Ambetter
5.4
Overall Score
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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
Nathalie Gooding Miami Beach, FL
They provide decent coverage at an affordable price but their so-called "member resources" are terrible. The website in particular is very poorly designed. Links lead nowhere, information on one page contradicts another, there is little overall logic to the way information is presented and finding a doctor is the most frustrating, fruitless process ever. Calling member services is no better! Each person who answers the phone tells you something different and most are just ill-informed.
6 years ago
DARLENE KELLER Selah, WA
If I could give this company a negative rating, I would. My primary care doctor who I have seen for over 20 years stopped accepting Ambetter insurance as did the majority of specialists in my area and one of the major hospitals. I did a search on Ambetter's web site for a primary care physician and started calling clinics and doctors on their list. Most of the doctors on Ambetter’s approved physician list were not accepting new patients or were 6 to 7 months out for an appointment. I found a doctor 50 miles from where I live that was on Ambetter’s online search list of in network physicians who was accepting new patients and could see me within two months. I specifically asked when I scheduled my appointment if they accepted Ambetter insurance. They assured that they did. I saw this doctor twice and had standard blood tests done at their clinic to the tune of about $1,000. My claim was denied. Out of network provider. I now see that this doctor is no longer on the list of network providers. No one bothered to inform me or my doctor about the change and I have a bill I cannot afford to pay. Some people say having Ambetter insurance is better that not having any insurance at all. Actually it is like having no insurance at all! Thank goodness I will be on Medicare in another few months which presented my next problem with Ambetter. I spent over 45 minutes on the phone much of which was on hold, talked to 5 different people repeating the same information trying to terminate my coverage when Medicare takes effect. When I questioned why such a simple request was so difficult for them to handle, I was rudely told that I had called the wrong number for policy termination. Gee I called the only number I had for them which was their customer service number. I repeatedly told them the date for termination which was the end of the following month which was already paid for. I even sent them an email through their web site with the termination date IN WRITING. Well they terminated my insurance one month early. Who knows how much time and effort I will need to make to try to correct this mistake. I purchased Ambetter insurance through the state change because the premium was what I could afford. I would have been far better off to have spent more and purchased insurance from a company that is reputable. Bottom line....stay away from this company. They are the worst of the worst Their insurance is worthless and their customer service representatives are ill informed, rude and imcompetant.
6 years ago
Chris W Mount Prospect, IL
AM-WORST.. nothing Better about them! Let me start by saying the in-network doctors to choose from are horrid and often have the worst ratings and reviews as doctors. Also I found myself in an all Spanish speaking office with clearly mostly medicaid welfare patients because that's the Doctors available in Ambetter's plan! I had to stop seeing my Doctor I've had for 20 years because she isn't in Ambetter. (same for my oBGYN) Between spending 40 minutes on the phone with billing problems ( not getting my monthly premium bill properly and having no reason why) to fighting to get my stupid $25 credit for a flu shot, they make you jump through a whole bunch of hoops and I'm writing this review as I sit on yet another phone call trying to resolve this -- my 4th one within 2 weeks and about 3 hours of my life I can't get back. Ambetter has this supposedly wonderful 'My health Pays' benefit where you get $25 if you get your flu shot and you can get it at your Doctor's office or a participating pharmacy. 1st I was told to wait another week (as the credit is only supposed to take 2 to 3 weeks but this was 4 weeks later. Today is October 24th and we received the flu shot on Sept 2. Their system can't handle a pharmacy claim instead of a Dr. claim. Its unreal. I've never had to fight this hard over $25 before. Maybe they should just stop offering this benefit if they can't even follow through and honor it! We will NOT be getting Ambetter for 2018. Back to Blue Cross, Blue Shield we go!
6 years ago
Brent Murphree Olive Branch, MS
Ambetter/Magnolia has been by far the worst health insurance company I have ever been required to use. The list of doctors that I'm allowed to see is ridiculous, getting referrals is borderline impossible, and medications most of the time are actually cheaper to purchase out of pocket than they are if you were to use your insurance. My monthly medications would end up costing me $140 more per month than if I were to just use an RX coupon website like GoodRX...and that's just terrible for an insurance company. Random generic drugs have been denied coverage because they claimed were unnecessary when it was plain as day that it was the one medication I need most for my condition and is relatively cheap compared to other drugs on the market. Customer support is severely lacking and I would almost be better off paying for my medical costs in cash rather than paying my monthly premiums - that is how sad this company is. The only problem would be if I had to go to the emergency room I would not be able to find one in my area that would accept me, and frankly is the main reason I stuck with them.
6 years ago
Carla Goroski Bothell, WA
Billing mix up and every time I call to resolve, I spend 40 minutes going over what happened, with the rep reading their records to "get up to speed". Then they ask me to mail info...which essentially goes into a black box and I never hear back from them...nothing happens...and I don't even know if they get it....but they won't us e-mail...even for "non-medical" info. Or they say they'll put in an investigation request and nothing happens...no one contacts me and the cycle continues. I call again...yada yada yada. Argh!! I had 3 months of premium payments that were sent directly (via checks) from my bank to Ambetter. They cashed the checks, but never posted them to my account. So my account showed 3 months delinquent (non-payment). They then threatened to cancel my insurance, if I didn't pay, so I paid the 3 mos again with my credit card and proceeded to work with Ambetter to resolve the issue of the unposted checks. I sent front and back copies of the checks showing that they received them. After months of prodding, they finally posted 2 of my initial 3 payments and issued me a check returning 2 months of "overpayment". It's 5 months later and Im still fighting to get them to correctly post that 3rd payment to my account.
