everyone has an extremely high deductible, you get stuck paying the bloated insurance price on your own. The reps are extremely inarticulate (my guess is they might have a second grade education at best). The reps are also extremely rude. I usually have to call a minimum of six times before my request is met. The latest is my insurance cards. I just got off of the phone with a moron for this same purpose (this is, so far, my third request). I hate, hate, hate, hate this company. But thanks to obama all of the other (decent) programs are so expensive I can't afford it. Many of us are stuck with this garbage. Hopefully, things will get better. I'd love to see this company go belly up.
6 years ago
Alicia gironda Valrico, FL
Scammers! They took $351.36 out of my bank account just a week before Christmas! I filed for a refund, was told 3-5 business days, then told 14 business days.. Just called after the 15th business day and the refund was never even issued! I've been hung up on multiple times by customer service reps because they didn't know what to do to help. I've remained as calm as possible with them, knowing it's not directly their fault.. I've gone above them and spoken with supervisors and management and have not been told anything in regards to whether or not my refund has even been approved or not. $350!! All because i had auto bill pay set up to take $12.95 every month for my insurance.. They automatically re-enrolled me and took the money without my authorization! Calling the insurance commissioners office today! DO NOT INSURE YOURSELF THROUGH THIS COMPANY. customer service is a joke!
6 years ago
Sandra Virginia Beach, VA
Ambetter, please check and update the doctor's phone numbers on your website. I keep getting calls for a doctor in FL where the area code is wrongly listed as 757. This wastes so much time for clients and for me. Thank you.
6 years ago
Rachel Dowda Lake Worth, FL
This is the ABSOLUTE worst insurance I've ever had.
They were impossible to reach...I always was on hold for 30min or longer.
I had to get treatment for a serious medical condition, and they wouldn't work out a single case agreement, even though what I needed wasn't covered in network. They finally agreed after I waited two months finally getting an attorney involved. Meanwhile my condition just kept getting worse.
While I was trying to get coverage during that time, they would agree to a place, and then a few days later call and change their mind. My case worker kept saying she was new to my case and thats why she didn't know what was going on, but in reality she was my case worker from the beginning. This company was very deceptive and difficult to work with. I would NEVER choose them again, and I'm encouraging all my loved ones to stay clear of it also.
6 years ago
Patrick Daly Shawnee, KS
If I could choose less than 1 star, I would. This company has been incredibly unprofessional in the time that I have had them as the provider for my daughter. First of all, their website doesn't even allow me to create an online account because my daughter is less than 12 (she is 2 years old). Why would anyone assume that someone less than 12 would be the one creating the online account to pay the bills? Second of all, they dropped a bunch of providers/hospitals last second before 2018. And finally, when I tried to call in to make a payment (because I am unable to make an online account to do so), I talk to someone who I can barely understand because their grammar is so bad. This someone says, "call back in an hour and talk to someone else about making a payment". This company is incredibly unprofessional and should not be allowed to operate in this fashion.
6 years ago
Arthur wanatowicz Muncie, IN
I received a letter notifying me that I was canceled on nov 1, 2017. That was what I wanted and I went to the healthcare website and removed my name by going into the my account. They sent me a letter stating I lost my chance to sign up because the healthcare window closed. Then three days later I received a congratulation letter that I was enrolled for 2018 and a bill for $1800.00. I called ambetter and the lady said I wasn’t In the system and transferred me to a rep from the gov website. She told me I was not enrolled and did I want to get off Their email and do not contact list. I said yes. She also told me the website does not send out bills. Ambetter is a maze of confused people.
6 years ago
Amanda Chicago, IL
Hard to find doctors that take this insurance. Too hard to find a new doctor even though i hate my old one. Their billing is so slow. I pay by check and even though the date on their bill is after my check cleared, they half the time claim i didn't pay last month and the call reps chew me out for doubling up on payments even though I pay every month. This last month i actually did miss a payment. I need to pick up a Rx and even though my payment shows rec'd Thursday and went thru Friday, it's Tuesday and they still can't clear my suspended status so I can pick it up. They say it will take until Friday for my status to clear. The cost has also kept changing at pharmacy over this and they can't explain why. (It's birth control and so should be no cost to me). Price has gone from $500 to $140 and even shows a copay? ALSO, their my health pays reward program is bogus. There's an error when you try to sign up and calling does nothing. They just say keep trying. Perks you can't get, false advertising.
