ambetterhealth.com Reviews 

Ambetter
The worst insurance plz don't get it you will be billed every where you go they give your wrong information all the do is take your money while you pay for your own bill you will be in debt with them like I am

Pay 753 dollars a month and have had nothing but denied claims,I had COVID and doctor gave me a Prescription for plaxlovid and they denied it then a week later they sent me a letter saying they would pay for some of it.you have 48 hours to take it or it's to late.had X-rays done on my back hospital said they take Ambetter insurance and ambetter refused to pay,said out of network.im stuck with 1300 bucks for it.horrible insurance company.and good luck talking to anyone you can understand.

I don't have this insurance but they keep spam calling my phone at least 4 time a week. When I did call back to try and figure out why they are calling I got hung up on twice after the representative said, "I'm done helping these stupid people" second time she said "these people are f@cking dumb." Worst company ever!!!!! and I don't even use them!!!

Do not get this insurance if a lawyer can read these reviews would be great. People are being denied diabetes medication, 40 yr old mammograms, brain MRI, Covid medication THIS INSURANCE IS ONLY GOOD FOR DOCTOR VISITS ANS IF YOU NEED AN ANTIBIOTIC!

Was trying to ask why my insurance always gets denied at drs and it was AI and no help at all. It was terrible. Switching insurance come January

They use customer service from India which every time my husband and I have called in they are almost completely unable to be understood through their very thick accents.
I've mailed in multiple authorized contact forms so that my husband could speak on my behalf when I am at work and yet somehow, they "never received them".
They keep increasing the premiums for their plans while at the same time decreasing what those plans offer showing they would rather just collect money than actually offer a decent product to consumer.

-10/10 Biggest scam ever that only exists because the ACA subsidies made the majority of their plans free to no cost.

This company deserves less than one star. This is theft and I’m extremely pissed! Do yourself a favor and go with ANY other company! The only reason I enrolled with them in the first place was because even though the coverage SUCKS on the front end, it’s great on the back end if you end up in the hospital. I unfortunately do quite a bit. I am a type 1 diabetic, and I have been getting the same medication with them for a year. Nothing has changed. My plan hasn’t changed, my premium hasn’t changed, etc. All of a sudden, the pharmacy is telling me that a pre-authorization is needed for my medication. This is medication that is keeping me alive by the way, it is medically necessary, and now I will be out of medication in 3 days. You might be wondering why I waited so long to get a refill, but again…no pre-auth was ever needed. I have a call in to my doctor but tomorrow is Friday, they say they can take up to 48 hours to get back to you, and I will run out of medication by Sunday. According to the customer service rep…pre-authorizations can take up to 72 hours JUST FOR A DECISION TO BE MADE. We all know how that goes. I’m sure after 72 hours, it will still be denied. The icing on top of the cake was that I called Ambetter to ask why it had changed and nobody could give me an answer. The first girl I talked to kept putting me on hold just to come back and say, “so I see here that that is a non-formulary prescription and so Ambetter won’t cover it. The good news is that after you get a pre-authorization from your doctor we will “. First of all, you can’t guarantee that. Second, that’s not what I asked you! I got angry after about 30 minutes on the line with this girl. I asked to speak to a supervisor. She says “my supervisor is in a meeting right now”. Yeahhhh. Okay. So I said “I don’t care. Get them out of the meeting”. She kept telling me they were in a meeting and couldn’t take my call. I then told her I needed to be transferred to someone else, and she then said “I’m the only one available to take your call”. I lost it at this point and I said “I know you’re not the only person available at that company. You can either transfer me to someone else or I will hang up and call back to reach someone else that way”. She put me back on hold for another 5 minutes or so and then transferred me to someone who claimed to be in the resolution department. I’m not going to go into what all we talked about, but it didn’t resolve anything. She ended up telling me that I could pay for my medications out of pocket and then if my pre-authorization went through and was accepted, I could then apply for a reimbursement from Ambetter. I just laughed at this point and said “does that actually work?” She couldn’t answer me. The part that’s theft is that I asked her about my deductible. I only have $130 left until I reach it, however, that’s only because I paid over $1,000 to a third party medical company for some diabetic supplies. My entire year of paying for my medications at the pharmacy WAS NOT BEING COUNTED TOWARDS MY DEDUCTIBLE. I have proof of that as well. I asked this girl if I could just pay the $130 over the phone and move on. She sarcastically said “that’s not how deductibles work”. To which I said “no you’re right. They’re supposed to be counting all of the prescriptions I’ve been paying for up until now, and yet here we are “. She told me that if I paid out of pocket for a prescription that was over $130, that my deductible would make it only cost $130 max. I then asked about this prescription in question. She treated me like I was a moron which…yes, sorry. Should have been specific apparently. She said “that medication isn’t covered!” I said “yes, I got that part. I meant after this pre-authorization goes through. It’s non-formulary, so even with a pre-authorization, should that be counting towards my deductible once approved?” (We all know health insurance companies have loop holes for everything). All she said was a sarcastic “sure”. Really? Yeah. I’m done. Do better Ambetter. There are people who need medications to survive. I understand not covering all of them but at the very least answer people’s questions. As a business owner myself, I can honestly say, this is not the way to gain customers or their loyalty. You need to hire people with customer service abilities. Also, Ambetter has been cutting people checks left and right due to not paying things the way they should (look it up!) If I have proof that my deductible hasn’t been met yet and I’ve been paying towards it all year, they’re about to be in a world of hurt. I have a call into my lawyer as we speak actually. Just steer clear of this company. There are so many better options for mediocre health insurance.

