Ambetter
1.4
5.1
Overall Score
Khan
I have only showed twice during 2016. However Ambetter didn't pay the bill to the clinic telling them the member was not insured during the time of service. At the same time Ambetter told me that the clinic didn't submit the details of their bill and the reason of the service. Once they provide that they will make the payment. This kept going for almost 8 months. I talked at least 25+ times on the same issue and wrote written complaint to their Appeal department. However, i didn't hear from them.
Its very unfortunate the way this Insurance company is handling its matters with respect to the billings and settlement of claims. I have will never ever used this company and highly recommend others to refrain getting near to this company. In the beginning you will get best rates but they will never pay to the service provider and you have to finally settle the bill of the service provider to save your credit.
If i have to total the number of hours i wasted following up and writing to Ambetter customer care, Appeal, Complaint department, it will not be less than 100 hours for a claim which was only for $400 approximately.
9 years ago
Nicole Waco, TX
ZERO STARS
I know it's hard to believe that a company could receive so many bad reviews, or maybe it's hard to trust this BestCompany.com review since it's so out of touch with the consumer's experience.
I've only had this insurance for one month and it's been a nightmare. I've made no claims. All I wanted to do was check to see if my provider was in-network. I called them with my provider's tax id and provider number and name (THE information they need), then I was put on hold nearly 5 minutes and hung up on. I called back thinking it was probably a technical difficulty, but had the exact same thing happen again. I proceeded to email them my provider's information through their online portal and received an immediate, computer-generated response that said I'd receive a response within 24-hours. Reasonable.
One WEEK later I emailed them again, forwarding my previous message. I received the same automatic message that I would hear from them in 24 hours. Okay, we'll see. The good news is I did finally receive a response. The bad news is it read, "Please call us..." Are you kidding me?
My provider was able to make contact with a person to verify that she was NOT in-network. She shared with me that spoke with more than one person, as most customer service/provider service professionals knew very little about the Ambetter health plan, even less about Superior, and absolutely nothing about the parent company--the one providers must be approved through to receive reimbursement.
I can't believe this is THE insurance the Healthcare Marketplace is selling. I don't take any subsidy and pay over $200 per month to not be able to use my insurance. It's an embarrassment to hard-working, under-paid Americans (I'm in AmeriCorps VISTA-- a national service program) that this is how our insurance providers want to serve us.
Stay away from Ambetter. I plan to stay away from Superior in the future, as well, and anything tied to this shameful excuse for an insurance provider.
PS - There's no grace period for payments. If you don't make your payment before the 1st of the next month, your account will be suspended.
9 years ago
Ashley McWhorter Tampa, FL
For me this insurance is DIRT cheap and I did purchase this "insurance" back in December through the Healthcare.gov/marketplace. Let me tell you.... I haven't received anything in the mail such as any ID cards or anything through these idiots. I call, I'm placed on hold all over again for such a long time. Very unprofessional if you ask me! It's almost FEBRUARY and I simply need an ID card to get checked up on. Not that hard to do. To make matters worse, I was in a car accident Friday and thankfully no major pain (not at fault - if needed to be checked, I'd use the other drivers info). But what if something horrific were to happen and I don't have MY ID card for my health insurance I paid for????? I hope my unfortunate situation helps others look else where.
9 years ago
Jon Vaughn
Hmmm..... Where should I start. Well first off lets start how terrible there representatives are which seemed like they pulled anyone off the street, taught them for 1 day to answer phones using a guided directory but having no clue on assistance. They have no idea what they are doing, please do not waste your time!! There web site is like someone from high school designed it, please do NOT rely on it to find a doc.!!!! You will be wasting hours of your time for someone to accept the crap insurance they provide. Also if you go for just a simple blood work and urine test for a physical check up, you will be getting billed astronomically from a 3rd party lab which they should've covered as they promised lol. These idiots for representatives will send you to places saying they will cover you, but will NOT!!!! Terrible Terrible Terrible insurance company please seek others or you will regret it.
9 years ago
Joelle Bart-Davis
I've had Ambetter for 28 days. I went to refill all my medications early, as I feared the worst. 17 days after I went to the pharmacy and several calls later, I was informed that a GENERIC medication I have been taking for 10 years was denied by a physician who reviews requests for Ambetter. A physician who apparently knows better than the doctor I have been with for over a decade ( who I pay cash for because he doesn't take Ambetter) The only reason it took ONLY 17 days was because I called and the expedited the process. I
I will run out of medication, thanks to Ambetter's "process". Not sure what will happen.
I read all the horrible reviews and was and am now fearful of the year ahead. My husband's cancer doctors take Ambetter so I had to chose them.
9 years ago
Jim Boyle Temple Hills, MD
If your reading this the best way to get help and results are contacting your state insurance regulatory agency. If your in Indiana thats the Indian department of Insurance. They provided me assistance! Ambetter could not provide me with approved in network doctors or services for cancer care. I was forced to use out of network providers which they approved. these providers made me pay in full upfront for services out of concern Ambetter would not cover the bills. As it turned out Ambetter in fact only paid a small fraction of the bills roughly 10 - 15 % as of this writing I'm still on the hook for the balance they say its my problem. I would choose another provider or you will regret it!!!! If I didn't have the cash upfront my cancer care would have been delayed. My concern is those of you who cant put out major sums upfront could be in peril!!!
9 years ago
Brieanna Mcnemar Houston, TX
If anyone is looking for a vision office that accepts ambetter in San Antonio, Bright Eyes on Nacodoches does. I'm posting this because it was hard to find a doctor who accepted ambetter (Even when looking on the website) but I finally found someone! FYI not everything is covered but it is decent. The exam was covered and the frames were covered up to $139 on the frames but I paid $40 out of pocket for my lenses. Hope this helps someone!!!!
