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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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jimbaker57
10/13/2023
They are terrible Customer service is the worst and they deny everything.


Maria S
10/5/2023
Ambetter/Silver Summit Health is THE worst insurance company I have ever had for coverage and have had to work with. Their customer service representatives are not informed, give boys responses, read of scripts ad nauseam, give contradictory (and typically incorrect) information, and don't call back if the signal to Manila is dropped, even though they ask you for your # in case of disconnection. Also, they have unqualified physicians assessing whether procedures should be approved or not. As my pain doctor said in disbelief and frustration, "What is a pediatrician doing assessing whether an MRI is needed for someone's cervical/back condition?!" The company also requires... Read More


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Paul H
9/20/2023
Ambetter has been the worst insurance in my 30+ years dealing with health insurance companies. There are very few doctors/facilities in my area that are in network and any urgent care or emergency care facilities that are in network are miles from where I live in Seattle. They seem to find a way to charge me for a good portion of my annual preventative care visit even though it states in their plan that "preventative care/screening/immunization" is "No charge." And, calling their 1-877 # to get answers is painful....they ask redundant questions, hold times are extremely long, and the person on the other end always seems clueless and isn't helpful. I went the cheaper route with... Read More


sharonroseciccone
9/7/2023
Be aware that when you sign up for Ambetter's autopay, they will inconsistently deduct your bank account. You will think that everything is being handled because you made the responsible choice, until you are refused service in your doctor's office being told that your insurance has been cancelled. It turns out that somehow it is my responsibility that Ambetter's autopay is not working. Ambetter did not make me aware that there was an issue, nor did they take responsiblity or fix the autopay issue. This happened to me 3 times! The stress and hassle is not worth the savings of a few extra bucks.


ms_dreamhunter
8/31/2023
These people have misapplied my very first payment from the beginning of service. I paid them for August 1 coverage to begin, on 07-31-23. They applied that payment as if I had had their service in July, not August (which I did not). I have called multiple times, been refused a supervisor every time, and the payment is STILL not applied. They are trying to charge me $971.04!!!! That is for two months of service, from my very first month with this company. I don't even know who else to reach out to at this point. In addition, they denied me my maintenance medicines. I have to have a special amount that is has already been appealed by my doctor, and they were well aware of when I... Read More


Linda W
8/22/2023
This insurance is not worth your money. They refuse to pay for any services you need done such as MRI's, deny claims, and the nearest Dentist is 50 miles away! Please do not use this insurance company. Read the reviews! This is a bad insurance company. Please don't waste your time and money with this company. It may look good online; however, they do not provide the coverage, you need you will be denied for medically necessary tests and procedures. I would give a minus score if possible.! These bad reviews are from others who have received the same bad treatment I experienced.


carolshepherd87
8/18/2023
If you are considering Ambetter, please read this. I've been on the phone for hours each day with Ambetter for almost a month since my coverage began Aug 1, 2023 just trying to get a PCP. That's all...I just need a PCP. That should be the easiest thing ever with health insurance, right? First Ambetter told me that even though my policy says "virtual" for certain visits, that I could switch to an inperson doctor, and they assured me in that phone call (on or near Aug 1) that they had done that for me. Then the next day I called Ambetter to confirm the doctor that the Ambetter rep from the previous day had assured me that I had been switched to was now my listed PCP, but this rep told me... Read More


nicolesnutrition
7/18/2023
No recommended. Very few providers actually available to see you. Even if it says a provider takes your insurance expect to be turned down. In addition, they contract with Medicaid so often times you will be turned away and not even allowed to do a cash pay payment at a doctors office. Overall, very very difficult to be seen by any in network provider and just holding this insurance may block your access to doctors who can help you.


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Chris S
7/5/2023
There is a class action suit for fraud violations of the RICO act for organized crime mail fraud and wire fraud is the state of Il.. When trying to otain a PCP from this company in Houston TX I took a List of 27 doctors and statrted calling ZERO of them Took this insurance.. lies opon lies opon lies.. They refused to pay for a preventive lung cancer screen. one that is a garrenteed coverage for any plan on healthcare .gov took 11 hours of my time to get them to pay fro this mandatory covered Item of the American healthcare act... These people are crooks.


jeanineives
6/21/2023
I looked into Ambetter about a year ago for affordable health insurance. Got in contact with them. They told me "too good to be true" statements. No co-pay, no deductible, no payments whatsoever, FREE HEALTH CARE. I was very suspicious, as they have sent me numerous forms over the last year. I NEVER signed up with them at all. Now? I got an invoice of 0, but I got an invoice! This includes a member ID number, invoice number, invoice date, plan name which are a bunch of letters and numbers, coverage period , everything you see on an invoice, but stated it was on the top, with no bill!! I will NOT sign anything!



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