6 years ago
Irina Vishneva Winter Park, FL
SCHAM!!!!!!!!
I signed up for the insurance based on the list of providers on their website. In reality more than 95% of the providers do not take the insurance: OB GYN only takes you if you are pregnant; no updated primary care on the policy...
They scheduled an appointment with a OB GYN only for me to arrive and to find out that they do not take my insurance. My primary care doctor was no longer with the insurance and they did not even know about it.
Primary care doctor wait is 3 months. Dermatologist visit is only possible through a referral from primary - so good luck getting it!
Zero professionalism and absolutely no doctors available! Complete misrepresentation of the health care providers on their web site!
Please, call your doctor to make sure they really work with this insurance because most likely they do not
6 years ago
Jerry Rockwall, TX
I have dealt with several different health insurance companies customer service departments over the years and have to say that without a doubt, Ambetter (who I refer to as Nobetter) has achieved the WORST customer service ranking of them all. That along with having healthcare plans that very few providers will accept, contain escape clause language so that they pay for very little if anything towards medical services, has escalated them to #1 WORST status for these areas as well.
Well done Nobetter, you have managed to achieved a trifecta for of the areas I mentioned above and earned you the status as the Worst Healthcare Insurance Company out there. That is not an easy task to accomplish, as there are several to choose from, especially when there are providers like Molina out there!
6 years ago
atanu sen Chicago, IL
I was insured with Ambetter in 2016. never actually got to make use of them other than once when I had to do a preventive blood screening. I was told that if tests were done through a LabCorp, Ambetter would cover 100% of the test charges. When I showed up at LabCorp, I was asked to order the test through RequestATest.com which I did on the spot on my smartphone and got the test done with an out of pocket payment of $199. When I later made the claim to Ambetter, they would not reimburse me saying that they do not identify RequestATest.com as legit, even though RequestAtest supplied all the CPT codes for the tests and a legitimate receipt. I therefore lost my $199 straight. If you are in the market looking for insurance, please please please!! DO NOT Purchase AMBETTER!!! They will take your money and never HELP you when you need them!!! Big time CONS and total SCAM!
6 years ago
Chanel
Ambetter is that ABSOLUTE WORSE insurance company I've ever heard of! My issue with them begin with an error in the spelling of my name which I discovered about 2 days after my coverage began, this led to one of their representatives choosing to cancel my insurance (without ever being asked to do so and without my knowledge). As fate would have it, I ended up admitted to the hospital about a week later. Once I gave my insurance card and the hospital contacted Ambetter they were told my costs wouldn't be covered due to ME canceling my insurance. I then spent the next YEAR going back and forth with Ambetter about this issue since I paid my premium for that entire month and never received a refund when it was cancelled without my knowledge (therefore it was still active). And recently I have been notified by Ambetter that since it has now been over a year since the issue began they are completely refusing to handle it! Like how low down can a company be?! THEY 100% dropped the ball and did so without my consent, then gave me the run around for OVER A YEAR constantly telling me someone would contact me (normally saying within 90 days everytime), and now that they've bs'd me long enough they are completely clear from paying a bill that my premium was paying them to take care of... meanwhile I now have all of the hospital bills negatively affecting my credit! I am UTTERLY DISGUSTED that a company that treats it's members like this has been allowed to continue for so long and doesn't have to face any consequences while it destroys people's lives!!! I literally would've had less stress if I had just had no insurance, but I didn't want to be penalized by the government! If anybody has any advice on what my next course of action can be, PLEASE LET ME KNOW and thank you.
6 years ago
Steven Milman Austin, TX
I have filed a lawsuit against Ambetter and their parent company Superior Health. My complaint is that they recommend doctors who are not on the plan. Most of the providers on the plan are Medicaid clinics because Superior Health's primary business is Medicaid. In my market, they offered an Affordable Care Act product that included a reputable group, Austin Diagnostic Clinic (ADC) and to this day refer you to ADC doctors but when you call for an appointment ADC tells you that they do not take the plan. Appears to be a bait and switch situation. Meanwhile, Superior Health's parent company, Centene, boasts about record profits and about looking forward to enrolling more people in 2018. I AM LOOKING FOR AUSTIN AREA PEOPLE WHO HAVE BEEN WRONGED OR MISLEAD BY AMBETTER. PLEASE MESSAGE ME OR LEAVE A FOLLOWUP REVIEW.
6 years ago
Kim Ham
Have had Ambetter since January 1 - thanks to Obamacare - I should have paid more and stayed with BCBS. I have a claim that still has not been paid since January 5th - it keeps being denied and when I call customer service I am told at least 5 different reasons as to why it's not being paid. When my doctors office calls in they are told different excuses as well. Ambetter even stated that they spoke with my doctors office on a specific date and there is no time stamp in my chart at the doctors office that they even spoke to Ambetter on that specific day. I am soooo fed up with this insurance company....cheaper isn't always better - lesson learned. I finally had to get the Indiana Dept of Insurance involved because I was getting no where with Ambetter on the one claim. That is when Ambetter finally called me back! Said the claim will be paid and they are resubmitting with modifiers - well lol what a joke - the claim denied AGAIN!
