ambetterhealth.comReviews of ambetterhealth.com

Biggest fraud and they don’t have answer and they just hung up the call and be ready to wait 1 hour on call and then those idiots will just tell you some inappropriate story which doesn’t match your insurance details . Up on asking details they get mad and hung up the call .

Can not understand customer service speaking. Not much covered for the high deductible

Held up reception of meds I had been on, previously under prior insurances. Errors with data entry caused further hold-ups. Still waiting for approval of immunosuppressants, that were prescribed in January (it's late March). "Have you missed a dose," they ask. "Do you need to speak with a pharmacist?" Don't buy from this terrible, inefficient, error-ridden, coverage-dodging, worse and worse the more I have to call them company. I'm just living on prednisone over here, until someone can do their job, thanks to bureaucratic idiocy.

it is not accepted at any halfway decent place, I got it just to cover for hospitalizations, guess what it’s not accepted at the hospital I went to. Even f it was covered on my bronze plan ambetter only covers 40% after 17000 deductible. I told the hospital I do not have coverage and need financial assistance they covered 70% cost of my brain surgery. So spending 8000$ later I got absolutely nothing form this insurance… I tried to get meds CVS does not accept them, and so I got transferred them to walgreens, walgreens said if you use your insurance charge is 100$ more compared to using Goodrx 😂.

I'm waiting on a third approval on recommendation for MRI that I'm sure they will decline again. This company wants it's customers to die before they will pay for needed healthcare.

They denied a medication so we filed an appeal. Called several times to be told they conveniently did not receive it. I requested to speak to a supervisor several times and was denied. Called multiple times until I finally reached someone who found the appeal and noted they had two more days to process. Very frustrating to spend so much time to get an update. Very poor service.

Absolutely the worst insurance ive ever had in my life if i can leave 0 stars i would

This insurance is very very difficult to use. So difficult, that I'd say I'm not really insured and that Ambetter's claim that I am, is fraudulent. The network is very narrow, giving me limited doctors within a reasonable distance. Yet, Ambetter does not trust the doctors they chose to work with. So, getting medical issues looked at is very difficult, requiring pre-authorizations that, so far for me, have been rejected. The doctors and their offices don't seem to know how to work the system, so I am stuck just living with my injuries. It takes a long time to get anything done. I have to contact one of the few primary care doctors near me, wait for an appointment, have the doctors request tests, have those rejected, then, then...Ambetter kicked my primary care doctor out of the network! So now I have to start all over! The doctor's office said that Ambetter came out of the blue and kicked them out of the network. This disrupts my care and forces me to start the medical waiting game, diagnosis game, and fighting with the insurance company game, all over again. I called Ambetter to ask if they could give me any information as to why my PCP who I already saw is not in network anymore, and they couldn't tell me anything. The customer service representatives have no clue. I've also called their customer service representatives as to all my authorization denials, and again, they can't tell me anything. It turns out, that Ambetter doesn't even process the authorizations. They farm that out to a company called Evolent Speciality Services. I called them, and they couldn't give me any specifics, other than saying I can go through a laborious effort of trying to prove my medical issues are real and mailing all this in by snail mail. I asked them if it was worth the many hours it would take me to try to gather all these documents and imagings, and they couldn't tell me anything about my chances, or even the best way of appealing. They had no advice or information other than to mail in an appeal. I asked them a direct question for advice, and one representative's response was something like, 'uh huh, yeah'. That response makes no sense to question, showing she was not even listening. A previous Evolent representative appeared to have hung up on me, although we could have been disconnected for technical reasons. Over the last decade, I've been to doctors multiple times for my knee and bicep. I've had two rounds of physical therapy for the bicep, and even had surgery on it! The surgery doesn't seem to have worked. I haven't gone back to the original surgeon because I'm on different insurance now. The knee has been x-rayed and I've done at home physical therapy based on what a doctor gave me to do. These are real medical injuries that should be looked into and are covered by insurance if the insurance company believed their own doctors in their narrow networks that say the only way to know what's going on is an MRI. For the bicep, pre-surgery, I did about 2 months of physical therapy before that insurance company at the time finally let me get an MRI. The MRI showed that physical therapy was never going to work because the bicep was too far torn. So, I spent a lot of money, hours, gas, wear and tear on my car, and time out of work, doing physical therapy, when an MRI could have shown that was a waste of time. That was under a previous insurance company, that was also bad, but not as bad as Ambetter.