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Ambetter

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5.5

Overall Score

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LAST UPDATED: November 22nd, 2022
Number 3 in Blue Circle

3 Things to Look for in a Health Insurance Company

  1. Plan Options — Look for an insurer that offers the kind of health plan you need. Some insurers specialize in specific types like Medicare.
  2. Extra Benefits — Look for the extra perks offered by the insurer with your plan like a fitness program or reimbursement. While not a dealbreaker, these benefits are worth noting.
  3. Claims Experience — Look for insurers that offer a good claims experience compared to others. Reading customer reviews can give you a sense of how well an insurer takes care of its plan members.

Ambetter insurance specializes in health insurance plans on the Health Insurance Marketplace in twelve states. These plans are also sometimes called Obamacare plans. Ambetter health plans are operated by the Centene Corporation. If you're looking for another kind of plan or don't live in an Ambetter service area, you'll need to consider other health insurers.

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Attention: Ambetter is a very unpopular health insurance company.

It has received a 1.4/5 star rating from reviews left on Best Company. Roughly 87 percent of the Ambetter reviews on Best Company gave a 1-star rating. Complaints against Ambetter include poor customer service, difficulty with pre-authorization, and high costs for limited coverage. Most customers do not recommend buying healthcare coverage from this insurance company.

View Ambetter Reviews and Complaints

Ambetter health insurance's covered services include preventative and emergency care, therapy, behavioral health help, medications, maternity, and hospitalization. It is an on-exchange health insurance option in the Health Insurance Marketplace.

Health Insurance Marketplace plans offer comprehensive health insurance coverage. For health plans to be on the Marketplace, they must be a qualified health plan that covers the essential health benefits listed in the Affordable Care Act.

To enroll in Ambetter insurance, you need to apply during Open Enrollment. The Open Enrollment period for 2021 healthcare coverage runs from November 1, 2020 to December 15, 2020. If you missed the enrollment period, you may qualify for a Special Enrollment Period after December 15, 2020 if you have a Qualifying Life Event.

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The Good

  • Health Insurance Plan Options
  • Helpful Online Account
  • Member Perks
  • My Health Pays™
  • Dental and Vision Coverage

Health Insurance Plan Options

If you're looking to get an Ambetter plan, you can view health plans by first selecting the state you live in and then selecting the type of health plan tier you're most interested in. From there, your options open up to several different plans with varying prices and benefits.

Ambetter Health Insurance Marketplace plan options include: Ambetter Essential Care (Bronze Plan), Ambetter Balanced Care (Silver Plan), and Ambetter Secure Care (Gold Plan).

Each plan offers insurance coverage for the essential health benefits listed in the Affordable Care Act, but the cost-sharing rules for medical expenses are different for each tiered plan option.

Members with Ambetter Essential Care pay lower premiums but have higher out-of-pocket expenses.

Ambetter Balanced Care, the Silver Plan, offers higher premiums and a lower out-of-pocket limit.

Ambetter Secure Care has higher monthly premiums, but the lowest out-of-pocket expenses of the three plan types.

For specific coverage and cost information, including the deductible, out-of-pocket expenses, and premium costs, you'll need to work with Ambetter directly. Depending on your income, you may qualify for a tax credit subsidy on your monthly premium.

Helpful Online Account

Each Ambetter member has access to an online portal through which they can make all of their payments, view healthcare plan benefits, and take care of logistics like obtaining a member ID card. The member portal offers extra features, too, such as providing reminders for members when they are due for another doctor's visit or allowing them to take a health risk assessment to determine which steps they can take to live healthier.

Members can track their claims 24/7 through the online portal, as well as connect with member services at any hour of the day.

Member Perks

Ambetter provides more than just logistical tools for members. Many of the extra features it offers also send the message that Ambetter wants members to get healthier and stay healthier. These tools include a 24/7 nurse hotline that members can access for questions and medical needs.

There are also health-promoting programs to support members with dealing with behavioral health and maternity and newborn care. Ambetter offers 24/7 Nurse Advice Line and integrated health management to enhance members ability to get the most out of their medical care.

Ambetter also offers telehealth access with some of its plans. With telehealth, members can have phone or video access to in-network providers for non-emergencies.

