ambetterhealth.com Reviews 

Terrible customer service!!! They don’t do what they say they are going to do causing multiple phone calls for easy issues. The provider list is not updated. The website will not allow you to do what they request you do on line. Customer service does not speak in a manner in which one can understand them. Customer service never seems to have the answers needed and if you ask to speak to a supervisor they punish you by putting you on hold for extremely long periods of time.

This is the worst insurance I have ever seen in my life! Everyone has said oh it's a great company. My ass it is! They keep lying and denied to pay for my son's meds with a Prior Authorization saying the docs office didn't send everything over when they did! I took the fight to the Florida Office of Insurance Regulation and let them have a field day with them. I iam not the one to play with when it comes to my son and his meds at all! You get one person telling you this and another person telling you that. Man screw this.....I am going back to Florida Blue for next year!

This is the worst insurance company I have ever dealt with in my 65 years of life. Poor Customer Service, long wait times, difficulty getting problems resolved, and representatives who are unhelpful or lack the authority to address issues. Supervisors who hang up on you and people at the administration office who just don't give a darn about you.
Chyenne Gilson left me unattended while she supposedly was trying to help me for over 6 weeks in some of the worst pain I've ever dealt with in my entire life. Now tell me that's not cruel and unusual punishment. Apparently, they have a lot of complaints filed on them at the Better Business Bureau of which mine will be next. They think because I'm a 60 year old woman I'm just going to sit back and be quiet and not do anything this is the worst insurance company ever my advice to you is stay clear of them.

This is honestly the worst insurance I've had in all my years. It's embarrassing, honestly. The customer service is dismal. It is impossible to get any real help on the line. They only have overseas call center employees who read from a script. I have tried to simply update my address several times. Even this task has proven impossible.

Surprised I cant give zero star’s . My neck is in really and shape . My dr sent me for an MRI that Ambetter denied and ordered physical therapy . Well , it made it 100 times worse . Seems like this is a pattern for them.

0 stars SCAM INSURANCE

Bullshit, rude customer service representatives, joke insurance , rude and unhelpful doesn't cover ANYTHING. Very insensitive & disrespectful people too such a SCAM

This insurance is an absolute joke. My bf has a scheduled surgery in two weeks and without any notice they are demanding $8,450 or else his surgery gets cancelled. What kind of joke is this? What’s the point of even having health insurance? To expect anyone to just come up with that money, especially on such short notice, is not only inconsiderate but unethical. Penalizing people for needing care and being greedy is so sad. Will NEVER use Ambetter and he won’t be using this pathetic insurance anymore.

This company is God forsaken. Customer service representative speak broken English. I am going to leave this company and just pay the IRS whatever I owe them at the end of the year. What an awful situation to wind up with them. I wish everybody luck.

My primary care doctor was changed without my knowledge. I was told by a customer service representative I had to keep whatever doctor the computer chose for me. I pay premium insurance each month and have seen the same doctor every year or whenever I need to. Hire more competent and knowledgeable Service Reps.

They have cheaper premiums because they don’t pay for nothing and they don’t approve any type of imaging if you get injured. My shoulder is so bad and I have needed an MRI for months, did physical therapy and I am even worse now. Still no approval for my MRI. It doesn’t seem smart or appropriate to order physical therapy on a shoulder that you’re not even sure what is wrong with it.

More like Scambetter. Horrible insurance company denies everything makes you go through hoops to just cover common medications with the prior authorization song and dance, my dr says they are the worst to deal with on the clinical side as well. Very poor customer service if you can even understand them correctly. Please save yourself trouble of dealing with Scambetter.

Holy crap, I am spending 660 a month to be told where to go and who to see.
On top of that, just got back from the Emergency Room and the ER Dr sent in prescriptions for me. Can I fill them through my insurance? NO - I need prior authorization - ARE YOU FKN KIDDING ME?? PRIOR WHAT??
I was just there people, and a insurance company is dictating my health, rather than the Dr I just saw. Sorry y'all, (OR ME, RATHER) my ER Dr has better things to do then to send ridiculous paperwork. So I'll just pay out of pocket... AGAIN...

THIS INSURANCE IS A JOKE AND A SCAM!!!

