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Ambetter Health Insurance Review

275 Customer Comments & Reviews - see all comments
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Ambetter is a health insurance company owned by the Centene Corporation, which is a multi-national healthcare company that provides programs and services to under-insured and uninsured individuals. Ambetter offers customers affordable health care plans in 14 states including Arkansas, Arizona, Georgia, Florida, Indiana, and Nevada, among others.

Ambetter is Centene Corporation’s option for a health insurance marketplace, so it’s intended for individuals who lack health insurance, and possibly don’t qualify for traditional plans.

What’s Included in Ambetter’s Health Insurance Plans?

Ambetter health insurance plans offer prescription coverage, mental and behavioral health services, integrated care management, maternity and newborn care, 24/7 nurse advice line, Ambetter Telehealth, My Health Pays Rewards, and optional vision and dental coverage for adults.

The company has three plan options to choose from: Ambetter Essential Care, Ambetter Balanced Care, and Ambetter Secure Care, which are classified as bronze, silver, and gold, respectively.

The Ambetter Essential Care offers lower monthly premium payments, but higher out-of-pocket expenses, the Ambetter Balanced Care offers the best balance between monthly premium payments and out-of-pocket expenses, and the Ambetter Secure Care has higher monthly premium payments, but limits your out-of-pocket expenses.

Each plan has a different type of coverage and payment, but all of them include essential health benefits such as emergency services, hospitalization. outpatient or ambulatory services, preventive and wellness services, maternity and newborn care, pediatric services, mental health and substance abuse services, and laboratory services, among others.

Final Thoughts

Overall, Ambetter offers flexible healthcare options that fit different budgets and needs, with a few perks like the company’s My Health Pays Rewards, which allows customers to pay for medical expenses with the money they earn through the program, a 24/7 nurse advice line, and Ambetter Telehealth, which provides 24/7 phone or video access to in-network providers for non-emergency health issues. Additionally, Ambetter members can manage and pay for their account online, and the company’s website offers helpful tools like a provider search engine, and educational articles for those who want to learn more about insurance.

Having said that, Ambetter health insurance also has its drawbacks, like the fact that it’s only available in 15 states, you must sign up during the open enrollment period, and that the company may have stricter requirements to qualify than other traditional insurance companies, so customers should keep this in mind before purchasing.


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275 Customer Comments & Reviews

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Christopher M
5/21/2019
This company is a total scam. It is available in Pennsylvania. However, it only covers southeast Pa. Having is insurance is a total rip off. I pay my $200 premium every month. Every time that I go to any doctor, they deny that I'm enrolled. The doctors staff has to call to verify coverage. It takes about 20 to 45 mins. Then when the doctor submits there bill they are denied payment. Ambetter has many different company names and addresses. They tell me that the bill was sent to the wrong place or, It was coded incorrectly. I was sent to get bloodwork done to test for Hodgkin's. They denied payment due to the fact that I did not have Hodgkin's. I was takin to the emergency room with chest... Read More


Kashif S
5/20/2019
Does not cover most of the Lab Test, Simple Service like Chest xray is not fully covered and much more to learn down the road.


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Chad K
5/10/2019
Jan 2018 I call customer services in order to set my PCP due to my continued failure to set a PCP online. The cs rep helps me select my PCP. I go to the doctor. April 2018 I start getting a bill for new patient services from the doctor I saw. I was confused because I paid my copay and thought I had everything set up. According to Ambetter, my PCP was not in-network. I tell them that they are the ones that approved this PCP. After fighting for over a year (now May 2019) with four appeals and grievances and after that bill was sent to collections and docked my credit score 28 points, I have no recourse. No justice. The last I spoke with customer service they were clear that I am on my own... Read More


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Theresa
5/8/2019
About My Ambetter Experience 1. Logging Into the Website On the first screen, I select the “Member” tab. That takes me to a second screen where again I have to select “Member Login” Then I get a third window where I actually get to log in. Though I have literally spent hours trying to select a PCP on both the website and on the phone with two different representatives, I still have no doctor. I use my zip code to search for a PCP. Why is it giving me a 200 mile radius? I don’t want to go 200 miles. Because there is no filter to filter out pediatricians, I have to search through the more than 1,000 names that come up. If I use the “General Practice” filter, I get 6 names,... Read More


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Alison
4/25/2019
This company is in large part a scam targeted towards lower-income Americans who are likely to have less recourse to fight them. At least in Texas, they lie about which providers are "in-network" - many doctors listed on their portal deny accepting Ambetter's health coverage. Customer service is no help and honestly probably isn't funded to be able to help. So you get basically nothing for the premium you pay.


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Judy S
4/25/2019
This is an absolutely ABYSMAL insurance company. Never in my life have I witnessed such slow claims processing. I'm not receiving floods of bills from my providers from JANUARY, stating my insurance company is non-responsive to claims and I must pay. I should have met my yearly max but they are purposefully slow and I am bleeding money. Go with literally ANYONE else. They just want you to die so they can avoid paying.


Hank M
4/11/2019
My wife has an ACA plan with Ambetter. She is enrolled in auto-pay. In early April 2019, the credit card company sent us new cards (just a new expiration date) so I went on their website to update the info. To my surprise, I found out her coverage was suspended because Ambetter didn't deduct the payment in late March even though the credit card was still active. Not only did they suspend her coverage but they never told us. A phone call to them revealed only that the person answering the phone was clueless.


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River
4/8/2019
Today is April 8th, 2019 and I called Ambetter twice and their system was down. I have written six complaint letters to Ambetter concerning their terrible services and none have been answered. I have been denied services and prescriptions after having paid my premiums. I have had to call a total of nine times to establish a primary care physician. Each time I call the representative it is always an incompetent human being who is unable to remember the reason I called or that I had already established a primary care provider on a previous call weeks ago. A supervisor whom I escalated the issues to was rude and nasty to me. After having paid for my insurance, my provider ran my insurance... Read More


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B
4/3/2019
Terrible customer support service. I have had this insurance for 4 months, and I have never once been able to login successfully to my member account on their website. I called multiple times for help, and each time I got the run around and horrible communication. They would say they are creating a "ticket" and that they would follow up with me via a phone call when my problem was resolved, but they never called back, and the issue after 4 months has still never been resolved. I still cannot login. So, I haven't been able to pick a Primary Care Doctor or see anything related my coverage online. The customer service representatives have been rude, inconsiderate, unsympathetic,... Read More


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MD
3/9/2019
Ambetter is the WORST ever!!!! They won't cover important tests, surgeries or meds. They employ uninformed stupid people who barely speak English, for customer service. They lie, give wrong information and hang up on you. They charge huge premiums with huge deductibles for services and meds, and will not credit your deductible for services you had to pay out of pocket for.



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