9 years ago
MARK A. SUNESON Irving, TX
We signed up for health coverage 12/13/2016, we made a payment at the time we signed up for coverage to begin January 1. 2017. As of mid-January, we have on;y received invoices, NO pharmacy card, i.e.a card verifying our coverage under Ambetter . We have called several times, and each time we are told the material was mailed to us, only the reps give us a different day of mailing each time we asked - obviously they are making this information up. Meanwhile we can not obtain prescriptions under our new Ambetter insurance without insurance proof at the pharmacy. Another Healthcare scam. Very poor service - NO, NON-EXISTENT SERVICE FOR OUR PAID PREMIUM.
We have been directed to the Ambetter website to print our coverage card, but guess what? The Ambetter website does not work ot allow one to even register.
9 years ago
edvi alcoba Miami, FL
WORST INSURANCE EVER!! Had MULTIPLE issues with them but last one was the last straw!! They put me on the wrong plan which was conveniently more expensive and after almost a year of phone calls they finally fixed it. They said they would pay my account through the end of year using my over payment and issue me a refund for the rest. Got a bill a month later and called to inquire since I found it confusing. Lady told me it must be a mistake because my account is paid in full through the year. Come to find out in January my plan did not renew into the new year 2017 because the bill WAS NOT A MISTAKE! Now Im stuck with no insurance and worst is my $140 birthcontrol I have to pay out of pocket!!! Thanks Ambetter!! STAY CLEAR!! Worst insurance company Ive ever had!!
9 years ago
mickey Demorest, GA
OMG I am dealing with such a nightmare. I had this company in 2015. Never used the coverage and ended up canceling the coverage in Oct 2015 because they could never get my payments posted timely. Had BCBS in 2016 but because of the huge increase in premiums went back to Ambetter for 2017. My payment cleared the bank on 12/21 as of 12/30 they were still not showing payment. So I paid it again on 12/30 to ensure the policy would be enforce on Jan 1. My husband broke his arm on the 30th and requires surgery Wed. They are showing the policy suspended due to non payment in 2015. They have currently have two payments for Jan 1 and still no policy in force.
9 years ago
Jacquelyn
I signe dup via the marketplace as hit sis the ONLY provider in my county. It is almost $1300 a month and none of our doctors will take this service. What can I do, we have to have insurance, there are no other choices, so I bit the bullet and sign dup. Well, the first premium us due January 1. I signed dup November 15. It has been a non-stop assault from this comfy to make my payment. Non-stop! An email every darn day. A phone call EVERY DAY, sometimes it is a human, sometimes it is a robocall. When I point out that the payment is not due until December 30 I am told payment is due when I receive a bill. Well, that is ALL I have received, a bill. No benefits book, no coverage info, no insurance card, NOTHING else but a bill. I was told they do not supply any info until after I pay and the rep even said "Ph Honey that is how all bills work." First of all, I am 42 years old and do not appreciate being called "honey," second, when I sign up for any other service I get benefits information up front SO I KNOW WHAT I AM PAYING FOR. This company is a nightmare, all they want is their money. I am dreading 2017 and having to actually USE the service. NONE of our doctors will take it, it is awful. It is terrible that this is the ONLY insurance offered to the public here in my state and county. No competition, how is this not a monopoly.
9 years ago
Lindsay
When I called to talked to them about a bill and phone call I got about coverage that I was signed up for without my permission, the woman I talked to was very rude to me and did not know what she was talking about. I was told in the message that was left for me to call them and talk to them about the coverage if I had questions or did not need it, but the woman said I needed to call the marketplace. I told her that this was in contradiction to what they had told me in their message they left me. She kept insisting that I call the marketplace and when I told her that the message they left me was to call them, she hung up on me. This is not only rude, but is horrible customer service. If this is how they treat people who are trying to figure out why they are getting billed when they are not signed up for their insurance, then I can only imagine what they do to their own customers.
9 years ago
John
Unbelievably unresponsive and irresponsible customer service. Many agonizing telephone calls resulted in no resolution of my problem, despite my statement that, if I could not get an answer to a simple question, I would have to cancel. Ambetter withdrew my first premium from my checking account (verified by my bank), and 9 days later, the website still showed that I had not made the payment. I called several times to ask if a mistake had been made, or at least, when I could expect the payment to be posted. Each time I was told that customer service had no way of knowing anything about my payment, but the issue was being escalated to the Invoice Management department, and I should wait 48 hours. On the final call, the afternoon before the Marketplace deadline, I was told that the issue had never been escalated to the Invoice department, but they would do that, and I should wait 48 more hours. The supervisor told me she understood my frustration (as if I need her understanding and not action). She said there was nothing more she could do. I had asked previously if someone could please take ownership of this issue and get back to me, rather than forcing me to repeatedly go through the ridiculously long process of getting a rep to look at my file. I was told that representatives aren't allowed to make telephone calls, and can't communicate via e-mail. I may have no choice but to keep this policy for a short time (assuming that my payment is eventually "found"), however, I will run screaming from Ambetter at the first opportunity, and will be happy to explain to everyone I know how incompetent and unhelpful they are, and how agonizing it is to deal with their so-called customer service. I've been stonewalled by the best of them - airlines, Ma Bell, the cable company, etc. - but this is a new low. When they take your money and say they didn't, despite the existence of positive proof of it, what can you do? I know it doesn't make sense, but I actually came to believe that their "service" protocol is meant to frustrate and deflect customers. What does it say that this company is rated 13th out of 25 health insurance companies after receiving 134 ratings of 0 (terrible)?