6 years ago
Andrea Piascik San Antonio, TX
Completely incompetent company:
PROVIDER LIST INACURATE : the majority of the provider's listed as being in their network are not in their network, subsequently you could easily spend 2-3 hours calling physicians just to locate one that takes their insurance.
CUSTOMER SERVICE: service is beyond unhelpful whether you're attempting to locate a physician in network or attempting to understand your bill. Supervisor's make claims to fix an issue but it remains untouched.
BILLING: They fail continuously to set up direct debit. Although we were assured by a supervisor that direct debit was in place, they did not bill me, did not notify me and then suspended our policy.
WEBSITE: Innacurate inforamtion, personnal account information is not available, attempts to speak with their IT department to resolve the issue have been useless.
6 years ago
Inder Singh
I have had Ambetter insurance for over a year and half, and have never used it once, because it has been so cost prohibitive, even for preventative services, and finding a provider that will take this plan has been a real challenge. My wife and I pay $530/month for two relatively young and healthy individuals. The yearly deductible is $6500 per person, making it useless for any routine medical needs, except catastrophic coverage. Their customer service is horrid -after navigating your way through the labyrinth automated system, and finally getting through to a customer service representative -they will spend several minutes re-validating your personal information that should already be in front of them, then try to redirect you to someone else. Thankfully, starting this month, I will have real coverage through my federal employer and have already cancelled this turkey. Would avoid Ambetter at all costs.
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Bottom line: Horrible coverage and customer service, high premiums and deductibles, useless for any preventative or routine medical needs.
6 years ago
Charles Woodward
Avoid this company. They should be investigated for fraudulent practices. I went to the dr they told me to go to for my sons broken arm.
They then denied payment saying he was out of network. Even after I told them that he was who they sent me to and that the Dr WAS LISTED ON THEIR WEBSITE AS A PROVIDER.
This was a common enough practice that many of the providers stopped just working with them. This is why you can't find anyone who accepts them. But Ambetter doesn't update their provider lists so it looks like there are providers. You find out otherwise when you call to verify and NOBODY on Ambetters list of providers will take you.
I was fortunate and the dr didn't charge me the thousands he could have for the X-rays and care he gave my son for his broken arm. I also dropped this scam of an insurance company the first chance I got.
6 years ago
Cody Ryan Richardson, TX
Coverage is comparable to the UHC plan we had the previous year but the network absolutely sucks. About the only place we can go when we're ill is Minute Clinic and we can forget about checkups or seeing any PCP. Data is out of date / invalid: They have a coverage map but half the physicians we've reached out to on that map have never even heard of this company. A little background: we're here in Texas and with the continuous BS going on with ACA, all but two names are left in the individual / family marketplace, Ambetter and BCBC. Naturally, I would go with BCBS but their monthly premiums for a family of 3 is ~$1500. We aren't ill enough to warrant paying this outrageous premium every month so I've opted for the $7xx / month premium with Ambetter by my God, we cant get any better than this?
6 years ago
Christopher McClure
I've been with abetted for 6 months, and I live in Dallas. No one including Carenow accepts it. I have yet to find a primary care physician since none of them accept it, and those that do refuse to see new patients. When I called to ask their healthcare advocates to advise me and to support me in locating one, they implied I was lying, attempted to revise my statements, tried to zocdoc a physician instead of a pcp (they couldn't find one), and proceeded to explain to me that I was paying them so that I wouldn't have to pay the IRS, not for health insurance. I asked them if they would transfer me to the department that deals with verification of in network physicians, and they refused stating that only physicians could speak with that department. Save your money, go elsewhere. Or pay the IRS, since they do a better job of providing services.
6 years ago
Joyce S Helena, AL
My mom was hospitalized on January 13,2017 due to an unfortunate serious health that left her suffering from 2 strokes and having to have an amputation of her right leg which landed her to 2 different hospitals CCU in Mississippi. She's been "actively" enrolled with Ambetter every since 01/01/2016 until now. Long story short, she was denied Home Care for which she needs to accommodate her disability. Her plan clearly state these bootleg services are available in her area... well guess what. NO PROVIDER IN THAT NETWORK WILL HONOR AMBETTER DUE TO AMBETTER NOT PAYING THE PROVIDERS ON A PATIENTS CLAIM!!! There contracts should be deemed as WORTHLESS and it's a shame how poor people are being forced to pay for something they can't use
6 years ago
Richard Kraus
I have only dealt with 2 Companies, Ambetter and Blue Cross. There was nothing special about Blue Cross....except by comparison!
Picked Ambetter by price for 2017....this was my mistake.
Turns out the Pediatrician we like who has been our Doctor for 8 years is not in their system. We had no idea.
The Customer service is so clumsy and cold hearted that I would have spent a good deal more per month to avoid them. Simply needed additional ID Cards and it was like I was asking something complicated. Almost as if they were doing me a big favor! If it is at all possible, I would recommend avoiding them like the plague.
