Ambetter
1.4
5.1
Overall Score
Colleen Sheahan ,
I use AM Better for doctor visits, preventive screenings, and medication only. I have had no issues, also get great customer service help. If you pay your monthly premium, stay in network, and do not need surgeries, this plan will work for you
5 years ago
Lizzy Puentes Tallahassee, FL
Ambetter is a great insurance for where I resided in South Florida. They have lots of perks that you can gain from a point system they have. They also have a great reward system where you get money back if you have the debit card. That money back can be used to pay any bills you have which is so convenient!
5 years ago
Jay Cole
There Customer Service is Wonderful I've been very pleased anytime I have needed help in the past there has always been someone to help me on the first try. And for that I am Thankful For
6 years ago
hem n sah Irving, TX
I was very worried about the negative review. But All the claims for emergency room was processed properly. It was a seamless experience and we had no issue at all.
Just follow all the network networks and no issue at all.
6 years ago
Ken Greenwood Austin, TX
Perfect for everything we need. Site works well. Fast response times. Always introducing new ways to make things easier. Been here for 3 years and have no intention of changing
7 years ago
Esmer McAllen, TX
I have had Ambetter for about 1 and 1/2 years and have not had a complain. They have everything displayed on the members website which makes it easier to see what is being submitted and paid.
7 years ago
Olha Auburn, WA
I use Ambetter from coordinated care second year. I have a problem when I want click my login, I haven’t access to my health pays rewards. Every time when you visit your doctor must check information about your doctor work with your insurance or no.
7 years ago
Yous Ibra Richmond, TX
You guys are scaring me. I just joined AmBetter and had my first doctor visit with no issue. I found a doctor about 5 min away from my house and got my 3 months prescription medication fully covered. May be it is too early to say anything about the company but my first impression is okay.
7 years ago
John Fort Lauderdale, FL
I live in Broward county in FL, and all the very negative reviews are surprising to me. True, their website is not great, but other than that I have had zero issues. Many doctors to choose from, great prescription coverage, even urgent care. I am sorry to hear the problems people say they have, but again, I have had no problems at all with them.
7 years ago
Virginia Young Cincinnati, OH
Absolutely the best health insurance I have ever had!I like it so much that when I turn 65 in March I will be using them for my medicare supplement plan. Kudos to your great insurance and service!
7 years ago
NobodySpecial Temple, TX
I wasted many hours with them on the phone. It appears that their strategy is to wear you out by wasting your time trying to find 1 actual provider out of the many providers that they claim that are in network according to their website, or any other way possible. During a call, Ambetter might help you search for providers, keep you on hold during their lunch break, waste 4 minutes on every call to run you through a long menu before speaking with someone, ask the same 2 questions on every single call, give you a list of providers that do not take their insurance, refer you to somebody else and finally RINSE AND REPEAT until you drop. Call center employees work cheaper than specialists. START VERY EARLY IN THE YEAR, IF POSSIBLE, WHEN SEARCHING FOR A PROVIDER.
Don't waste your time trying to pick the best provider yet. FIRST, just confirm that the provider actually takes Ambetter insurance AND that someone has successfully filed an Ambetter claim with them for what you need to have done. Talk to the person that handles the insurance claims at the doctor's office just to be sure. And then, ask them again 2 more times to be sure. If you are lucky, they are correct.
Record all calls to Ambetter, if possible, and use an internet phone service that keeps track of all calls numbers and call lengths.
After wasting months with them, I filed a complaint with the Texas Insurance Board. Two weeks later, THEY CALLED ME BACK TO HELP FIND A PROVIDER. The provider I chose was one that was on their website for quite a while, but they only recently signed a contract with them. Surprise.
My health problems have all been taken care of by a very good provider. I was very lucky!
Best of luck to you! Hope this helps somebody!!!
7 years ago Edited September 14, 2021
Rebecca a Cecil Hernando, FL
THE ISSUES I HAVE WITH AMBETTER IS THEIR IN NETWORK PROVIDERS ARE FEW AND FAR BETWEEN. AMD WHEN I CALL MY SUPPOSE TO BE AGENT HE SOUNDS LIKE HE WORKS FROM HOME AND JUST ROLL OUT OF BED EVERY TIME WHETHER IT IS DAY OR NIGHT. THEN HE ENVER HAS ANSWERS FOR ME SAYS HE IS NOT MY AGEENT THEN GIVES ME HIS SONS NUMBER WHO IS SUPPOSED TO BE MY AGENT ACCORDING TO THE DAD BUT THE SON SAYS HIS DAD IS. SO CONFUSING - I JUST WANT ANSWERS AND GET NONE.