My Health Pays™

My Health Pays™ is Ambetter's rewards program to provide incentives for members to live healthier with better habits. You can earn money for taking a survey provided by Ambetter, getting a flu shot or having your wellness exam. This money can go toward your next premium. Members can be reimbursed for gym membership payments as well. This rewards program promotes health and well-being among Ambetter members. While this program is great, it's only available in some of the states Ambetter services.

Dental and Vision Coverage

Dental and vision coverage are available with Ambetter, but the benefits and availability of each are entirely specific to the state you live in and the type of health plan you choose.

Dental benefits, for example, is not available in Texas, but vision insurance is. Dental coverage includes exams, cleanings, and screenings, overall, and vision benefits include yearly eye exams and glasses or contacts. Those seeking vision coverage and dental benefits in addition to health insurance can find options through Ambetter.

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The Bad

  • Poor Customer Reviews
  • Access to Plan Information
  • Limited Service Areas
  • No Mobile App 

Poor Customer Reviews

Ambetter has received an overwhelming number of 1-star reviews on Best Company. These Ambetter reviews mention difficulty getting medication and treatments approved for coverage, issues with claims that were difficult to resolve, frustration with customer service, and difficulty finding an in-network provider.

With such a high number of 1-star reviews, you'll likely be better served choosing another insurance provider if you can.

Access to Plan Information

It's somewhat difficult to access specific information about the types of health plans Ambetter has. Its website primarily just explains the metal tiers (gold plan, silver plan, and bronze plan) as well as how essential health benefits are covered by every plan.

To find out what kinds of plans these are, such as Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO), not to mention what prices and benefits you qualify for (like out-of-pocket expenses, copayments, deductibles, covered services specifics,and if you need prior authorization for certain medical services), you'll have to contact a representative.

Upfront, it's important to know that Ambetter is part of the Health Insurance Marketplace (HIM). It's Centene's option for HIM plans, which are intended for people who don't have health insurance and maybe don't qualify for typical plans.

Ambetter only offers Marketplace plans. If you are looking for another kind of insurance plan, like a short-term health insurance, Medicare, or Medicaid, you'll need to find another insurance carrier.

Limited Service Areas

Ambetter plans are available in a some states. These include Arkansas, Florida, Georgia, Illinois, Indiana, Massachusetts, Mississippi, New Hampshire, Ohio, Texas, Washington, and Wisconsin. If you don't live in any of these states, then you'll need to consider another insurance provider.

Even if you do reside in one of the states they service, make sure to check the location of their in-network providers (e.g. a primary care physician, specialist, etc.) for your state to ensure they have an in-network provider near you.

No Mobile App

Unlike many of its competing insurance companies, Ambetter doesn't have a mobile app. Some companies provide this for enrollees to access their accounts right from their phones, making communication and logistics much easier. Ambetter hasn't provided this yet, making account management slightly less convenient than with other companies.

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The Bottom Line

Ambetter should be somewhat of a last resort when choosing an affordable health insurance company. While its plans all have decent health coverage for preventative care and some vision and dental benefits, it is difficult to access full details of its various plans. Data points such as the annual maximum out-of-pocket limit and co-pays are difficult to find on the website.

Plan cost and deductible levels vary among plans. Availability depends on location. Cost is also affected by the number of people on the plan and some demographic information, like age.

While Ambetter's plans offer comprehensive healthcare coverage, it's important to review customer reviews to get a sense of Ambetter's quality — health plans, value, cost, and customer service — and compare Ambetter to other health insurance companies before making a final decision about signing up for an Ambetter plan.

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Star Rating

1.4

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971 Reviews

Review Breakdown

5 grade

5%

4 grade

3%

3 grade

1%

2 grade

3%

1 grade

88%

Sentiment Criteria

Value

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Quality

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Justin Crafton

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

3 weeks ago

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Cheryl Norris

This is THE ABSOLUTE WORST Insurance I have EVER had. They have denied coverage twice for imperative cardiac testing wanting me to jump through hoops and they aren't even paying anything until I meet a rediculously exorbitant amount for a deductible. I pay a 588$ a month premium just for myself. Choose another company if possible. Unfortunately in Indiana its Ambetter or Caresource and both are a waste of money!!!!!

