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Ambetter Health Insurance Review

282 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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282 Customer Comments & Reviews

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taigarz136
11/21/2019
Ambetter is a terrible health insurance company if you live in Tx. Owned by Centene, they hardly pay for any medical basic bills. They are like vultures scamming the government and the person that pays part of there health insurance premium. They also threaten people, that they will not offer you any health insurance, if you do not sign up by November before the new year starts. Horrible !!!!


Jeff R
11/14/2019
Ambetter's "My Health Pays Rewards" is ridiculous. Just found out it can be used only at Walmart or Sam's Club (until end of 2019). I was just informed by an Ambetter Rep that beginning January, 2020, the My Rewards Visa Card will only be accepted at Sam's Club. That's just not right! We need better choices than just Sam's Club. This just stinks. I have $100.00 on my Rewards card, and hubby has $75.00. Ambetter is becoming Amworse!!!


Yelena A
10/30/2019
AmBetter is a terrible company , who will deny any claim , even something like ECG in cardiologist office. Not medically necessary!!!! it is not like some expensive invasive procedure, it is simple standart care testing !!! something needs to be done about it


mayadams1979
10/16/2019
My husband has been trying to get a ct for a torn rotor cuff for almsot 3 months and they deny it at every turn. He has been in sever pain this whole time. Ambetter doesn't care about its patients at all. We will be switching asap.


wordsmithrus
10/9/2019
Most hellish experience of my life using Ambetter. The Arizona Licensing Board needs to shut them down. They will do whatever it takes NOT to pay your bills. After paying nearly1K monthly premiums, they refused to pay my hospital bills despite authorizing the stay. It's been months and months of nightmares trying to get bills paid in the midst of trying to recover from surgery. They have contributed to making my illness worse for sure. From the terrible customer service and non working computers and crashing web site to the people in the grievance department who outright lied to me. You could waste hours on the phone and get nothing accomplished. Shame on all of you!


A
angiemarshall42270
10/3/2019
I would be lost w/o Ambetter! You all rock. I've never been denied or get doctor, or hospital bills. Great coverage great premiums.


cyberbshopping
9/17/2019
98% of health insurance companies don't deserve more than 3 stars, so I'm giving Ambetter 2. They seem so inefficient and awkward to work with, it's like they're run by the federal government. I was billed by a provider (lab) for a biopsy, and the explanation of benefits was coded "out of network". So I paid the $133 and appealed with Ambetter during their "balance billing" campaign, and received a letter several months later confirming that they were indeed "in network" and were "contractually prohibited from balance billing you". They didn't balance bill me you morons! They billed me for the entire amount because you told them they were out of network when they submitted the claim,... Read More


D
DJS
9/16/2019
This company is a joke. After denying the original claim, for emergency services in the ER, the provider filed a claim dispute. Took Ambetter 10 months to review the claim dispute, which they denied again. The timeframe to resubmit a new claim has passed. Now I’m stuck with bill.


Michelle H
9/9/2019
After a recent 48 hour stay in the Emergency Room and PVU floor at IU Health Methodist Hospital in Indianapolis, Indiana I received two letters that my coverage would be denied as "not medically necessary." The Medical Director who denied my coverage was Dr. Daniel Hayford, a Pediatrician. He does not have the medical knowledge to make that decision. I have a congenital heart defect and was admitted by a seasoned On-Call Cardiologist and my personal Cardiologist. If Dr. Daniel Hayford and Ambetter read the paperwork submitted by the Hospital they would be aware of my heart defect. As their denial letter states "there is no evidence of heart failure." Please rethink having Dr.... Read More


R
Rselvidge
9/4/2019
Worst, look around the internet for reviews. I bought this insurance off the marketplace, they deny every claim and force you to fight them.



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