7 years ago
Helen Willingham Seminary, MS
My account was suspended for 20 cent payment which was their mistake on April 11th. I had to cancel appt with physician for this unless I wantef to pay for visit. My physician says Ambetter is nightmare and some of the associates in the clinic have stopped accepting Ambetter.Iam resheduled for 2nd time for colonoscopy consult April 18th...which I will have to cancel again because they still have acct inactive...btw I paid acct March 27th the amt that website said I owed..pmt cleared my bank March 28th...Ambetter says I underpaid by 20 cents. So I paid 20 cents..acct still inactive...this insurance SUCKS..I HAVE HAD IT SINCE JAN 2017 AND YET TO USE IT!!!!
7 years ago
Aaron Braun
I'll add to choir - Ambetter is terrible. I'm simply trying to find a PCP to have a look at some swollen lymph nodes that I'm freaked out about. Of the doctors that come up on the Ambetter site, most are either pediatricians who don't see 40 year old men, or they don't take Ambetter, have never taken Ambetter and have no plans to ever take Ambetter. The rest of the results are community care clinics with 8 week waits for an appointment, who then refer me to urgent care clinics. So, I spend over $1200/mo for my individual family plan for... urgentcare?! Unbelievable. Not that it's news to anyone, but healthcare in the county is a complete farse.
7 years ago
katherine Irving, TX
THE WORST INSURANCE COMPANY EVER!!!! Someone needs to shut them down. They publish Doctors on their website - that don't take Ambetter That's FRAUD! I've asked Doctor's why they don't take Ambetter . I've been told that they do not pay their claims. Which means I'm responsible for the service, I thank the person telling me this. I've been told that Drs. would have to hire another staff member just to deal with Ambetter crazy claims process. I had never felt compelled to write a good or bad review, until I tried to find a Dr. that accepts Ambetter. This is a very sad state of healthcare. I like others will file a complaint with the Texas Insurance Office. I say lock them up!!!
7 years ago
KHopp Portland, IN
Ambetter is the worst insurance I have ever had! I will never have this insurance again! I am pregnant and they have denied every claim stating my Dr. is out of network when he is in network and everyone I have talked to can't tell me why this is getting denied, why it states out of network when he is in network and cant help at all. I have been working on this now for 3.5 months with nothing resolved still. Also before I picked this insurance I went to make sure all my Dr. were in network and they all were so we picked this plan. Well one of my bills got denied as out of network, so I called spoke to a guy he said he does see my Dr. as in network on their website but their internal site she is out of network! So I have to appeal this and see if they will pay. I have to see this Dr. every 2 months since I am pregnant now and I have to pay full price because they have providers on their website that are not in network with them? How can they do this to people? This insurance is horrible and I would never recommend this to anyone!
7 years ago
Tieny13
I just join this company last month, no body tells you what kind plan you choose, it's all set up, and I say no problem, now they set me up with a primary care physician and when I tried to schedule an appointment to see this doctor after so many attempts some one answer the phone and says this doctor is no longer working here and you need to check with your insurance another doctor cause we don't accept this insurance !!!! Seriously, Now after all that I find another one is around the corner from where I live and the one they gave me first time is about 7 miles???
Now finally I visited this clinic but you can't see the doctor for first time, you have to see a nurse and get some prescriptions and a meter to check blood glucose then I go to the pharmacy to get my meds and the shock was the meter and the lancet are covered but the strips and the alcohol pads are not covered, SO what's in this world is the benefit from having the meter and you can't even use it???? By the way the price of the test strips for every month is $48.00 and the alcohol pads is $2.00 and much much more services are not covered. BOTTOM LINE IS ( THIS COMPANY IS THE WORST ONE, ONE STAR IS TOO MUCH.).
7 years ago
Tiffany Lee
Run!!! Do not get this insurance!!! I have had the insurance for three months, and they still have not provided me an insurance card. I have called 11 times and they keep saying they will send it for the last three months and still have not. I am pregnant and my OBGYN needs the actual card but I don't have one. I got sent away today from getting my blood drawn because they need the actual card and not just the number. I called Ambetter and they won't fax or email a copy of my card to the lab leaving me with no medical services provided despite paying every month. They are a scam, do not get this insurance..
7 years ago
Rafael Suarez
Being a cancer patient is bad enough. My previous insurer through ACA opted out of the program and the ACA refered me to Ambetter. BIG MISTAKE! I developed an allergic reaction to the current chemotherapy that I have been on and prior to receiving the next chemotherapy, my oncologist needs a biopsy completed. I have attempted to call multiple dermatologists listed on their provider list each stating they do not accept Ambetter Health Insurance. I have written a total of three e mails requesting for assistance all remain unanswered. I've contacted member assistance which is also a big disappointment!
7 years ago
PEACHY
I AM SICK OF THIS COMPANY, THEY ARE A FRAUD AND A SHAM .F.Y.I.