Just spent 2 hours trying to get ready for a doctors appointment tomorrow and yet again their site is down and not working. It’s always the case. The worst part is, there’s not even an indication on the site that they’re doing work. It just doesn’t work.
I had to call in And they confirmed that their site was having issues and they were working on it. the problem with calling in is you never have proof of what’s discussed.
It’s completely unacceptable to not have these things for health insurance company. To not even be able to access anything and the site is inaccurate anyway.
my deductible nearly doubled this year too. I don’t have any major health issues and most of my appointments are for preventative . In addition, they denied part of coverage that should’ve been completely covered. Then you have to go through a ridiculously long process to try and argue that it should be and prove it.

Ambetter has been a nightmare. They previously approved my autistic son's occupational and physical therapy—services that were clearly medically necessary, well-documented by his licensed therapist, and making a real difference in his progress. Then out of nowhere, they denied the renewal, claiming the therapies could be done at home by a non-licensed individual.

My son is 13 years old and cannot walk independently. He can't run, jump, or do any of the physical things other kids his age can do. How exactly is a working single mother supposed to replicate the specialized interventions and equipment used by trained professionals? It's insulting, unrealistic, and potentially harmful.

Even worse, when we appealed the decision, they denied that too—ignoring clear medical documentation. And now they’re claiming they never received the appeal, even though it was faxed weeks ago. This isn’t just poor service—it’s actively putting children at risk by cutting off access to therapies they desperately need.

Ambetter’s policies are clearly driven by cost-cutting, not care. They hide behind cookie-cutter guidelines and ignore the real, human consequences. If you have a child with special needs, I urge you to think twice before trusting them with your care. Disgusted and heartbroken by how we've been treated.

Absolutely the Worst Insurance Experience I’ve Ever Had

Ambetter is by far the worst insurance company I’ve ever dealt with. Their service is abysmal, and trying to reach them is a complete nightmare. They inexplicably terminated my coverage, despite everything being in order with the Marketplace, where I originally purchased the plan.

To make matters worse, their plans are wildly overpriced. I was paying $1,000 a month—just for my dad, who has no medical conditions or current diagnoses. That’s an outrageous premium for a single, healthy individual.

As a physician, I’m in and out of surgeries all day, with about an hour between cases. I used that time to call Ambetter—five separate times—and every single call was a disaster. I waited on hold for 45 minutes each time, only to have to re-verify that I was calling on behalf of my father (the member), even though I was already confirmed as the authorized representative earlier that same day. Every call started from scratch. No one ever had a record of the previous calls—no notes, no continuity—just a complete waste of time over and over again.

They charged me for an extra month and refused to refund me, even though I paid for three months waiting for the first PCP appointment. Then they abruptly canceled the policy two days before the appointment and kept my money.

When I finally had time to sit for over two hours on the phone, I reached the escalation team—only for them to ask if I had contacted the Marketplace. I told them yes, repeatedly. I even sent them a letter from the Marketplace showing everything was fine. Before I could finish explaining, they transferred me back to the Marketplace and dropped the call. That was the final straw.

I would never recommend this insurance to anyone—not even to my worst enemy. I will never use Ambetter again. Save yourself the time, stress, and money. This company is overpriced, incompetent, and completely disrespectful of people’s time and lives.

I am paying for the Focus VALUE Silver + Vision + Adult Dental plan. I chose this because it's the only one I could afford (including a $390 a month tax credit) and because it says that it covers dental. The catch is that this insurance plan does not cover even 1 dental location in all of Fort Worth. So I'm stuck here paying way too much without any way of getting my money back and my teeth are still rotting away.