7 years ago
Tefft Crystal City, MO
I live in Missouri and have had no problems with coverage, copays, payments, or finding a doctor. This past year, I needed several tests, infusions, procedures, and medication. Never had an issue. Hopefully the coverage and copays do not go up next year. I will keep it .
8 years ago
Tom & Misty Mathein New River, AZ
While I have good health care with Ambetter, their customer service is terrible. I have now been sitting on hold for over an hour and counting.... Trying to get answers to questions is one of the most difficult things I find with this company. In addition, when you send your payment, they do not credit your account right away. So even though it is in their possession, as confirmed by my bank, you can still get a late notice in the mail, threatening cancellation. The processes overall leave a lot to be desired.
8 years ago
Amal Sweis Little Rock, AR
I wish there is an email address to contact them instead of the useless customer service people that keep answering my calls. I needed a proof insurance for all my family for the year 2017 and I had to call them more than 20 times until eventually I received the papers for all my family except my husband whom they denied he had insurance with them, I found my husband's receipts for most of the year and I want to show them that there is something wrong with their system but how can I do that?! they don't even have an office to visit in my state!
Me and my family where unlucky in 2017 because someone in the marketplace referred us to ambetter !
8 years ago
Harold Ferris Atlanta, GA
Ambetter misled me on 4 occasions, saying that they would cover my child when playing sports for her school. The team coach revealed, in a 3 way call with Ambetter, that they in fact DO NOT COVER my child. The school has secondary insurance ( not primary) and Ambetter will not pay anything unless the secondary (backup) insurance pays first. Even talking to a supervisor (Cathy A. ) at Ambetter did no good. Why lie, Just tell me the truth! You know you don't cover. Don't waist every ones time!
8 years ago
Sandra Pharr, TX
Don't get this insurance Melissa supervisor in customer service is horrible and won't help you with anything the WORST customer service Ever if you don't want to be ignored and a 0 priority stay away from getting An better coverage
8 years ago
Rhonda Petrukitas
I have no problems with ambetter in Indiana. My questions get answered correctly. It seems they pay the provider quickly.
My husband had to have MRI and brain scans approve. We received in a timely matter. The only complaint I havevisbthr selection of providers are very limited. You have to do a lot of searching find doctors.
8 years ago
ALVIA TOMLINSON Miami, FL
I have no problems with this insurance. I went to the ER in 2017 and they took take of my bill .I only had to pay a few dollar out of pocket.
The only draw back is that my PCP is not in there network
.
8 years ago
Marsha Moore Indianapolis, IN
I was pleased with Ambetter and appreciated my experience with them.I think they are one of the better choices.Thanks Ambetter moving to Medicare.Wish there was as good of choices as your company unfortunately All well didn't meet my needs
8 years ago
Liss Austin, TX
We had ver little issues with coverage but we also never went to the dr. We only did our yearly exams. What’s upset me with Ambetter is the offered money back rewards for Wellness checks, forms to complete which took 20 mins each, flu shots, etc. We earned $100 and they never sent to us. They told me they sent twice and that my address was my old and that it’s my responsibility to update. Which I had already. They had 6 months to get to me and continued to say because I didn’t update my address. Needless to say all of our monthly bills made to us just fine! Lies from them regarding the address.
8 years ago
Lillian Thomas
I am so happy that I have Ambetter really didn't have no insurance.. very affordable and very good network provider... I am very please... customer service do all that can to help you find the best provider..
9 years ago
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?!!!!
4 years ago
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!!