I HAVE CONTACTED TEXAS INSURANCE FRAUD UNIT .AND FILED A COMPLAINT AND I HAVE ALSO CONTACTED THE TEXAS STATE F.B.I. AND I SUGGEST ANYBODY WHO IS BEING SCAMED CONTACT THE AGENCIES IN YOUR STATE ...MAKE SOME NOISE PEOPLE ..IF ENOUGH COMPLAINTS FLOOD IN TO THE RIGHT AGENCIES MAYBE WE CAN PREVENT THE NEXT GROUP OF PEOPLE FROM HAVING TO SUFFER THROUGH THIS....MAYBE PEOPLE WONT DIE BECAUSE THESE SCUMBAGS ARE ALL ABOUT THE PREMIUM...AND ITS NOT YOUR PORTION THEY ARE REALLY CONCERNED ABOUT ,ITS THE PORTION THE STATE PAYS FOR YOU.EVEN IF YOU DONT PAY YOUR PREMIUM ,THEY WILL TAKE THEIR TIME CANCELLING YOU BECAUSE THEY ARE THE ONES WHO NOTIFY THE STATE...AND THEY CAN TAKE THEIR TIME AND STILL RAKE IN THE MONEY..MAKE SOME NOISE
7 years ago
Rob W Athens, GA
Oh...dear...GOD. I am 52 years old, and this has been the worst experience by far of my entire life. It's not even close. My premium has been paid and they keep denying my prescriptions that I need for my heart and diabetes. These are prescriptions that I took all of last year, and never had a problem with. Suddenly, one month into this year and I can't get anything paid for. Every time I call, it's a different answer. This was done incorrectly, that was done incorrectly, this wasn't sent over properly, I'll have to send this over to blah blah department for an escalated review. They claim that my coverage is active, but my pharmacy keeps telling me that I am being billed for the full price as if I had no insurance at all. Just this morning, I have spoken with three people, for a total of over 2 1/2 hours, and it is still not fixed. I waited almost an hour for a supervisor only to be told there are none available. No big surprise, they are probably overloaded with so many irate customers like myself that they don't have time for any more. Either that or they are sitting on their fat asses, and everyone is laughing about how they can screw over the next person. Don't waste your money or your time. Everyone there that I've dealt with is about as dumb as a bag of hammers. I'm reading this as a zero, only because there is not a lower rating.
7 years ago
Jared Caddell
Only had them for a few months and made me wish I went with someone else :). They are god awful. Their customer service takes forever to get ahold of, the reps are ignorant AND useless and you often have to repeat yourself multiple times to get point across. Worst of all though, they're just here to take your money. They have declined multiple medications that I need to take (1 of which they say they cover on their website... wait what? yeah). I do not feel safe being with them. I am doing everything I can to report them and wish them the worst. I hope they get shut down and fined for illegal fraudulent services. Nothing irritates me more than large corporations taking money from those not in the best financial position.
7 years ago
Khan
I have only showed twice during 2016. However Ambetter didn't pay the bill to the clinic telling them the member was not insured during the time of service. At the same time Ambetter told me that the clinic didn't submit the details of their bill and the reason of the service. Once they provide that they will make the payment. This kept going for almost 8 months. I talked at least 25+ times on the same issue and wrote written complaint to their Appeal department. However, i didn't hear from them.
Its very unfortunate the way this Insurance company is handling its matters with respect to the billings and settlement of claims. I have will never ever used this company and highly recommend others to refrain getting near to this company. In the beginning you will get best rates but they will never pay to the service provider and you have to finally settle the bill of the service provider to save your credit.
If i have to total the number of hours i wasted following up and writing to Ambetter customer care, Appeal, Complaint department, it will not be less than 100 hours for a claim which was only for $400 approximately.
7 years ago
Nicole Waco, TX
ZERO STARS
I know it's hard to believe that a company could receive so many bad reviews, or maybe it's hard to trust this BestCompany.com review since it's so out of touch with the consumer's experience.
I've only had this insurance for one month and it's been a nightmare. I've made no claims. All I wanted to do was check to see if my provider was in-network. I called them with my provider's tax id and provider number and name (THE information they need), then I was put on hold nearly 5 minutes and hung up on. I called back thinking it was probably a technical difficulty, but had the exact same thing happen again. I proceeded to email them my provider's information through their online portal and received an immediate, computer-generated response that said I'd receive a response within 24-hours. Reasonable.
One WEEK later I emailed them again, forwarding my previous message. I received the same automatic message that I would hear from them in 24 hours. Okay, we'll see. The good news is I did finally receive a response. The bad news is it read, "Please call us..." Are you kidding me?
My provider was able to make contact with a person to verify that she was NOT in-network. She shared with me that spoke with more than one person, as most customer service/provider service professionals knew very little about the Ambetter health plan, even less about Superior, and absolutely nothing about the parent company--the one providers must be approved through to receive reimbursement.
I can't believe this is THE insurance the Healthcare Marketplace is selling. I don't take any subsidy and pay over $200 per month to not be able to use my insurance. It's an embarrassment to hard-working, under-paid Americans (I'm in AmeriCorps VISTA-- a national service program) that this is how our insurance providers want to serve us.
Stay away from Ambetter. I plan to stay away from Superior in the future, as well, and anything tied to this shameful excuse for an insurance provider.
PS - There's no grace period for payments. If you don't make your payment before the 1st of the next month, your account will be suspended.