Ambetter health insurance doesn't deserve a 1 star. The worst insurance ever. They customer service just lie to get you off the phone. They won't let you talk to a supervisor or manager. I have been waiting for a refund check for over 2 months. I moved over 1 year and 6 months never have a problem getting their mail monthly for billing and when they don't want to pay my doctor bill but haven't received my refund check yet. So I called like 8 times and each representative has something different to say but won't let you talk to a supervisor or manager. Well yesterday I received an ambetter letter stating they want pay my doctor bill but today when I call, all of a sudden my address in their system is changed to my old address, the address I changed over 1 year ago but I'm getting their mail at my new address for over 1 year. They are so full of shit and I'm reporting them for keeping my refund check for no reason. I'm calling market place and healthcare commission over ambetter. They are lying and they are never getting money from me again. I suggest anyone else to stay away from them because no one accepts them because they don't pay. I wish I would get another bill from them.

Ladies who get annual mammograms (and the men who support us), if you have the common sense.beliet that all annual mammography screenings should be covered at 100%, do not choose Ambetter. I am a healthy woman with no history of breast cancer. My annual mammogram was a contrast enhanced mammogram due to dense breast tissue, which required an accompanying ultrasound to get a baseline reading for accurate readings for future mammograms because it was my first one, and Ambetter made me pay for it.

I have this documented, including the denial of my insurance claim, of which I was given no notice and learned about from a conversation with my doctor's office months after the fact, and my appeal which was also denied, not to mention the many discussions with a collections agency that the imaging center sicced on me as I navigated through several months of an insurance claim process.

Save yourselves the stress, insomnia and anger caused by having to deal wirh an insurance company's discriminatory practices against women and look elsewhere.

I'm self-employed and paying for Ambetter from the marketplace, which is commercial insurance and supposed to be decent for the co-pay about $400.
Everything about this insurance is bad.

1. ZocDoc, the largest online scheduling system for doctors, doesn't even recognise Ambetter in my state and I can't use the convenient website to schedule any of the appointments. I can't overstate how inconvenient that is.

2. Impossible to find providers - the website doesn't update them frequently, you have to call multiple times to find someone who actual is in network. The number of providers is so tiny you have to wait for weeks to get an appointment.

3. Does't cover anything! Refused to cover my yearly mammograms (prescribed by my doctor based on my personal medical history!) and covers literary ZERO of anything fertility-related. Not a single fertility test is covered. This insurance is a punishment for women, please stay away.

I'm leaving 2 starts because customer service actually was trying to help me and I was able to reach a human being relative easy.

This is the worst insurance company possible. Their own case manager assigned to me on their Wellframe app provided me a dermatologist that accepted Ambetter. I have skin cancer. They have since denied all my past visits saying I chose an out of network provider. I didn't chose Ambetter sent me there. I appealed their decision and they still refuse to pay the doctor. I now have a $1500 bill just dumped on me and now don't have anyone to treat my cancer. I'm getting a lawyer. They now at the end of the year sending me bills for almost every medical appointment I've had this year. They changed their policies in March without telling anyone.

Scam company tried to charge me 600 for a month I didn't even have a cold? Lawsuits up the wazoo to boot. Yikes. Just spent the last 2 days jumping through probably 20 hoops but I am finally free of this god awful company.

Website is the worse, always tech glitches where ypu can't get into your account and always getting locked out, can't even pay the bill or pick my plan for open enrollment. Yall need to fix this seriously. Now it just keeps looping and buffering even after you sign in 🙄

Karen Spencer from Tennessee keeps using my e-mail address to sign up for all sorts of things, including health and insurance. So when I get mails from services she signed up for, I try to unsubscribe. Unfortunately there is no way to e-mail or chat with this service without an account. There's a phone number, but I'm in Europe. That's not convenient. I need you to provide a way to sort out this kind of problem. And I need you to contact her (not via my e-mail address) and tell her to stop using mine. I don't know if I'm signed up here with that address. But you sent this mail today. The first I've seen, and it's addressed to Karen Spencer in Tennessee. BTW, how is it possible she still does this? Must be coming up on two years or more, and my e-mail address is nowhere near her name. And I've had it for many years. Since my first Android phone, or longer.

Ambetter is the worst. High cost with a $16,900 deductible. We are out of state, I called to see if we are are covered for out of state emergency, and after 20 mins on the phone, they can’t answer the question because she is the policy holder, even though I am her spouse and the member in the same policy. All while my wife is suffering. I am driving to pick her up and trying to save another wasted 29 minutes. I can’t wait until January to obtain new insurance coverage.

I could write a book on how terrible the experience I've had with this company, but you don't have all day to read it. The list of "Cons" are a mile long, There are NO "Pros" At all cost STAY AWAY FROM "ambetter"

They charge OVER $1500 a month for their "insurance" to still deny my much needed CT scan and they don't even cover the basic blood work. Even with my Doctor jumping through their hoops, they still find a way to deny. She said every one of her ambetter patients have the same problems. Just ONE of the blood panels they required me to get before getting the CT scan cost $1361.42 ...Ambetter paid $98.87!! I haven't seen the bills for the other 2 but the claims page said one of them was over $4k not looking forward to seeing how much I have to pay. You are better off not having insurance and paying the cash price. When I die from my spleen rupturing, it will be their fault.

This company is the worst... I cannot even tell you how many phone calls I have with these idiots...Since before Feb 1st when my coverage started. Nobody knows what they are doing, outsourced CS, terrible service, they won't pay for labs for the ONE TIME PHYSICAL!! They offer points if you watch videos which you are supposed to use to pay for premiums etc... that doesn't work and they can't explain why. I've called them a hundred times with issues and again I've been to my doc once... This is beyond nuts.

Horrible customer service. Over billed multiple times and tickets are continuously canceled without notifying me. Their coverage is garbage also. Will be cancelling.

It's working for me. And I'm grateful.