9 years ago
Sandra B
After waiting for an hour and 38 minutes to get someone on the phone, the representative was having a difficult time reading her script. She wasn't sure when I told her I'm self employed and my income changes on a given month.
When I told her I thought I was calling Aetna, she told me she could provide me with their number but after a 3 minute wait I was passed to the survey department, that's the best thing she did for me after spending 2 hrs on the phone. I would never heard of this company and just from the sound of the name, so unprofessional name, my opinion. I could never think of getting insurance thru them.
9 years ago
kristin Racine, WI
Ambetter charged my card 6x what my bill was supposed to be which drained my bank account and I had to file a fraud ticket with my bank and finally got it back since Ambetter had NO record of it anywhere. Then after I tried to pay my monthly payment over the phone, I got a confirmation number and a mailed receipt. It still says my health insurance is suspended. So forget it. Its not even worth calling them again to ask why they are so unorganized. You get different answers each time you call, no one knows what they are doing and you will get yourself into the biggest headache ever. Good riddance!
9 years ago
Tiffinie Johnson
Everything that's been posted is absolutely correct. Ambetter is the absolute worst. Leave them if you haven't already. Things go well with them until you actually use the insurance, then it's all downhill afterwards. I was involved in an auto accident in April of this year and was rushed to the nearest hospital that happens to be out of network. However, upon receiving the medical bills and attempting to handle them, I was given false information and the run around. And like previous posts, the reps were amused when I asked to speak to a manager. That happened on FOUR SEPARATE OCCASIONS!!! First, I was told that there is no manager, which I replied that's incorrect as I've worked in a call center before. The second time I was told that there was no manager available and that the rep was knowledgeable enough to assist, she wasn't. The third time I called asking for a manager, I was told that a request was put in and to expect a phone call in one or two business days. A week later still no call. I called back today, requiring to speak to management, again, I was told that a request will be put in and to expect a phone call. PLEASE PLEASE!! Do NOT use Ambetter's insurance. They may be cheap but you will definitely get what you pay for, crappy service. Another incident with them happened in March of this year. I was scheduled for my annual exam when I told my insurance has lapsed. I asked how could that be when I e always paid Ambers on time and in full. Turns out my payment wasn't processed in time for my appointment THEN I was told there was a balance of $8 on my account and that's why the insurance supposedly lasped. $8 freaking dollars people!!! Only after going off did they correct the issue. The company and its employees are total scammers. So if you've come here to see what kind of company you're dealing with, take heed to what you read here. I've had similar experiences as everyone else who posted here. Don't waste your time and money with Ambetter.
9 years ago
Moirraine Campbell
In real time, on the phone, Ambetter's personnel listened as I told her I was being neglected while at Immediate Care in Olympia, Washington.
I had pneumonia, was blacking out every few seconds and was MOCKED by the medical personnel after Ambetter ABUSED my privacy.
Ambetter is owned by Centene - a CLUELESS, MONEY GRUBBING ENTITY that has ZERO control over its employees or its service and it CERTAINLY does NOT get that there ARE bad medical personnel who can't even figure out PNEUMONIA nor tell the TRUTH about SERVICES in THAT FACILITY.
Ambetter had a person who was LEAVING THE COMPANY contact me, and of COURSE SHE lied about the NEXT person who would 'contact' me, supposedly higher in the company structure.
Then on top of ALL the abuse, Ambetter has the NERVE not to comprehend that they have been FIRED FOR CAUSE.
9 years ago
Kevin Fort Wayne, IN
Great prices in obamacare. I'm lucky to have good Drs that accept it nearby. Have had a baby on this. I was astounded when the EOBs came and they kept denying things, most commonly for the hospital billing each individual thing rather than adhering to an agreed upon bill for deliveries or something like that. One bill came to us after the insurance company wouldn't pay it. It was for the circumcision. My wife went rounds with them to pay it and got nowhere. They wouldn't pay it because it was "cosmetic". I told them it was ordinary, customary and they'd have to show me in literature this procedure wouldn't be covered. I told them I was going to file a complaint with the Indiana Insurance Commissioner. That's when the Customer Service Rep asked if I wanted to file a dispute. I did to which I was supposed to hear back in 1 week. I never heard back but 3 weeks later the Dr said his bill had been paid. The money I save by having this policy through healthcare.gov completely makes up for my problems. Be careful though, make sure you have a network available. Of the 2 large healthcare groups in our area, only 1 accepts them.
9 years ago
Brian
7.4 LOL!!! Does this company give you kick backs or something?
Customer service laughed at me when I asked to speak with a manager. When I confronted her, she tried to defend herself. "I laughed at you because you were irate." Is literally what she said.
Now why was I upset.
1. 6 months later I still can't log on to my online account, I've called multiple times, and even had the manager promise to call me back which he never did.
2. They have duplicate accounts for me and 6 months later even though I called them several times they still can't (or won't) delete my duplicate account
3. They keep sending me bills saying that I haven't paid, and I've called and set up Auto Pay 3 times.
4. I asked to talk to the manager 3 times, but the lady who laughed at me kept asking me questions about my problem
Stay away from this company.
10 years ago
Jim Boyle
I have Ambetter and have payed the full amount 748.00 per month since I don't qualify for any assistance. Dealing with this organization is a nightmare! They've sent me to out of network providers for cancer care since they did not have approved providers for my particular problem vocal cord related. They then refused to pay my bills since provider was out of network. As of the writing of this rating my out of pocket cost for cancer treatment is higher with insurance than it would be without. I'm forced to use state agency's and the court system for relief. If I didn't have my own personal financial resources to pay for care I can't say what would happen. If your value your life and sanity chose another provider.