6 years ago
Hunter Memphis, TN
DO NOT USE AMBETTER/MAGNOLIA!!! After I moved out of their coverage zone, they essentially refused to cancel my coverage even though I was no longer eligible for it. On the phone, they assured me that my coverage was terminated, then I was charged for another month. When I called back, they said I was still enrolled and then REFUSED TO terminate my coverage. I eventually had to do a three way call with ambetter and the healthcare marketplace just to ensure they would terminate my coverage. They told me I would be refunded for the month I was wrongly charged for, but I never received that money. I've been considering calling and asking about that money, but losing that much money might be worth it to never have to deal with this horrible organization again.
6 years ago Edited September 14, 2021
Kat Mesa, AZ
Why isn’t “No stars” an option? I underwent cancer treatment 18 months ago, and due to all other insurances leaving The Marketplace for 2017, I was stuck with Ambetter as they were the only insurance offered. I was to have a PET scan every 6 months as a follow up protocol for the next few years, because, well- cancer.
My PET scan in April was denied by Ambetter. They authorized a CT scan, and of a smaller body region. After finding enlarged lymph nodes in September, another PET was ordered. Denied. But they authorized a CT, which showed nothing. I then had an ultrasound and needle aspirates. Positive for cancer. A PET was order again to find out where else the cancer may have spread. Denied! Come on!! My oncologist spent 30 minutes on the phone with Ambetter to get it approved! Can’t wait to see what else they deny. If I they had authorized the PET back in March, I may not be in the boat I am now. Thanks Ambetter for toying with my life.
6 years ago
Ross Kleman Decatur, GA
BEWARE, call any Dr they are advertising as 'in network.' This company is dishonest. Marketplace website and their rep on the phone told me three of my five main family Doctors are in their network. When I called the Dr offices they all reported that they haven't been, are not now, and aren't going to be next year covering their insurance. One said they aren't accepting new Dr members even if they wanted to join. I have reported them to the Georgia Insurance Board and would ask you to as well if you find these illegal practices. Once you sign up you are stuck with them for a year and as you can see from the reviews, no one is happy. I told them of this and a week later all three doctors remain listed as 'in network.' You will regret signing up with this terrible company.
6 years ago
Denise M Garland, TX
If I could give this company 1/2 of a star, I would... and they only get half because they covered most of my prescriptions. However, even though I live in Dallas, paid for the PPO plan at $667 a month... not one time did they actually pay a doctor's visit. NOT A SINGLE ONE! My thyroid needed to be looked at by an ENT... not some rare specialty... an Ear Nose and Throat doctor... IN Dallas. The closest one they had on the plan was in Ft Worth. I submitted everything to go through that doctor's referral process, which took 6 weeks... only to be told that the ENT that Ambetter sent me to, after being on the phone for almost an hour and a half... that doctor told me, again after 6 weeks of calling and following up... that they don't take Ambetter. Try calling ANY doctor, they have never heard of this company. This is a scam!!!!!!!! This insurance company should be put out of business... they are committing theft with every premium they collect.
6 years ago
Danielle Miami, FL
If I could give this insurance a 0, I would. This is the worst insurance I've ever had. I called to see if the doctor I wanted to go to was covered and they told me he was. Then after I go I received a bill because he wasn't covered. Now I have been disputing this claim for 4 months. No one ever calls back when they tell me they will call me back and I can't even count how many times they've told me that they were going to escalate the issue. I can't believe how bad the customer service is because every single insurance that I have had in the past has been very helpful. I'm definitely cancelling this insurance and telling everyone I know to not waste their time and energy.
6 years ago
Randy Constan Tampa, FL
Its a shame that this company was even allowed to qualify for ACA silver plans. By making their plans cheapest, that diminishes the tax credit based assistance to pay premiums for all plans. That would be fine, if not for the obvious reason they can make their plans so cheap: They have no doctors! Oh they have a list, but if you've had a history with other "REAL" companies like Fl-Blue, United Healthcare, Aetna, or anything like that, and have had a few medical issues, you know that you'll likely never find a single one of your doctors in the Ambetter "network", and further, none of your doctors will have even heard of Ambetter. The ACAs future is obviously in jeapardy at this point. But I still wish Ambetter was never allowed into the ACA.
6 years ago
Maria Garza San Antonio, TX
Warning to all seeking an insurance plan please do not and I repeat do not go with Ambetter by Superior through the Marketplace. Its been a nightmare trying to find a doctor that takes this insurance, even facilities will not take this insurance. The doctors that see you at the hospitals that are in contract are not in contract so you will be responsible for paying these doctors hundreds to thousands of dollars. My thyroid doctor dropped me because Ambetter wouldn't pay and also because they kept sending him people to see from out of town. I am so glad that my plan ends December 31, 2017, finally this nightmare will end and I hope to pick a better insurance that pays and will be accepted by doctors.
6 years ago