7 years ago
Ashley McWhorter Tampa, FL
For me this insurance is DIRT cheap and I did purchase this "insurance" back in December through the Healthcare.gov/marketplace. Let me tell you.... I haven't received anything in the mail such as any ID cards or anything through these idiots. I call, I'm placed on hold all over again for such a long time. Very unprofessional if you ask me! It's almost FEBRUARY and I simply need an ID card to get checked up on. Not that hard to do. To make matters worse, I was in a car accident Friday and thankfully no major pain (not at fault - if needed to be checked, I'd use the other drivers info). But what if something horrific were to happen and I don't have MY ID card for my health insurance I paid for????? I hope my unfortunate situation helps others look else where.
7 years ago
Jon Vaughn
Hmmm..... Where should I start. Well first off lets start how terrible there representatives are which seemed like they pulled anyone off the street, taught them for 1 day to answer phones using a guided directory but having no clue on assistance. They have no idea what they are doing, please do not waste your time!! There web site is like someone from high school designed it, please do NOT rely on it to find a doc.!!!! You will be wasting hours of your time for someone to accept the crap insurance they provide. Also if you go for just a simple blood work and urine test for a physical check up, you will be getting billed astronomically from a 3rd party lab which they should've covered as they promised lol. These idiots for representatives will send you to places saying they will cover you, but will NOT!!!! Terrible Terrible Terrible insurance company please seek others or you will regret it.
7 years ago
Joelle Bart-Davis
I've had Ambetter for 28 days. I went to refill all my medications early, as I feared the worst. 17 days after I went to the pharmacy and several calls later, I was informed that a GENERIC medication I have been taking for 10 years was denied by a physician who reviews requests for Ambetter. A physician who apparently knows better than the doctor I have been with for over a decade ( who I pay cash for because he doesn't take Ambetter) The only reason it took ONLY 17 days was because I called and the expedited the process. I
I will run out of medication, thanks to Ambetter's "process". Not sure what will happen.
I read all the horrible reviews and was and am now fearful of the year ahead. My husband's cancer doctors take Ambetter so I had to chose them.
7 years ago
Jim Boyle Temple Hills, MD
If your reading this the best way to get help and results are contacting your state insurance regulatory agency. If your in Indiana thats the Indian department of Insurance. They provided me assistance! Ambetter could not provide me with approved in network doctors or services for cancer care. I was forced to use out of network providers which they approved. these providers made me pay in full upfront for services out of concern Ambetter would not cover the bills. As it turned out Ambetter in fact only paid a small fraction of the bills roughly 10 - 15 % as of this writing I'm still on the hook for the balance they say its my problem. I would choose another provider or you will regret it!!!! If I didn't have the cash upfront my cancer care would have been delayed. My concern is those of you who cant put out major sums upfront could be in peril!!!
7 years ago
Brieanna Mcnemar Houston, TX
If anyone is looking for a vision office that accepts ambetter in San Antonio, Bright Eyes on Nacodoches does. I'm posting this because it was hard to find a doctor who accepted ambetter (Even when looking on the website) but I finally found someone! FYI not everything is covered but it is decent. The exam was covered and the frames were covered up to $139 on the frames but I paid $40 out of pocket for my lenses. Hope this helps someone!!!!
7 years ago
MARK A. SUNESON Irving, TX
We signed up for health coverage 12/13/2016, we made a payment at the time we signed up for coverage to begin January 1. 2017. As of mid-January, we have on;y received invoices, NO pharmacy card, i.e.a card verifying our coverage under Ambetter . We have called several times, and each time we are told the material was mailed to us, only the reps give us a different day of mailing each time we asked - obviously they are making this information up. Meanwhile we can not obtain prescriptions under our new Ambetter insurance without insurance proof at the pharmacy. Another Healthcare scam. Very poor service - NO, NON-EXISTENT SERVICE FOR OUR PAID PREMIUM.
We have been directed to the Ambetter website to print our coverage card, but guess what? The Ambetter website does not work ot allow one to even register.
7 years ago
edvi alcoba Miami, FL
WORST INSURANCE EVER!! Had MULTIPLE issues with them but last one was the last straw!! They put me on the wrong plan which was conveniently more expensive and after almost a year of phone calls they finally fixed it. They said they would pay my account through the end of year using my over payment and issue me a refund for the rest. Got a bill a month later and called to inquire since I found it confusing. Lady told me it must be a mistake because my account is paid in full through the year. Come to find out in January my plan did not renew into the new year 2017 because the bill WAS NOT A MISTAKE! Now Im stuck with no insurance and worst is my $140 birthcontrol I have to pay out of pocket!!! Thanks Ambetter!! STAY CLEAR!! Worst insurance company Ive ever had!!
7 years ago
mickey Demorest, GA
OMG I am dealing with such a nightmare. I had this company in 2015. Never used the coverage and ended up canceling the coverage in Oct 2015 because they could never get my payments posted timely. Had BCBS in 2016 but because of the huge increase in premiums went back to Ambetter for 2017. My payment cleared the bank on 12/21 as of 12/30 they were still not showing payment. So I paid it again on 12/30 to ensure the policy would be enforce on Jan 1. My husband broke his arm on the 30th and requires surgery Wed. They are showing the policy suspended due to non payment in 2015. They have currently have two payments for Jan 1 and still no policy in force.