10 years ago
Abigail Hecht Federal Way, WA
Ambetter is a REALLY BAD HEALTH INSURANCE. I've had Ambetter for about 2 years now and although it may be cheaper than some other insurances, this will be my last year with Ambetter. The first year everything seemed fine because I never had to use my insurance, but the second year I ended up having to go to the emergency room and spent about a week in the hospital and after being discharged, thats when everything went downhill. Ambetter continually screwed up everything. They kept not sending the EOB to my secondary insurance and had made a huge mistake by claiming themselves to be my secondary insurance without checking that my other insurance is actually supposed to be my secondary since it is my father's insurance that I am under so this caused such a mess. They did not communicate well with my secondary insurance or with me and every time I tried to contact customer service (which was literally everyday for like 3 weeks), I constantly would get dropped, transferred, or given numerous different answers that didn't help at all and whoever was helping me usually had no idea what to do or would give me false information or tell me they would take care of it yet never did anything.
Also, literally no one takes Ambetter and they have a horrible reputation with hospitals because Ambetter constantly loses bills, make mistakes, or just flat out doesn't pay! They are awful. After this year is over I am switching to a new insurance.
10 years ago
Tammy Herman Austin, TX
When I signed up with Ambetter it was posed as a ppo. They took away my tax credit even after I sent them all info requested that was backed up by the IRS. They gave me the credit initially then lost my info. Even had my email incorrect. All of the providers that were listed when I signed up are no longer accepting this plan. I broke a bone recently. When I called them for a list of orthopedic doctors they gave me six providers. I called of them. Not one accepts Ambetter anymore. Finally after calling them again I was given only one in all of Austin Texas who accepts this plan. I pay $570 a month. Ridiculous. I am disgusted to the point of educating myself on filing a class action suit against them.
10 years ago
Ashley Bartow, FL
I have had this insurance for almost 3 months and I have not been able to get my prescription for my chronic migraine syndrome because it is a name brand with no available generics. They have requested multiple times that my doctor tell them why I need this medication. It is the only medication that has worked and I can't get it because without insurance it is over $300. I have had to go 3 months without medication. I get 3-5 migraines a week. DO NOT get them.
Also, every doctor they had listed as in their network is NOT in their network. I checked with the insurance company before I bought this insurance and they told me every single one of my doctors take this insurance. Only one did and I can't see him without a referral due to the wording in our insurance. A doctor that I have been seeing for over 3 years on a 6 month basis I cannot see because this insurance is complete and utter crap.
10 years ago
Robin Price Fort Wayne, IN
I am very disappointed with this Insurance co! I switched from PHP due to the cost but this Insurance is not worth the savings! It took forever to get an Insurance card to start off. Then it was one problem after another. Every month I get a new statement with another months premium added! Keeps saying I am deliquent even though the payment clears my account the 1st of every month! Billing calls must be outsourced to another country because everytime I try to call and straighten it out, I get someone that can barely speak english, I can't understand them and I end up hanging up! I have tried contacting by email several times to straighten this out and I get no response. Me and my daughter both have had to switch several medications because they refuse to authorize them. My gastric reflux symptoms are awful now because they will not cover anything that works for me when I am already borderline Barrett's Esophagus. Guess they would prefer to pay for Esophageal Cancer? Everything seems to require pre-authorization which they either deny or twiddle there thumbs on authorizing. As soon as there is open enrollment again I will be switching back to PHP or Blue Cross, if I have to get a 2nd or even a 3rd job!
10 years ago
Barbara Lowe Barker Chicago, IL
This insurance is an actual racket! They are charging people the lowest rates, best co-pay vs deductible, but AREN'T providing ANY avenues for care. They are putting DRs on their providers list that are retired, dead, have stopped taking Ambetter or still undergoing the application process to become a DR with Ambetter. I called 11 DRs to find a primary care physician and these are the results I experienced. It's coincidental others are coming up with the same experiences? I came into this with no expectations... I didn't know what to expect, I know now that I am paying $159 per month for nothing. I can't get any care under this plan. I have found NO Drs that will take this plan. I have even spoken to Drs who explained the reason why they won't deal with Ambetter is because they won't pay. It's like getting Detroit to pay their debt before they go bankrupt.. not going to happen. Run! Get private insurance!
10 years ago
lea depew-grunow Orange Park, FL
THEY ARE TERRIBLE!
Every possible thing with this company is disastrous. They fill my medication through one manufacturer only, which is a manufacturer that no pharmacy uses. Every month when I need to go in for a refill they have trouble filling my prescription which ends up causing a 2-3 day delay during which I'm stuck without medication. I am an undergrad student who has been receiving medication for a learning disability practically my whole life, me having to go 3 days (sometimes a week) without medication is very stressful. If you already have enough of "life" om your plate, do not sign up for this insurance! I can't stand the fact that I'm stuck with them until the end of the year. They need to hurry up and get out of the insurance business!
10 years ago
Tanisha Lenae Columbus, GA
Okay so, Um I'm not even a customer yet, but I Signed up over the phone recently. The woman I talked to her name was Jennifer **** and she was extremely nice and all but I recieved no calls or nothing discussing my insurance I was supposed to get for $95 a month but she had told me there was going to be a $115 charge which included the application fee and I'm guessing the first charge, but I only see that $24 and some change is taken out. I really hate the idea of being scamed...... And I just hope that isn't the case and honestly don't want to judge without knowing what is going on, but I feel ad if that is what happened. I left a voicemail and got a little snappy this time and told her there was going to be a report filed because this is my third voicemail I've lleft her and nothing in return... And I am honestly just a person trying to help myself because I have no insurance. And NEED some. ASAP....