2 weeks ago

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jamie clark Rogersville, TN

Ambetter is the most worthless insurance company I have ever had I was diagnosed with MS and they needed to do a brain MRI and a spinal MRI to see what stage I’m at so I could get medication to help me well they think that they can play God and decide well you don’t need it so they like to play around with your life I would never recommend these people to anybody they’re dangerous and ignorant

2 weeks ago

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Megan Maloney West Chester, PA

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

1 month ago

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Diogenes DeFawkes Warner Robins, GA

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

1 month ago

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Val Johnson Atlanta, GA

Broke my ankle and needed a scooter and later a walker. Never got them. They said I qualified but sent me all over the place while i was sick. Everytime I called they told me to do something else. I gave up. I paid my bill automatically every month never missing a payment.

2 weeks ago

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Claudia Ruiz Hialeah, FL

When I started with them 3 years ago, it was excellent but over time, it started to spoil. Currently I do not recommend it to anyone, poor medical care, I think they have people hired as doctors and they are not, from my bad experience I say, when I started with them 3 years ago, it was excellent but over time, it started to spoil. Currently I do not recommend it to anyone, they even charge you for wellness exams, when all compañías are to be free. I DON'T RECOMEND IT.

1 month ago

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Thomas Bath Gulfport, MS

Beware of accepting their offer of a cost free colon screening as provided in the Affordable Care Act. They will not process it as screening, so instead of no cost, we are stuck with a $1400 bill that we can't afford for a procedure that really wasn't medically necessary because there were no symptoms. You are supposed to get a colonoscopy after age 50. They will cheat you. After filing a grievance with them, they said that we weren't covered for a screening colonoscopy... EVEN though they sent us a message telling us so. Use anyone else if you can.

1 month ago

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SaneB4Kidz Leavenworth, KS

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

2 months ago

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AmbetterIsTheWorst Tulsa, OK

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

2 months ago

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Gary Siegel Seattle, WA

There is nothing good about this company. I knew I was getting "high deductible" insurance, but my experience with this company was the worst of my life. Customer service is horrible. They will basically take your money and give you nothing. Try to get an authorization; they will give you a never-ending run-around to get out of paying anything. Have a question? Get ready for call-center hell. Stay away; no insurance is better!

2 months ago

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joe mail Naples, FL

I WISH I WOULD HAVE FOUND THESE WARNING BEFORE I PICK AMBETTER ONE OF THE WORST INSURANCE COMPANY YOU CAN GO WITH AM GOING TO ALSO FILE A COMPLAINT AGAINST THEM I CANCEL MY INSURANCE AND THEY KEPT BILLING ME UNTIL I FOUND A BILL FOR 1500 THAT I NEVER GOT TO USE THE INSURANCE NOT IN ONE DAY OF MY LIFE EVEN WHEN I WAS MAKING MY MONTHLY PAYMENT ON TIME

2 months ago

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ANPR Miami, FL

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

3 months ago

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Joan Castro Dallas, TX

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

3 months ago

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Reno Dog Reno, NV

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

3 months ago

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Pankaj North Bend, WA

There is nothing good about this insurance company. They give you a rundown on approval and will reject most of the approvals.

1 week ago

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Me Jeffery

Took child for routine vaccination that was scheduled prior to getting ambetter. Visit denied.. Customer Service horrible.. Been trying to fix this since June & first response.. Denied.. It's now Nov..

1 month ago

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Wizard 4717 Spring, TX

Nothing approved. No doctors will take it. They just laugh. I don't even bother with Ambetter. Better negotiating with the doctor. I pay 50.00 a month and the government is being cheated out of 800.00 a month for this scam. I am sure that this company is just a few people in a strip mall in Florida.

2 months ago

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Calvin Green Rolla, MO

There is nothing to like about Ambetter Health Insurance. I only selected one star because that was the only option available. No stars would be more reflective of my evaluation. I live in a city with a sizeable hospital and yet Ambetter has a very, very limited number of doctors to be primary care physicians, dermatologists, and enologists that are part of their network. Their customer service is atrocious. They cannot even email information such as doctors in their network for specialty procedures or treatments.