4 years ago
Lauren Woolsey Panama City, FL
The absolute Worst insurance provider ever! Family of 8 here. Paying $1260/month for what originally appeared to be good coverage. Long list of "in network providers". Turns out to be a Huge lie and i feel that my family has been scammed. Thankfully we are only 3 months in and Daniel with Healthcare.gov was able to help us on yesterday to have new coverage with BCBS effective 4/1 (25 days away) but i still cant help but being extremely angry with Ambetter for basically robbing my family of $3600 in premiums for the past 3 months. We hadnt used the coverage as we didnt need to until 5 days ago when my son broke his hand and i AM STILL TRYING TO FIGURE OUT HOW TO GET MY SONS HAND CASTED TODAY BUT CANT FIND ANYONE THAT TAKES THIS CRAPPY INSURANCE. There is literally no urgent care centers within 200 miles that take this insurance, NO Orthos within 100 miles that take this insurance, customer service is HORRIBLE when calling ambetter for help. They basically told me "Sorry, that is your problem not ours, you should have checked for providers before agreeing to this plan". The problem is that, I DID!! there was a list of all sorts of different in network providers.
You call them and they say the have stopped TAKING AMBETTER because they are hard to work with. Also, because its ambetter, every provider automatically assumes that it is medicaid when it is not!! I paid allot of money for this plan. I am so angry and will get to the bottom of this. Do NOT FALL FOR AMBETTERS SCAM! YOU WILL PAY ALLOT OF MONEY FOR ALMOST NO COVERAGE AT ALL.... THEY PAINT THE MOST BEAUTIFUL PICTURE FROM START BUT WHEN YOU WILL TRY TO USE THE INSURANCE, NOBODY ACCEPTS IT!!! THEIR LIST OF IN NETWORK PROVIDERS IS FAR FROM UPDATED. AT LEAST40 OUT OF THE 42 PLACES THAT WERE SHOWING IN NETWORK ON THEIR SITE NO LONGER ACCEPTS THEIR INSURANCE. DO YOURSELF A FAVOR AND STEER CLEAR OF AMBETTER ALLTOGETHER. THEIR CLAIMED COVERAGE IS A LIE AND THEIR CUSTOMER SERVICE IS THE WORST I HAVE EVER EXPERIENCED!!!!
4 years ago
Gloom Bunnie Fort Worth, TX
They don't deserve a single star.
Let's start from the beginning: All of their website information as far as providers is inaccurate. The numbers aren't in service, the Dr's don't even work at any of the offices anymore, and none of them are taking new patients even though the website says they do.
So,I call them about this little hiccup.. as far as I'm concerned, stuff happens. I get it. Except, the employees don't even give accurate information. I am on call #6 trying to resolve these issues and getting put on hold just for the calls to drop 15 mins later. They'll try to "fix the issue" so you don't escalate but it's a lie, they don't get you accurate info to fix the situation.
Disgusting company, liars, scammers as far as I'm concerned. None of them know anything, none of them fix anything, and I've wasted over $200 in 2 monthly payments alone and still have 0 healthcare because I wasted the entire first month waiting for an appointment just to find out they can't actually take me!!!
SHAME ON YOU AMBETTER!! Do NOT get this insurance!!! I'm doing everything in my power to cancel it and not give them another dime, and this is coming from a very tolerant, kind person.
4 years ago
Heith Gay Las Vegas, NV
Ambetter charges high rates but does not provide even basic care. I signed up for care under the Nevada health exchange and then used their "find a doctor" to set up a physical. I spent 6 hours calling different numbers. The list is so out-of-date that it is a serious burden trying to find a general practitioner. And for those you do get in contact with, no appointments are available for 3 or 4 months. I finally called Ambetter and they told me that I could get an appointment in the next city sooner probably and I should start calling people far away from where I live. I quickly canceled before the policy was to go into affect and Ambetter assured me I would receive a full refund in 7 days. It has now been 3 weeks and there is no way to contact billing. They simply put you on hold for more than an hour waiting for you to give up. Ambetter is a common thief. Avoid at all costs.
4 years ago
Sharon D. Winter Park, FL
Avoid Ambetter! I did not re-enroll in 2022 because 1) They dropped my primary MD, hospital and others without notification, new providers are not close to my zip code. and 2) Admin. is terrible, the negative reviews are spot on. We had to routinely "appeal" for accurate benefits payments because Ambetter routinely denied stating "out of network", which was not accurate. I had major surgery end of 2021 and can't access 2021 Evidence of Benefits processing because I'm no longer a member in 2022, nor will Ambetter mail. I'm receiving provider co-pays but met the member out of pocket for 2021, and providers should be paid 100%. Customer Service puts you on hold for unreasonable periods, e.g. 1+ hour and often disconnects you. The appeals process is equally dysfunctional. I've contacted BBB and Florida Customer Services.