10 years ago
Katrina Mintz Cleveland, GA
I reported Ambetter to the Georgia Insurance Commissioner today. They have sent me in circles since June denying claims. They have only nine oncologist on their website now IN THE WHOLE USA and not one in the state of Georgia. How deceptive!!! An insurance company with the peach state symbol that has not one cancer doctor in the whole state. When I call their services division, they just tell me the cities within a 100 miles they have checked and tell me they are sorry they can't help. THEY ARE SORRY! IT TOOK VERY LITTLE EFFORT TO SEND PAPERWORK TO GEORGIA INSURANCE COMMISSION. STAY AWAY FROM THIS COMPANY. THEY HAVE GIVEN BOGUS NAMES OF DOCTORS AND BOGUS PHONE NUMBERS TO ME NUMEROUS TIMES.
10 years ago
Rebecca
I live in GA. They have providers listed on website or you call to verify or find a provider and when you actual call to make an appointment oh the doctor doesn't take Ambetter. You contact Ambetter and inform them and they apologize and tell you that they have plenty of doctors in Atlanta which is 250 miles and 5 hours away. They cant even verify their prescription services co pay. I was better off going to the public health clinic and using Good Rx. A year later I still cannot see an orthopedic doctor or a neurologist and I am in so much pain that I can not walk. Then when you call the customer service rep ask me if I have had my Well Woman appointment or my colonoscopy that I need to do this but no doctor takes their insurance in Savannah. No not get this insurance. A word of advice the Insurance Commissioner's office advised me that they have to provide coverage locally and how to do it. Call their office for information. It took me 9 months just to get an ID card from them. Please chose another company and make a complaint to the State's Insurance Commissoner. This is graud. The HIM is very aware of this and does nothing. How horrible can this be?
10 years ago
Richard Christy Olive Branch, MS
Awful. Just awful. It's like being on Medicaid except you're paying for it. You get to see the lowest rated doctors, in the oldest and funkiest offices with the most outdated of equipment. And you're lucky to find these. Most doctor's offices either chuckled at the notion of taking this insurance, or had never heard of it. Then when you call in to find a doctor they tell you there are 4 within 120 miles. I mean cmon. Anyways I resubmitted with a life change of an increase of an extra $50 every two weeks on my check and picked Humana this time so I can actually see a doctor whose name I can pronounce.
10 years ago
Darlene Meldrum Marysville, OH
When I enrolled my physician was listed, with the healthcare market place you sign up in the fall and insurance doesn't begin until the next year. When my insurance took effect my physician was no longer on the plan. Now I have to pay for each physician visit in full! No, I'm not switching from a physician I know well and trust to someone who doesn't have much of a practice because they are either new or not very good. Every time you need to find out if a physician, lab, or anyone else is on your preferred list you have to call because the website doesn't work. Since the beginning of the year they have told me they are working on this, it's been 8 months and no resolution. Of course when you call it takes forever and the person doesn't speak English! Today I received a bill saying I owe for my yearly eye exam, it states in my booklet that this is covered 100%! After being on the phone with Ambetter rep for 22 minutes I'm informed the claim was submitted without a code #. I called my optometrist office and they said they were told that routine eye exams aren't covered. I called Ambetter back and went through all the questions, explained the problem, another 22 minutes on the phone. My optometrist has to resubmit.
I would save a lot of money not having health insurance and paying out of pocket for everything. I hate "Obamacare" and will never do business with Ambetter again.
10 years ago
Jan Cook Stephenville, TX
this company is a huge FRAUD!!! first off they dont explain anything to you when you call & if you get cut off (which ALWAYS happens if you ask hard questions) you never get the same answer or you get cut off. i got a letter on 07/13/16 telling me that they had cancelled my policy for non payment--which is odd since I just got an invoice from them which i pay every month!! now the interesting thing is the date for cancellation was 04/30/16---now i go to the doctor once a month EVERY month! not once did they refuse me or say anything different. i call & was told that all my payments were set aside because they were waiting for a new file from HealthCare.gov--why?! I then was told oh no you arent cancelled at all just suspended till they got an updated file....ok i then call HealthCare & was told nope cancelled is what they told them & no need for a new file for anything since i was signed up for the entire year.
I then find out that they have refused to pay my medical bills by returning them & telling the dcotor office to resend it with a different code-- they do & it gets rejected again but told to use the other code & its a circle jerk!!
i just went in for my monthly appt & get told that Ambetter now said i was cancelled & never covered for non payment which meant i was told that i had to pay 4 months of bills or they would refuse to see me!
this company is worthless & a scam!!!
10 years ago
Stewart Pooler, GA
Horrible, horrible, and horrible! Please be aware of this insurance company scam. Purchased Ambetter through in agent Jan 2016 in my local area. Purchased plan that did not require specialist referrals. In May of 2016 needed to see a specialist. Learned the nearest specialist was 119mi away. Contacted Ambetter and was told they would authorize an out of network provider and expedite request because I was ill. Contacted specialist and informed me the physician I chose still does not have letter of authorization. Contacted Ambetter and was told I would need to go to my primary care physician for a referral. Contacted the doctor they chose to schedule a visits for a referral. Doctor informed me that they have explained to Ambetter since Jan 2015 they do not or have ever accepted Ambetter. Contacted Ambetter and was giving another provider. Contacted his office and was informed he has never heard of insurance company. I normally do not post reviews but If you read this please avoid Ambetter membership at all cost. The company starting to remind me of an upcoming "American Greed" episode
10 years ago
S Brown Killeen, TX
We signed up for this insurance because we could afford the silver plan and receive a little more coverage. We researched their website and looked at all the doctors that would accept this insurance and we thought we had found a decent plan. Unfortunately, as soon as we started calling doctors on the list to schedule appointments we were repeatedly told over and over that they do not accept this insurance. Finding doctors has been a long, tedious process and we have ended up spending so much money out of pocket, we might as well have just stayed with a bronze package with another insurance company.