3 months ago

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Laura Schott Philadelphia, PA

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

4 months ago

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Nabrin Noor Ellenwood, GA

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

4 months ago

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Laura Langford El Mirage, AZ

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

4 months ago

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Adrienne Wissa Phoenix, AZ

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

4 months ago

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robert lee Little Rock, AR

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

5 months ago

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Darlene Tucker Scotts Hill, TN

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

5 months ago

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Donna Reeves Charlotte, NC

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

5 months ago

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Elizabeth Conard Philadelphia, PA

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

5 months ago

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Kristen Carroll Nashville, TN

Ambetter double charge me for my already over-priced premium and it is taking weeks to get my money back and it is still not resolved.

2 weeks ago

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Sarah Savannah, GA

Ambetter is the worst insurance on the market . I pay $200 a month and get nothing ABSOLUTELY NOTHING COVERED . They are so uninformed one representative tells you one thing and the other the opposite omg Run

2 months ago

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Bill O

Site doesn't work ("Try again later") so you have to deal with calling for information. You have to go through layers and layers of info just to find out if a pharmacy is covered. Idiots.

2 months ago

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Stephen Eldred Portsmouth, NH

Absolutely useless service. Fully paid my premiums but they block collection of meds at the pharmacy because "the computer has a glitch". Spent 4 1/2 hours over 2 days on hold. No resolution. Total crooks.

2 months ago

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Dave Fant Ozark, AR

Having had Ambetter previously myself and my wife has it. We both have found Ambetter will deny coverage for clearly medically required surgeries. Avoid this company if you can. If you don’t die from old age being on hold and then getting wrong answers and no results you will suffer from denied medical needs!

3 months ago

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Shelley Steed Knoxville, TN

The app is useless unless you are looking for their "perks & rewards". I don't need a discount on my phone bill (because it's not better than my regular rate); I just need to be able to access (at a minimum) my bill to confirm due date!! I'm very suspect of a line of credit they are offering. $750 line of credit to be used almost anywhere. Terms are "pay back later" and "never a finance charge". Yeah, rite. I hope the marketplace, (healthcare. gov), gives this company the boot at the end of the year.

4 months ago

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Evil Jared Philadelphia, PA

Unfortunately, there’s no way to give this piece of crap company a review with negative stars. After assuring me four months ago that my upcoming surgery would be covered, they send me a letter 72 hours before the procedure telling me it isn’t approved. 12 months unabld to walk properly and they deny me 3 days before the surgery is scheduled!!! Absolutely despicable crimnal bastards. F this company! Not worth one cent, let alone the $900/month premium.

4 months ago

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Holly Conyers, GA

If I could give 0 stars I would. Ambetter gave me an insurance quote of $46.44 a month. I was laid off from my job which made me ineligible for the tax break. Instead of informing me my insurance went up they just took $627.44 out of my account. This is theft. I agreed to pay $46.44 a month. Not $627.44. So far they haven’t refunded any of my money. If you have this insurance set up on auto pay I suggest you cancel it fast!!

4 months ago

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Zachary VanTilborg Las Vegas, NV

NEVER USE AMBETTER. Their customer service is non existent. I tried to get a PCP through them and every single doctor that pops up on their list says I need a referral from Ambetter just for a primary care. So I call Ambetter and after getting hung up on several times and repeating my information over and over the representative told me that wasn't the case and then began just reading off the FAQ page of their website. So I cant even see a PCP. Theres a 1000 links to pay them but you cant actually use their trash insurance.

4 months ago

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Robnole Canton, GA

Ambetter is the worse health insurance company I have ever used. They reject 85% of prescriptions that our Ambetter approved doctors prescribe. These are things like a decongestant when a sinus infection is diagnosed. They also approved a colonoscopy but rejected the solution you are required to drink before the procedure. I would strongly advise avoiding Ambetter.

4 months ago

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Robert Reese Indianapolis, IN

Horrible. They claim to cover Farxiga yet denied coverage after having taken medication for 3 months under a Cobra plan that has expired and they will not accept responsibility to cover use as they say it is not medical necessary though Farxiga is the only medication so far to reduce my A1C. They should be ashamed to reel people in with false claims of coverage. What will they deny next?