4 years ago
Anonymous Chicago, IL
Discontinued membership after being enrolled in a Vision, Dental, and Health Plan. For reference, I live in Chicago and per their tool to find a dentist, I reached out to all 27 listed providers within my area to schedule a check-up. Each of them confirmed that they do not accept Ambetter and do not know why their practice was listed on the website. Members of their practice also called Ambetter requesting information on why they were listed, requested for it to be removed, however, months later it was noted they were not removed.
Ultimately, paying $336 a month for vision, "dental", and health seemed like a waste and so I decided to cancel my membership in December 2021. I called to request a cancellation and was also provided a refund in January. In February however, $668 was deducted from my bank account by Ambetter. I called to inquire why and rightfully request a refund. 8 calls later and close to 8 hours of call time, my request was denied because the "pay through" date on their system was February 1st. I pushed back on the call I made in December and it was noted to me that I had to cancel my plan with Ambetter as well as the marketplace for it to fully go through. I called the Marketplace and they confirmed it was canceled in December and their system shows no record of me receiving coverage in 2022.
I called Ambetter back and this time it was noted that the call log in December shows that I called to request account cancellation and a refund, however, no cancellation request was submitted (by the representative). I was then told that I should have received a letter in the mail in October noting that I need to take action to cancel my plan and if not, I will be re-enrolled in 2022. They backed out of their initial reason by noting that because my plan was started under"on-exchange", the marketplace would have no record of my coverage (basically their initial reason was incorrect).
Finally, I asked what further action would have been required by me to make sure my plan was canceled beyond giving them a call in December to request to cancel it and receiving verbal confirmation that it has been cancelled and I can expect a refund. Furthermore, I was not charged in January and on February 2nd was charged for two months. They could provide no explanation other than my plan was set up to be re enrolled in 2022 regardless of calling to request for it to be canceled in December 2021.
I then asked for a copy of an application to re-enroll into Ambetter in 2022 after canceling my plan in December 2021. They were unable to find one.
I have still not received my refund and nobody seems to understand the reason for it. They have "escalated" my case twice but I have not heard back and frankly, I have given up on trying to get a refund.
Ambetter of Illinois is a scam that misrepresents information on their site from dental providers that offer coverage to lying that a plan was re-enrolled (without having supporting documentation to show the account holder requested for it) and charging bank accounts. Please avoid using this service if you are in Illinois and stick with a larger provider.
4 years ago
pooh nani Kingsport, TN
Ambetter is literally the worst. I dont know how its legal what they're doing. They'll charge you for plans you didn't sign up for or use, you'll pay for your plan and they'll say they even got your payment but they wont give you credit. They'll take your money, Bill you again, and not give you your insurance. Theres no way this is legal and im looking into fixing this. Getting my money back and making sure they never do this again. They are horrible. They literally hang up on me. I cant even contact them. I have to call marketplace and stride health and talk to them. Ambetter is worse than no insurance. Seriously.
4 years ago Edited February 2, 2022
Elle A Atlanta, GA
I've been a customer for nearly a year and I would never choose Ambetter again. Know the overviews represented on the Marketplace website aren't accurate in terms of cost, in network providers, or cost of coverage. Customer service is insanely inept, they will just read the brochure version of your coverage for you with no ability to answer any problems. The in network providers listed on Ambetter's website aren't necessarily in network (please contact your current doctors directly before signing up for any insurance on marketplace). I pay a high premium for insurance that covers nothing. Every time I tell an office what my insurance is they either grimace, laugh, or contemptuously cut me off. Please only treat this disgusting company as a last resort. I am deeply suspicious of any review left here that is 5 stars as it was likely someone compensated/employed by Ambetter.
4 years ago
Hal F. Berkeley, CA
The worst customer service I've experienced in a long time. Currently on the 5th call today. I can't connect my account with my login on their website. So far, ticket sent 2 weeks ago and still not fixed. Got a rep that said he "activated" my account, not fixed. Called again and got a phone number to Nevada Health Link, this is not my problem. Called again and was put on hold. Got transferred while on hold then call dropped. Called back, on call for 7 minutes but there's no one on the line. This is where I'm at right now. Got a bill to pay, but not sure if that's happening. Absolutely the worst.