10 years ago
maikeru1 Decatur, GA
Ambetter's slogan should be "For people who can't do better" because that's exactly what it feels like with this insurance company. Here's the breakdown of my experience with Ambetter:
The good:
Insurance plus dental, the cheapest rate their is.
Easy to contact them and the staff were friendly to me
I didn't have any issues with auto-pay until I had a job change
The bad (the real bad):
You don't know who is in your area. The coverage map you have to look at to select your provider is NEVER updated. Expect to spend hours and hours calling to see who offers what. You might as well not even use the website. You're left feeling that you just have to select who you manage to find.
You can pick your primary care doctor on the website if the are accepting patients. Funny thing is, since Ambetter never updates their database you are able, and likely, to pick a doctor that either no longer accepts ambetter insurance, or doesn't even work at the same hospital anymore. Completely useless function. Expect to get the lowest common denominator of doctor choices.
FOR DENTAL:
This was a nightmare to find somebody for my dental work. More than 80% only accept child patients. Finding somebody who accepts adult patients is just pure dumb luck. Take what you can get. I live in the middle of Atlanta and I could only find 3 possibilities.
The only reason I give this review a 1 instead of a 0 is that "you get what you payed for" can be loosely applied here...
10 years ago
Maria Pelaez Miami, FL
BIG JOKE! They cancelled my policy then when we started receiving bills from medical providers it took me more than 5 months and dozens of calls to Ambetter to finally get this straighten out. At one point I would call the customer service line and they would hang up or they also have automatic message of a guy saying that he can't hear us and giving information about ID cards. It's a joke. Worse, when I called to complaint about the message and that it takes me 30 min to get a hold of anybody, the lady Lynn didn't even seem surprised. I had problems with enrollment, disenrollment, wrong information, cancelled charges that weren't supposed to be cancelled, you name it! I've talked to Sabrina, Chayra, Darielle, David Rex, Tina, Carmen and the list goes on and on. Don't waste your time!
10 years ago
Tammy Wayne Schererville, IN
I purchased this on 5.25.2016. Their system did not register my payment. As a result, I did not show as "active". I called them on 6.3.16 to attempt to straighten this out. I had to "prove" that I paid. I did and had at least 5 different customer service reps tell me 5 different things. Liars!!! On 6.6.16, I still do not have insurance. As a result, I am a Type I diabetic without insulin. Further, I will not have insurance for at least 72 more hours. As anyone knows, insulin is like buying liquid gold. I can't afford it as I lost my job due to my position being eliminated. I paid for insurance so I would be able to afford my insulin. Now I will likely end up in a coma, or die. I explained this to Ambetter, but they claim that their hands are tied and can't do anything until U.S. Script updates the system. Apparently, life does not matter to insurance companies. I will die in comfort knowing that I will not be fined for not having insurance that failed to cover me!!
10 years ago
David Happe Waconia, MN
Worst health insurance we have EVER had. I cancelled it after 90 days. Here's the deal : Expensive premiums through the ObamaCare Florida exchange. Almost NONE of the doctors listed on their web site will actually take the insurance, and the ones that will are the worst rated/reviewed doctors in the State. If you go to a doctor out of state? Not covered. They assigned me (a 45 year old male) a primary doctor... I didn't pick it. Guess what? They assigned me a PEDIATRICIAN 45 minutes away from my home. If you don't go to the assigned doctor? YOU GUESSED IT... denied claim as you didn't use your "primary" physician. In short, this insurance is a 100% SCAM intended to fleece people out of money to subsidize other people. It's literally the WORST. Oh and if you are travelling? No coverage. ANYWHERE in the United States. Use an out of network emergency room while you are vacationing? NO COVERAGE. It's the worst. RUN AWAY from this scam.
10 years ago
You know Seattle, WA
Ambetter Coordinated Health is the worst company that I have dealt with in this digital of the new millennium.
1) Billing: You can't pay t:hem. You can pay by credit card and walk away and they will pre-authorize your payment to your bank making the funds unavailable then after 10 business days they don't take the money and then suspend your service for non payment.
-To combat this I sentdthe the receipt in their messaging system telling them to make sure they follow through with the transaction. know one should have to do this.
-They didn't have proof of any transaction that you have made. The customer service agent doesn't have access to verify that you even made or attempted to make a payment. However after I complained in March they now show transactions and the receipt. Even with that the payments that they show that I have made in the last six months are inaccurate or incomplete.
2) Customer Service: they cannot see or access any real information. Don't leave a survey it is not their fault. But they should tell you the truth about their limited access instead of speaking strongly and frustrated with the customer in repeating wait 3-5 business days.
-They can't tell you what happen to a payment that wasn't processed to be resubmitted and they can't see any receipts.
-When they make a mistake in not completing the transaction it takes forever for them to clear up the suspension they have against you from using your insurance. Even though it's their fault in not processing the payments. The agents will state it will take 3-5 business days . When you come back with the statement "but your record shows you have had the payment processed and out of my account for 7 business days" there is no answer and the agent gets angry and repeats 3-5 business days and there is no one in billing that they can transfer you to to get real business taken care of rather than speaking to a frustrated agent that knows their information is inaccurate.
3) The phone system know more about processed payments than the website or the agent does but still unreliable.