7 years ago
Jacquelyn
I signe dup via the marketplace as hit sis the ONLY provider in my county. It is almost $1300 a month and none of our doctors will take this service. What can I do, we have to have insurance, there are no other choices, so I bit the bullet and sign dup. Well, the first premium us due January 1. I signed dup November 15. It has been a non-stop assault from this comfy to make my payment. Non-stop! An email every darn day. A phone call EVERY DAY, sometimes it is a human, sometimes it is a robocall. When I point out that the payment is not due until December 30 I am told payment is due when I receive a bill. Well, that is ALL I have received, a bill. No benefits book, no coverage info, no insurance card, NOTHING else but a bill. I was told they do not supply any info until after I pay and the rep even said "Ph Honey that is how all bills work." First of all, I am 42 years old and do not appreciate being called "honey," second, when I sign up for any other service I get benefits information up front SO I KNOW WHAT I AM PAYING FOR. This company is a nightmare, all they want is their money. I am dreading 2017 and having to actually USE the service. NONE of our doctors will take it, it is awful. It is terrible that this is the ONLY insurance offered to the public here in my state and county. No competition, how is this not a monopoly.
7 years ago
Lindsay
When I called to talked to them about a bill and phone call I got about coverage that I was signed up for without my permission, the woman I talked to was very rude to me and did not know what she was talking about. I was told in the message that was left for me to call them and talk to them about the coverage if I had questions or did not need it, but the woman said I needed to call the marketplace. I told her that this was in contradiction to what they had told me in their message they left me. She kept insisting that I call the marketplace and when I told her that the message they left me was to call them, she hung up on me. This is not only rude, but is horrible customer service. If this is how they treat people who are trying to figure out why they are getting billed when they are not signed up for their insurance, then I can only imagine what they do to their own customers.
7 years ago
John
Unbelievably unresponsive and irresponsible customer service. Many agonizing telephone calls resulted in no resolution of my problem, despite my statement that, if I could not get an answer to a simple question, I would have to cancel. Ambetter withdrew my first premium from my checking account (verified by my bank), and 9 days later, the website still showed that I had not made the payment. I called several times to ask if a mistake had been made, or at least, when I could expect the payment to be posted. Each time I was told that customer service had no way of knowing anything about my payment, but the issue was being escalated to the Invoice Management department, and I should wait 48 hours. On the final call, the afternoon before the Marketplace deadline, I was told that the issue had never been escalated to the Invoice department, but they would do that, and I should wait 48 more hours. The supervisor told me she understood my frustration (as if I need her understanding and not action). She said there was nothing more she could do. I had asked previously if someone could please take ownership of this issue and get back to me, rather than forcing me to repeatedly go through the ridiculously long process of getting a rep to look at my file. I was told that representatives aren't allowed to make telephone calls, and can't communicate via e-mail. I may have no choice but to keep this policy for a short time (assuming that my payment is eventually "found"), however, I will run screaming from Ambetter at the first opportunity, and will be happy to explain to everyone I know how incompetent and unhelpful they are, and how agonizing it is to deal with their so-called customer service. I've been stonewalled by the best of them - airlines, Ma Bell, the cable company, etc. - but this is a new low. When they take your money and say they didn't, despite the existence of positive proof of it, what can you do? I know it doesn't make sense, but I actually came to believe that their "service" protocol is meant to frustrate and deflect customers. What does it say that this company is rated 13th out of 25 health insurance companies after receiving 134 ratings of 0 (terrible)?
7 years ago
Sandra B
After waiting for an hour and 38 minutes to get someone on the phone, the representative was having a difficult time reading her script. She wasn't sure when I told her I'm self employed and my income changes on a given month.
When I told her I thought I was calling Aetna, she told me she could provide me with their number but after a 3 minute wait I was passed to the survey department, that's the best thing she did for me after spending 2 hrs on the phone. I would never heard of this company and just from the sound of the name, so unprofessional name, my opinion. I could never think of getting insurance thru them.
7 years ago
kristin Racine, WI
Ambetter charged my card 6x what my bill was supposed to be which drained my bank account and I had to file a fraud ticket with my bank and finally got it back since Ambetter had NO record of it anywhere. Then after I tried to pay my monthly payment over the phone, I got a confirmation number and a mailed receipt. It still says my health insurance is suspended. So forget it. Its not even worth calling them again to ask why they are so unorganized. You get different answers each time you call, no one knows what they are doing and you will get yourself into the biggest headache ever. Good riddance!