4 years ago
Maria Tajman Fayetteville, NC
Please be aware this is the worse insurance I’ve ever had. If they had a minus star that’s what they would get from me. Now why I understand most of the doctors in my area do not accept it. Had to drive 2 hours for mammogram, 1 1/2 fir colonoscopy ( which by the way they are trying for me to pay 500+ out of pocket because supposedly it’s not preventive, did I understand correctly? Colonoscopy after 50 is to prevent colon cancer, right ?? They refused to pay for an MRI that I needed for approval on a epidural shot I needed which I had to pay myself out of pocket and they still did not approve it!! Nevertheless I changed to United Healthcare at beginning of this year and after seeing my MRI and X-rays approved it right away. Never ever again I would use their services
4 years ago
Steve D Overland Park, KS
Jan 2022: I'm a brand new customer with Ambetter - Kansas and...
Dropping them already!
In Dec 2021, before signing up, I confirmed by calling Ambetter Customer Service, that my physician was in plan and my daughter's pediatrician was in plan. I was told they both were. Yeah!
Now 10 days into January, I cant assign either of our physicians as the PCP using my online account, can't even find them in plan. Called Ambetter C/S and was "escalated" to the Resolutions Dept. I was informed both physicians are "Specialists", not PCP's and unable to be assigned... WTH?
Nice to have known that about 1 month and a over $1,000 ago.
4 years ago
William McNeel
So far 6 day in with Am Better and not impressed at all. My doctor even accepts the coverage and told me that was the worst insurance coverage anyone could have. When trying to figure out what medication to try me on for Type 2 diabetes all required a PA prior approval for the pharmacy to fill them. I’ve never heard of such. I mean it’s not like I’m trying to get approval for a CT Scan or surgery just a simple medication to combat Type 2 diabetes. I’m still waiting for approval and it’s been over a week now. I think what if I was in dying need of medication I don’t have a week to wait. Plus my sister has had am better for over a year she went to the local hospital ER and was told they do not accept Am Better. This stuff must not be any good at all
4 years ago
Michelle Coatesville, PA
They charged my credit card twice and never gave me a member number or account. When I called multiple times to try to resolve it they said they could not find me in the system. The foreign customer care couldn’t understand my name despite me spelling it many times. He gave me a number to help me, which I found out after dialing it was to healthcare.gov. I didn’t purchase through them so that was pointless. The next person transferred me to a number that hung up on me immediately.
At this point I had to dispute the charges with my credit card company because I could find zero person to actually help me. Needless to say I won’t be moving forward with Ambetter, this felt much like a scam.
4 years ago
MAXINE POWELL Riverdale, GA
Ambetter is a rip off. I have been paying over 2 years for my sons. I just happen to call Market Place and they informed me that I was that I was not supposed to be paying a premium for the past 2 years. I reach out to Market Place to update information and this was when I found out. I have tried calling Ambetter 5 times and they hung up on me, when I explained reason for call.
I did ask for legal department to discuss reimbursement and they did not have number. Still cant get help so I will be reaching out back to Market Place see if they can help me get over $1000 back that Ambetter took from my account each month. At least $40 month.
4 years ago
Bri Dee St Louis, MO
By far the worst insurance I've ever had. Moved states, and literally zero PCPs available. Cannot get in to see ANY doctor. The few doctors that do take this insurance are low-income clinics where you're getting the worst quality care... But like I said, haven't seen one of those in months because NONE OF THEM ARE EVEN TAKING PATIENTS. I'm paying for insurance I can't even use. I get sent an explanation of benefits I didn't ask for every two weeks in the mail, even though I'm signed up for paperless everything. No one can seem to figure out how to get them to stop sending it. The site never works, customer service is a joke and they will hang up on you if they can't figure out what you need. Lost coverage for a couple months and lost access to my therapist because Ambetter screwed up a billing issue. Never paid late once. Please, if you care about your health, don't bother with this company.