4)I have never had such a hard time paying for services in my life. I don't know the other end yet. Being that we have had the services for 5 months and I gave them the last payment 3 business days ago because I am going to another company They still haven't paid for my services from 45 days ago. It's pending because of the payment they did not take out of my bank after the funds were there and pending for 10 business days. We are full paid until the end of the month but we are still suspended.
5) On their side it seems they only want to take payments from checking accounts and not credit cards. I guess because they know there is flaw in their system. But I don't want to give out that info because it's easier to dispute/ trace a transaction with a credit card and it's easier to cancel a card. But to cancel a checking account because of potential fraudulent activity is a greater impact on the consumer. So I don't like to give out my checking account info.
Watch out. I have spent more time trying to pay this company. With all of my other bills it takes 30 minutes total monthly. With this company I have spent hours a month checking to see if they payment is still pending and if they eve took the payment and resubmitting the payment after the preauth falls off and the funds become available again and being suspended most of the time because of this circle
10 years ago
Hena Parveen Bothell, WA
I never write reviews for anything, but I HAVE to for this company. It has to be one of the poorest health care insurance service I have ever had. Their reps are not helpful, and I talked to one who was downright rude! They had a miscommunication with the health exchange and did not cover me for a month (which I am willing to pay the fine for later) but now they are claiming I was covered and I should pay the premium! Even my welcome package says my effective date of coverage but they said they changed my effective date about 2 months after my coverage began! Ridiculous! I will never use this company again! They are unprofessional and won't accept their system error.
10 years ago
Janet C Gatesville, TX
since I got this insurance back in Jan2016 I have nothing but issues!!! First off my doctor is within their network but yet they seemingly make it super hard for them! they say it needs to be filed under eye doctors & then when they do they get told no its medical.....no winning! then they "forget" to credit my payments in a timely manner & threaten to drop me! i paid my bill at the beginning of the month & still nothing but a nasty letter & now they have tripled my month bill!!! i try to get into my account online it doesnt let me sign in & then i call & for 1 question it takes about 45 minutes to get an answers--most times the person doesnt speak english or does so poorly or just plain RUDE.......had o know they were this bad i never would have taken this crappy service!!!
10 years ago
Leah Dugan Chicago, IL
DO NOT EVER PICK THIS INSURER! You will regret it.
Dealing with this company has caused me time, money, frustration, and my son going without coverage for 3 months. I paid for coverage on time, every month, from Jan - May of this year. I kept receiving letters stating that I owed them money from the previous month. I would call, tell them I had paid already, and after 15-30 minutes on the phone with a rep, was told, each time, the situation was getting fixed. I did this three months in a row. In an attempt to fix the situation, I paid the extra money they insisted I owed (which I had already paid) because my son was overdue for a well visit. At the beginning of this month (May) I received a letter stating that my son's coverage was cancelled in FEBRUARY. This was BEFORE all of my phone calls. No one I spoke with at anytime over the phone told us we had been dropped, they simply took our payment and let us believe we were covered. I have since called the Market Place and they have escalated my case and we hope to get it resolved. In the meantime, my son is STILL WITHOUT COVERAGE and I have paid MORE than what I owed for literally nothing. This is the worst customer service experience I have ever had in my life. And I will be filing a complaint with the BBB.
10 years ago
Veronica Miller Spokane, WA
I don't even know where to begin. This company goes beyond negligent, incompetent, and dishonest. This company is intentionally stealing money from taxpayers, clients, and providers. What they do is calculated. I have been paying faithfully every month my premiums over the phone with my debit card, have confirmation numbers, and the whole nine yards. Just found out today that I have not even been covered since January. They intentionally put you in what they call "suspension" for some alledged mispayment. All the while they are taking your money they have no intension of paying the provider. At the same time they are taking your payments, they are collecting huge monthly premiums from the federal government and ripping off tax payers. They know what they are doing. I had one of their reps get honest with me today. He said this happens all the time and that he has chosen to pay the federal fines and have nothing to do with Ambetter or Obama Care. This coming from a guy that works for them. Go figure. When is there going to be a class action suit? Dishonest companies like Ambetter couldn't do a "better" job of sending our nation into bankruptcy than if that was their intention to do so in the first place. Do you think maybe it is? Every complaint posted in these miserable reviews I have experienced. Believe me this goes beyond incompetence. This is intentional.
10 years ago
Annie Lovato Seattle, WA
Ambetter customer service is the worst I have ever experienced. After signing on for a new plan at the start of 2016, I noticed my payments were not being taken out of my account. I called to inquire and was told that my auto pay through my bank was not set up. So, I went through the process for a 2nd time and was assured that it was set up correctly. Stil, no payment was taken out so I called again and was told the same thing and went through the same process, again. Still no payment so I called a third time and was told that the reason no payments were being made was because I had a credit on my account. Unsure of where this credit would come from I inquired about that. They were clueless. So, I took at as fact because they are supposed to know what they are doing. I then call back a couple months later because I am still not getting charged and they tell me that all I owe is $19.03 and they say my autopay through my bank is STILL not set up so I go through that process again. Here it is the end if April and I receive a letter in the mail telling me my account is suspended because of non-payment and at the same time I receive another letter in the mail with an enclosed check of $121.03 telling me I have overpaid and they are paying me back. WHAT!?? So after several oblivious customer service reps later and being asked if I am related to Demi Lovato, which I did not appreciate I FINALLY get a supervisor who then spends another 40 minutes trying to figure this mess out. It gets figured out and then I am hit with the amount of ALL of the months I had tried to pay all at once which was a large chunk of change. I was told to NOT cash the check and that once I paid 4 months worth of payments my account would be back to active. I am LIVID that this is how things went down. I basically begged them to let me pay my monthly bill each month, was given the run around, had my insurance taken away from me and a check mailed to me, then was hit with all four months of payments that I had tried to make in the first place all at once. HORRIBLE COMPANY!!!! If you can get your insurance anywhere else DO IT!!!