7 years ago
Tiffinie Johnson
Everything that's been posted is absolutely correct. Ambetter is the absolute worst. Leave them if you haven't already. Things go well with them until you actually use the insurance, then it's all downhill afterwards. I was involved in an auto accident in April of this year and was rushed to the nearest hospital that happens to be out of network. However, upon receiving the medical bills and attempting to handle them, I was given false information and the run around. And like previous posts, the reps were amused when I asked to speak to a manager. That happened on FOUR SEPARATE OCCASIONS!!! First, I was told that there is no manager, which I replied that's incorrect as I've worked in a call center before. The second time I was told that there was no manager available and that the rep was knowledgeable enough to assist, she wasn't. The third time I called asking for a manager, I was told that a request was put in and to expect a phone call in one or two business days. A week later still no call. I called back today, requiring to speak to management, again, I was told that a request will be put in and to expect a phone call. PLEASE PLEASE!! Do NOT use Ambetter's insurance. They may be cheap but you will definitely get what you pay for, crappy service. Another incident with them happened in March of this year. I was scheduled for my annual exam when I told my insurance has lapsed. I asked how could that be when I e always paid Ambers on time and in full. Turns out my payment wasn't processed in time for my appointment THEN I was told there was a balance of $8 on my account and that's why the insurance supposedly lasped. $8 freaking dollars people!!! Only after going off did they correct the issue. The company and its employees are total scammers. So if you've come here to see what kind of company you're dealing with, take heed to what you read here. I've had similar experiences as everyone else who posted here. Don't waste your time and money with Ambetter.
7 years ago
Moirraine Campbell
In real time, on the phone, Ambetter's personnel listened as I told her I was being neglected while at Immediate Care in Olympia, Washington.
I had pneumonia, was blacking out every few seconds and was MOCKED by the medical personnel after Ambetter ABUSED my privacy.
Ambetter is owned by Centene - a CLUELESS, MONEY GRUBBING ENTITY that has ZERO control over its employees or its service and it CERTAINLY does NOT get that there ARE bad medical personnel who can't even figure out PNEUMONIA nor tell the TRUTH about SERVICES in THAT FACILITY.
Ambetter had a person who was LEAVING THE COMPANY contact me, and of COURSE SHE lied about the NEXT person who would 'contact' me, supposedly higher in the company structure.
Then on top of ALL the abuse, Ambetter has the NERVE not to comprehend that they have been FIRED FOR CAUSE.
7 years ago
Kevin Fort Wayne, IN
Great prices in obamacare. I'm lucky to have good Drs that accept it nearby. Have had a baby on this. I was astounded when the EOBs came and they kept denying things, most commonly for the hospital billing each individual thing rather than adhering to an agreed upon bill for deliveries or something like that. One bill came to us after the insurance company wouldn't pay it. It was for the circumcision. My wife went rounds with them to pay it and got nowhere. They wouldn't pay it because it was "cosmetic". I told them it was ordinary, customary and they'd have to show me in literature this procedure wouldn't be covered. I told them I was going to file a complaint with the Indiana Insurance Commissioner. That's when the Customer Service Rep asked if I wanted to file a dispute. I did to which I was supposed to hear back in 1 week. I never heard back but 3 weeks later the Dr said his bill had been paid. The money I save by having this policy through healthcare.gov completely makes up for my problems. Be careful though, make sure you have a network available. Of the 2 large healthcare groups in our area, only 1 accepts them.
7 years ago
Brian
7.4 LOL!!! Does this company give you kick backs or something?
Customer service laughed at me when I asked to speak with a manager. When I confronted her, she tried to defend herself. "I laughed at you because you were irate." Is literally what she said.
Now why was I upset.
1. 6 months later I still can't log on to my online account, I've called multiple times, and even had the manager promise to call me back which he never did.
2. They have duplicate accounts for me and 6 months later even though I called them several times they still can't (or won't) delete my duplicate account
3. They keep sending me bills saying that I haven't paid, and I've called and set up Auto Pay 3 times.
4. I asked to talk to the manager 3 times, but the lady who laughed at me kept asking me questions about my problem
Stay away from this company.
7 years ago
Jim Boyle
I have Ambetter and have payed the full amount 748.00 per month since I don't qualify for any assistance. Dealing with this organization is a nightmare! They've sent me to out of network providers for cancer care since they did not have approved providers for my particular problem vocal cord related. They then refused to pay my bills since provider was out of network. As of the writing of this rating my out of pocket cost for cancer treatment is higher with insurance than it would be without. I'm forced to use state agency's and the court system for relief. If I didn't have my own personal financial resources to pay for care I can't say what would happen. If your value your life and sanity chose another provider.
7 years ago
Abigail Hecht Federal Way, WA
Ambetter is a REALLY BAD HEALTH INSURANCE. I've had Ambetter for about 2 years now and although it may be cheaper than some other insurances, this will be my last year with Ambetter. The first year everything seemed fine because I never had to use my insurance, but the second year I ended up having to go to the emergency room and spent about a week in the hospital and after being discharged, thats when everything went downhill. Ambetter continually screwed up everything. They kept not sending the EOB to my secondary insurance and had made a huge mistake by claiming themselves to be my secondary insurance without checking that my other insurance is actually supposed to be my secondary since it is my father's insurance that I am under so this caused such a mess. They did not communicate well with my secondary insurance or with me and every time I tried to contact customer service (which was literally everyday for like 3 weeks), I constantly would get dropped, transferred, or given numerous different answers that didn't help at all and whoever was helping me usually had no idea what to do or would give me false information or tell me they would take care of it yet never did anything.
Also, literally no one takes Ambetter and they have a horrible reputation with hospitals because Ambetter constantly loses bills, make mistakes, or just flat out doesn't pay! They are awful. After this year is over I am switching to a new insurance.
7 years ago