4 years ago
Holly Gutierrez Hamilton, TX
I wanted to try Ambetter out because they were a new company that I had never heard of and they were very reasonably priced and the deductible and out of pocket max were very low. My husband and I have a plan with them through marketplace. It was very easy to apply and sign up. I paid my 1st few months premiums and everything was going great. They even paid for the surgery on my shoulder, which had me almost meeting my yearly individual deductible. Around July, I realized that our yearly income was going to be higher than anticipated at the beginning of the year. I went into marketplace and changed it. When I did this, I still qualified for the same Ambetter care 12 plan, but I would be paying more for my premium, which I understood. I found out that my income change put me in a different tier, same plan different tier, I went from the 90% to the 80%, meaning what they would pay. I was fine with all that. But because I had changed tiers, they put me in a new policy with a new policy number. This reset all my deductibles. The 1st several times I called, either the person had no idea how to help me and would put my call into a supervisor, which I never received a call back. Two people spent over 2 hours each on the phone with me to try and get this sorted out. They were on the phone with their supervisor at the same time. At the end of the calls I was reassured by both of these people that my deductible from my previous policy would transfer over because it was the same policy but a different tier. I had also received a rewards card from them for doing different activities in the amount of $50. I had used it some to pay my monthly premium but still had a balance of $30. When my old policy was "canceled", my Visa rewards card on associated with thus policy was canceled as well and I lost that money, which I had spent the time to do the activities for. This escalated over 2 months. In all this time I never received a phone call from a supervisor. Finally, after speaking to someone on the phone and having to tell them for 30 minutes straight that they could not help me and I wanted to speak to a supervisor, they finally got me over to a lady who proceeded to tell me that I was lying about everything that I had been told because I could not provide her the conversation number. She told me she could see all the conversations that I had had but because I could not provide her with the number she could not verify that that's what that person said. She told me that they never transferred deductible that it was my fault I canceled my policy. And that if I wanted to use the rewards card I should have used it before canceling my policy. I tried to tell her that I did not cancel my policy, that it was changed by Ambetter because I had been put in a different tier. But she would not listen. She just kept saying you're right ma'am what can I do for you. And when I would tell her she would say we can't do that, we've never done anything like that before so what else can I help you with. When I ask to speak to her supervisor to her supervisor she denied this request. I did not have a problem with anything but their customer service. Their premiums were reasonably priced, they paid for my surgery with no problem, but the way they treat their customers is absolutely is absolutely uncalled for and unjustifiable. I will not have a plan with them ever again.
4 years ago
Maddybaddy01 Des Plaines, IL
Terrible customer service. Extremely disorganised and I get different answers from nearly every person I speak with. They take forever to approve claims for treatments of chronic pain. I have terrible knee pain- waited a month for prior authorisation for an injection. Got denied. Never mind I am struggling to function. I was diagnosed with sleep apnea 8 months ago. Still not being treated because nobody wants to work with Ambetter and their process of getting treatment approved is ridiculously difficult. I was told by some medical facilities that they won’t work with Ambetter because it is Medicaid. Excuse me?! I am paying $341 per month, NO government subsidy- for this so called “Medicaid “. Had they disclosed this when they coerced me and basically pressured me into buying them this plan, I would have happily declined. They’re a rip off company who wants to steal your money. Don’t let the cheap benefits fool you. I’m looking into lawsuit options.
4 years ago
Rachel Y Columbus, OH
I purchased AmBetter through the Marketplace. It was difficult to find providers who would take it and it was very difficult to get a medically necessary knee surgery approved because AmBetter kept denying it for no apparent reason. But the worst part about AmBetter was that I met my out-of-pocket maximum early in the year, so AmBetter tripled my out-of-pocket maximum right in the middle of my contract, even though my income did not increase. They also increased my deductible and copays. I called many times, trying to get a resolution, and AmBetter pretty much said, "Tough, we changed the contract." I have a hearing scheduled for later this month, with a Federal Hearing Officer. It is outrageous that in the middle of my year-long contract AmBetter would just be allowed to change the terms of the contract and put me in the position of paying thousands more than I had anticipated when I chose AmBetter at the beginning of the year. What good is an out-of-pocket maximum if they can just increase it after you meet it? I will never use AmBetter again.
5 years ago
Kelley-Dan Young St. Marys, GA
100% worst insurance I've had in my entire life. Tiny network. Claims denied for legal modifiers. Have to travel an hour in two different directions for care. Most caregivers only in the covered office 1x/week to 1x/MONTH and are booked until we colonize Mars. Few specialists in network that have rights to any hospital also in network - so can't get emergency care because hospital doctors won't touch current meds and won't communicate with primary docs. Denying claims for random code errors that other insurances don't have a problem with, and refusing to contact the medical office to discuss the problem.