10 years ago
Emily Ardolf
It took me 6 months to see a doctor and only after I went to the local news. This is because in Waco no one will take this insurance if you're a new patient. When I switched insurance, my dr office claimed that meant I was a new patient. After multiple calls from the local news, my dr office finally saw me. However, I can't now update my PCP to whom it is and when I search in their system not a single provider comes up in my zip code. However, magically they found me a PCP to assign me. This insurance has been a nightmare to use and I'm looking into private insurance which may cost me a significant amount long-term, but result in better coverage.
10 years ago
Lori Tampa, FL
This company is the worst insurance I have ever had. Online and with a telephone rep it looked like my primary was associated to them. He was not. I found this out AFTER I signed up and paid. When I went to make a vision appointment I found out the majority of options available were dropping the plan that had Ambetter attached to it. I was literally told there wasn't a vision option for me within 300 miles that would be covered with my plan. What? They drafted my account for a monthly payment too early and by 'accident', without my permission. Their customer care reps are clueless. I've paid for this plan for 4 months at nearly $300.00 a month and haven't used it because nobody takes this insurance! I'm dropping it. Such a mistake.
10 years ago
Andy Resende Savannah, GA
I HAD to get health insurance in the end of last year because of the Affordable Care Act. I chose Ambetter because it had a primary doctor that was covered under Ambetter.
I came to find out as soon as I tried to make an appointment with him that he is no longer with Ambetter and Ambetter refuses to take his name out of their site.
Along with this doctor, I learned that there is almost ZERO coverage with Ambetter in the Savannah area... and I am talking about: dentist, allergist, orthopedic, dermatologist, you name it! No one takes this insurance in Savannah!
I am now stuck with this insurance paying for something I can't use... If I cancel it, I will be penalized for not having insurance, but at least my fine will be less than what I have to fork out every month for no use... but that's the avenue I am going for because I contacted the Healthcare Marketplace and they said there's nothing they can do about that either...
10 years ago
Tinh Savannah, GA
None of the Drs. or health facilities accept Ambetter in the Savannah, GA area, yet, when we sign up online at the HealthMarket place, it shows that several family doctors and specialty groups accept it. Of course, when you show up with the Ambetter card, NO ONE accepts it in this city!!!! You will pretty much pay for health coverage that isn't accepted here. Pay for nothing!!!!
Representative at Ambetter was able to pull up one doctor in their system that accepts it, but it turns out, that doctor no longer is here in Savannah! That goes to show how slow their system is. It's not current or updated at all! This wasted too much of my time. It's April now and I still not have any health care I paid for!
10 years ago
Matthew Heller Coral Gables, FL
I have a catastrophic plan with Ambetter. I knew what I was getting into, but paying over $1300 a year just so I can go to a doctor for three health maintenance visits (no labs or prescriptions covered mind you) is too much. I have also found inaccurate information on their web portal (i.e. website says I owe an extra month's premium while agent on the phone guarantees I'm paid up--glad I didn't blindly pay online). All calls made to Ambetter take several minutes to reach an agent, which is the only option since repeatedly entering my Member ID#, SSN, DOB, or zip code in the automated menu are always met with a recorded "Sorry, there is no record for that information." The company is frustrating and a time suck, but tell me something about the US system of health care that isn't.
10 years ago
Sabrina Diz Key Biscayne, FL
i signed up through the Marketplace on 11/2015 and on 02/11 I called to get my info packet and sign up a doctor. I had just gone through a death in the family and was a little late in doing everything, but still on time. The rep I spoke to fabricated a whole story, stated that my policy was cancelled due to non-payment, and when I asked her for more details, she said I hadn't paid the "Initiation Fee" or the "Start up Fee"...I was floored. I called Marketplace and started a new policy with Coventry Health - but Marketplace told me that their Health companies don't have any of those fees. So I called back Ambetter and the new rep told me my policy wasn't cancelled and that those other charges did not exist!!! Now I was in a pickle stuck with two insurance companies. I've been trying to get Ambetter to cancel my policy for 2 months now AND get a refund. They refuse to refund me because they say I had coverage!!! The following are my conversation notes:
FEB 11: AMBETTER REP SAID AMBETTER IS CXLED, GOT NEW INSURANCE CO WITH COVENANT, CALLED AMBETTER WAS TOLD NOT CXLED, ASKED FOR CANCELLATION AND REFUND $126.54
MAR 01: CALLED AMBETTER AND REP SAID SHE WOULD SEND THIS TO THE RIGHT DEPARTMENT, TO CALL BACK IN ONE WEEK
MAR 22: REP SHOWS THAT THE POLICY IS BEING CXLED; DOES NOT SEE A REFUND BEING PROCESSED - 1/1 TO 2/29 HAD COVERAGE; EXPLAINED TO REP I DID NOT HAVE A DOCTOR NOR PAPERWORK - 2 PACKETS WENT OUT IN NOVEMBER AND ANOTHER IN FEBRUARY; NOTATIONS IN SYSTEM - "PROBABLE LIABILITY MUST BE PROVEN IN ORDER TO GET REIMBURSEMENT, CONTACT MARKETPLACE REGARDING COVERAGE". CANCELLATION# FL20166193994950
***DO NOT TRUST THIS COMPANY OR THEIR REPS!!!!
10 years ago