Do not EVER use this insurance, it is a scam.
Buckle in.
I had this insurance with my husband(at the time) for a little over a year. When all of the sudden I got a letter in the mail of a cancellation notice. I went online and sure enough my account was cancelled. The issue was that it said I owed them over $2,000 and that my premium went from around $35 to $650 something. I called and the person I spoke to told me he had to use an OUTSIDE TOOL to identify what the issue was.
He told me my tax credit was removed from my account bringing my premium up to the original price for the insurance. I told him I never changed that myself and my husband didn't even know the information to get into the account so who did it? and he couldn't tell me...
I never got an notifaction that my payment didn't go through or that I missed any until the cancllation letter came in the mail. They apologized and offered to set up my account with them AGAIN because that is the only way they'd be able to access my information to forgive those months that were not paid. I didn't want to but I did it. They told me that since this wasn't my fault, they would forgive the payments.
Tax season came around(for 2023) and I filed with my 1095-A form and because of that hiccup, I owed over $1,900 for my taxes. I called them to see why that is and they claimed it was because I filed married separate instead of joint with my spouse(we were separated and not talking at this point). However, I don't recall ever recieving notice or even being informed that this would happen and that I would have to file a specific way in order to have those forgiven.
Even WORSE, I went to file my taxes this year and they were declined because I didn't fill in my 1095-A form, however, I never received it. When I called to get it, they claimed that I didn't get it because they listed my EX HUSBAND as primary. Although I created the account, I made decisions on the account AND every payment was made with a card in my name. Did they just assume the husband was in charge of the account? This is ridiculous because the reason I had to pay the totality of what was due was BECAUSE I was primary. My ex husband paid nothing because of this incident.
Anyway, I went to file with my form and aparently they decided to get every single cent they wanted and charged me the regular amount for jan, feb, and march. So this year I now oww $833 because of something that occurred on THEIR end.
Do not trust this insrance and make sure to do HEAVY research before you make your decision.

Im really shocked to see the low rating. I have the silver plan. After 12 years a die hard BCBS customer, I was done with them. If anyone thinks Ambetter is tough, just try BCBS. Initially transferring 3 years ago, there were a few teething problems that upset me, and were at odds with what was on their website. However, they provided me with a dedicated representative and made special provisions for me. Yes I've had issues with them, but less than with others.

Also, I've been able to find resolutions and resolve my concerns with ease. They provide telehealth which has been great, they have dedicated nurses and professionals to assist you with most of your needs. I pay far far less, out of pocket. Prior authorization so far have been excellent. Try getting help indicated for weight loss with a BCBS etc. They denied every medical procedure, often only getting approved while im at a medical facility, the stress caused was awful. If you've come here to leave a bad review because you've had enough. I'm telling you to try calling them again. Im only getting the same numbers as you. If you're picking a plan that's basic, because you don't want to psy a premium, knowing it will not cover your complex medical needs, then that's on you.

I picked a plan suited to my needs, I have multiple overlapping autoimmune diseases, I scrutinized the plans, searched for in network doctors in my area, entered all my medicines to see if they'd cover it. I researched the plans and opted for what would cover my needs. If you picked a plan because there was no additional premium. That's on you! Your choosing a Health Insurance, everyond should research a plan to ensure it will meet your medical needs. I love Ambetter. My experience is positive.

First off you might as well NOT have insurance dealing with this company! On top of that the last two times, I have received mail with my address and SOMEONE ELSES ACCOUNT INFORMATION! I will be reporting this to FTC(Federal Trade Commission).

Bought the bronze plan through the Georgia access portal. Plan says Ambetter will pay 100% of costs after deductible. Ah but the catch is they have to approve. My hip has gone totally bad and I’m crippled and I can no longer walk without a cane, I have to use the electric cart in any store and I can’t work and I’m in constant pain. Orthopedic specialist says I absolutely need a hip replacement to walk again and be pain free. Ambetter denied my treatment for no reason and denied my appeal again. I’ve been paying them $1000 a month for 3 years and have never needed anything till now. What a total piece of s*** company. Do not expect anything from this insurer. They have one of the highest rates of denial at 19% of all surgical procedures regardless of your need. They do not care about you and they don’t have to cover anything they don’t want to. Their rate of reversal on appeal is half a percent. That’s one out of every 200 cases no matter how much pain you’re in. I feel so stupid that I thought that if I needed them they would be there. Pay attention to the 3 star rating they have. If you were buying something off Amazon would you buy the 3 star rated items, NO you wouldn’t. Next year if Trump hasn’t screwed up my insurance I’m going to get the 5 star rated company plan that I didn’t like because you have to go to their facility instead of going to the doctor of your choice. Turns out now that I’ve looked these things up, that other company plan has only a 6% denial rate which is way lower than Ambetter. Too bad I can’t post a review where it would count on the Georgia access portal where people would see it. Guess I’ll be riding the cripple cart till next year. Thanks for nothing Ambetter