Having this insurance is absolutely terrifying and if there was any other option whatsoever for our location we'd bail immediately. We've literally considered moving in order to get new insurance.
5 years ago
SummerSpringWinter Smyrna, GA
My college age son has Ambetter Insurance in GA. I have Medicare as does my husband, his dad. He is a private pay customer as he doesn't work for a company full time that offers insurance (of course he is a college student with a part time job). My son goes to college out of state. He had an ER visit in FL, in CT, and some tests at a hospital in CT. He is an athlete so this is normal. Ambetter ignored these claims and haven't even recorded them on their claims page of my son's account. We have sent the claims personally, the hospital has sent them twice, We have called Ambetter numerous times and they don't acknowledge anything. But they bill my son $360. a month like clockwork and they never lose that. I wish we could choose a different insurance company but the only other option is Kaiser if you are private pay in GA which would not help as there is not a Kaiser Hospital where he was in school and where he is in school now. Also his pediatrician in GA is not in network with Ambetter. The insurance is worthless. I've never seen insurance this bad. I've never seen record keeping this bad. It is October and the claims have not show up for activity in April or May or anytime for that matter. Don't use Ambetter. GA needs better options.
5 years ago
Neville Mistri Berwyn, IL
My wife and I pay about $1500/mo for incredibly subpar coverage. I don't think most people could even fathom how bad this company is, so let me give a few examples:
- Often when I try to login to my account it's locked on the first attempt. If I send for a link to unlock my account, the email rarely comes. A representative once told me they almost never do. If I call the number on my card I get a long wait time of course, but wait there's more. When you finally get to a representative, seriously probably 30 - 40% of the time they'll tell you their system is down, so they can't unlock your account either. I think they’re on Windows 3.1. So they cannot unlock your account, and you cannot look for a doctor in your plan. That's not subpar service that's literally the definition of no service. I've gone through this several times.
- Twice now my wife has had to spend hours calling Ambetter and her doctor to try and get them to pay for a mammogram. Even initiating a conference call with them both. I believe both times it took 6 months plus to resolve that simple matter.
- I’ve lost count of the number of times the phone disconnects on you after substantial time on hold, or it just throws you into voice prompt loop to nowhere where you’ll be repeatedly asked to enter your personal information.
- Oh and even though we've been with Ambetter for a few years now and had the same primary care physician the entire time whenever we're talking to a representative they can't find her in their system. So don't forget to get your doctor's NPI number so you can give it to Ambetter. Anyone can look it up on the web, except for Ambetter apparently.
I honestly can't even believe such a company exists. They make Comcast and AT&T look like superstars. I would really only use them for major medical coverage if it’s your only option. After the $15,000 deductible they may pay if you can get through to someone, and they can find your doctor.
5 years ago
Mikieme Phoenix, AZ
Grievance after grievance .... nothing resolved .... then bang ... sir the podiatrist removed your female parts from your toe it has been RESOLVED your toe had female parts and a heart valve ..... Wow .... you cant make this s#$t up.... so what good is it to file a grievance... and oh yeah ... sorry but I cant find a grievance on that .... again WOW!
Over a year and head of grievance to fix my account so I had my pcp and not a default pcp. .... Taiwamo not English no stateside you have no problem now ok ... yes I do you did nothing ... I fix problem for you you happy now ok and hangs up...or.... Supervisor call you ... never do... doesnt say that in notes ... well it says that in the phone recording... a Supervisor will call you NEVER HAPPENS... COMPANY IS A JOKE AND IM EMBARRASSED TO ADMIT THEY HAVE PLAYED ME SO LONG....
5 years ago
Raymond B.
Signed up for Ambetter 6 months and didn’t have to use the dental option until now. My wife had an excruciating tooth ache and I needed to find a dentist who accepts the plan. Called customer service, after 20 minutes of trying to get through, and I get a list of dentist who take their dental plan. The representative says you have to tell the dentist office it’s billed under Envolve dental. Sounds simple until I call the list of dentist to make an appointment, of course either no one accepts the plan or the numbers are disconnected. Most of the dentist I talk to tell me they haven’t accepted that plan for years! At this point I log on to the Ambetter website and just start calling down the list, regardless of distance or reviews. Same results…….nothing. Finally into day two I call back to Ambetter and speak to the 4th representative and guess what? I’ve been giving the wrong information the whole time, the dental provider they use is not Envolve but another carrier. Which explains why, after countless hours of calling every dentist, I could not find one who took the insurance. What a waste!!!