5 months ago

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D. Jones Arlington, TX

BUYER BEWARE!!! I spent hours filling out their member rewards program. After a few months I finally received my debit cards, and they cancelled them before I was able to use them. Tried to call their customer service about it and they basically told me I was screwed. Why bother sending the cards? Dishonest company. Thank God I never needed to make an actual claim with them. I can't imaging what would have happened. DO NOT USE THIS COMPANY.

5 months ago

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Ashley Smith Kansas City, KS

This company is awful. I have been painfully waiting for a hip replacement. They said they wouldn't pay because I smoked, so I quit. A month later they said I had to wait 2 more weeks. Today they said they can't file the same claim again until it's been 180 days longer! Worthless, greedy p.o.s. I've got an appointment to talk to my lawyer soon. There's been many previous lawsuits against them. Do yourself a favor and stay far away from these heartless a$$holes.

5 months ago

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medrevur Elmhurst, IL

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

6 months ago

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Kimberly L. Houston, TX

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

6 months ago

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Irritated Counselor Olathe, KS

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

7 months ago

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DJ Bruffett Wichita, KS

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

7 months ago

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Tyler McCoy Owasso, OK

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

7 months ago

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Golf Forlife San Antonio, TX

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

7 months ago

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Angela Bell La Marque, TX

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

7 months ago

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Ryknow777 Wichita, KS

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

7 months ago

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ENERGY HEALTH KC Lee's Summit, MO

It looks good on paper but, in reality, it's a mess. I signed up for auto pay....numerous times. But for some reason they aren't taking my payments out and then I get overdue bills. They can't tell me WHY this keeps happening. I live in a state that makes the federal gov't pay back for overcharging for insurance. One year I got over $3,000 back. The next year (when they stopped taking my payments again and I had to call) I was told they could take out my measly $35 payment out of my refund for the remaining few months of the year. This time I only got $182 back. And my payments went up to $94/ They took the first payment out in December (for January) and then no more after that. My last phone call to them lasted an hour...most of it on hold waiting to talk to someone without an accent who could get to the root of their billing problem..... and then the phone just disconnected. I called back and went through the same BS with another Phillipino. Got no answers just a "thanks for your payment...our autopay has been having some problems". This has been going on for over a year now. Heaven forbid I should need it in an emergency only to find out my account has been suspended due to "non-payment". Who has this kind of time to go through this rigmarole every other month?!!!!

8 months ago

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Cassidy Robinson

My new job requires me to get insurance off marketplace. The 1st time I opted for very high end Alliant plan. I rarely use my insurance. So this year went minimal with AmBetter Peach Care. I have a psychiatrist and have meds I fill. Otherwise healthy. I checked my Dr. before- i spoke to a representative- my doctor is in network. 1st claim denied. Ambetter said verif that dr takes Ambetter- they do. Dr office said they have had multi issues with Ambetter denying claims in the past. Today I can not fill the RX i had fill last month. It is Wellbutrin- I have been on the phone 2 hours- they gave me 3 NDC#'s and I called the pharmacy with them. NON OF THEM WORK. I had to go to Walgreens because they are not accepted at CVS. Wellbutrin is covered but they make the customer try to troubleshoot all the problems with the coding. I have never had to call and do the work like i have with AmBetter. This insurance is on the same cost as my monthly mortgage. WTAF!!! Worse! I work in healthcare- and I have crap insurance- it seems to get worse every year. AmBetter is the worst coverage I have ever had, What am I [paying for?!! AGREE- they ask for your # incase call is dropped- LEAVE YOU ON HOLD FOR 30 minutes- DROP the call--- AND NEVER CALL YOU BACK!! What kind of BS scam is this company?! Why ask for our # if you have no intention of calling customers when calls are dropped?!! I have called them 20 times since jan 5th. Today is March 11th. 5-6 calls required until I AM NOT HUNG UP ON and actually speak to a representative who can and does try to help. THESE POOR representatives! Im sorry your company is so horrid cause' the phone reps get all the frustrations. I HOPE at the very LEAST AmBetter offers their employees ANY INSURANCE that is NOT Am Better!!

8 months ago