5 years ago
PSDTennessee Rogersville, TN
I've had Ambetter coverage for about 3 months now. Here's a typical experience for me that just happened today: Called to check the cost of a procedure (can't do it online as their website is broken and has been since I first signed up, when you search for the cost of a procedure, it comes back with the result "nothing within a 100 miles of your location" no matter what you search for). It takes just over 5 minutes each time for me to navigate the automated phone menu and talk to a live human. I finally reached someone and she had me review all of my information, including a phone number I could be reached at in case of disconnect. We, of course, get disconnected. I wait for a call back that doesn't happen. I call back, spend 5 minutes navigating the automated menu, finally get a human again, only to find that there's a really bad echo on the line. I ask the agent to call me back and she says that she's not able to place outgoing calls. Excuse me? She tells me she can understand and we continue despite me having to pause every time I say something to let the echo die down. I get the normal "please verify all of your information" questions even though I'd already answered them 4 times in the last 2 days. And then she asks "what number can you be reached at if we get disconnected?" I say "but you just told me you can't place outgoing calls?!!!" Her response? "Ma'am, it's just a field on my computer that I have to fill out before I can continue." That conversation sums up Ambetter perfectly: customer service reps responding by rote, no empathy, simply a script to follow, but no actual follow through, a computer system that's broken that no one bothers to fix and after all of my time spent, I still had the same unanswered question. No matter how cheap the price, this company will never be worth it.
5 years ago
Sam Pennington Ada, MI
If I could give Ambetter ZERO stars I would do so. They delay, delay, delay paying providers for services that were given PRIOR AUTHORIZATION. I was billed the total cost ($9,100) of a procedure by my provider when, after 6 months, Ambetter was unable to tell the provider when they would receive payment.
The customer service agents give conflicting information about providers being in network, or out of network.
I have spent HOURS on the phone with Ambetter attempting to make sense of the information that I get via the website, or in the EOB'S I receive in the mail.
I have filed complaints with the Insurance Board of my state, as has one of my providers.
There is a reason that this company has the cheapest premium on the Marketplace.
5 years ago
Mike Ungar Miami, FL
I would give them negative 5 stars if I could. After using their crap service, I finally switched over to another insurance provider. When canceling, I requested a refund for the month ahead I had paid in advance. They said no problem and issued the refund. I had requested the refund to be by check as opposed to the credit card the payment had been made through. I was told it's not an issue and would be sent in 7 to 10 days. Fast forward 4 weeks later and no check received in the mail. I called in to find out where it is and they informed me that they determined that day of refund request that they can not send out the check and the refund can only be returned the the credit card payment they received it by. So my question to them was 2 fold. 1: why than have you not returned the refund to my credit card if that's the only way you can do it? 2: why has nobody called me to tell me this after 4 weeks of waiting for the check?
The response from the manager on the phone was that it was my responsibility to call them and ask them if my refund request would be honored by check. They denied the request by check the day they told me it was approved yet expected me to know that information telepathically and call them and tell them to send the refund to the initial card instead. 4 weeks later no phone call from them or email or text ot anything and I have to wait another 7 to 10 business days for my money to be returned when it fact we know they can easily return in the same day. And than to blame me and put the responsibility on ME for not calling in to find out? I lost it with these guys. Do yourselves a favor and stay away from these crooks. Better go find yourself a different insurance company. Litterally anyone else. Don't say you weren't warned
5 years ago
Marty Novak Tucson, AZ
Ambetter is the worst. I have a very high deductible. I am not even close to meeting that. I need an MRI for a spine I already had fused, but is having problems WHEN I PERFORM MY DR. PRESCRIBED PT AT HOME!!. They will not authorize the MRI because they require 6 weeks of PT, the same PT that is causing me nerve problems, before they will authorize the MRI. They would not have to pay one cent for this MRI, as it is all out of pocket for me at this point, and are unwilling to negotiate an insured rate for me to pay out of pocket. A lot of doctors don't accept their insurance and now I know why. Don't waste your money.
5 years ago
