ambetterhealth.comReviews of ambetterhealth.com

Low (as low as they ever get) premiums but also they change covered services & in-network providers with no communication. I have now had 4+ instances where I sought healthcare by in-network providers for covered services only to receive bills 6 months later claiming they are out of network and/or not covered. In one instance I literally booked through the Ambetter site because it said "get 24/7 virtual care -- $0!" and am now receiving bills for it. Have had to spend hours sitting on hold and getting the runaround from customer service reps trying to get it fixed.

Terrible health insurance. If you have ANY other option for coverage you should take it. Customer service is the worst I have ever experienced. The agents tell you the wrong answer constantly. They read off a script and cannot go beyond that. They literally tell you "trust me" and after several poor experiences there's no way I can trust them. Hold times are long and then you have an unsatisfactory and very frustrating conversation where you receive no help and waste hours of your time. You get a different answer depending on who you speak to each time. The network is misleading. Many doctors listed as "in network" don't actually take Ambetter. For example they showed hundreds of options under a certain specialty as "in network" - when I called through literally every doctor listed only ONE actually took Ambetter and they were terrible. They are such a waste of money and their poor reviews clearly reflect that. Take the time to read through them they provide a good representation of what you will receive.

This will be my third year with Ambetter sunshine health through healthcare.gov marketplace. Earlier this year in 2025 I was approved for Zep bound and lost almost 50 pounds. I sought the opinion of a plastic surgeon regarding rashes/infections and pain in the areas of my breasts as well as my abdomen. I lost almost 50 pounds and had an apron belly as well as sagging breast. I went from a size D to a size B with a massive amount of under arm boob. My plastic surgeon was able to get a Panniculectomy approved. She has since submitted a prior authorization for mastopexy which is a lift. She believes this is medically necessary to alleviate the pain that I am experiencing as well as the rashes and infections underneath my breast. Ambetter has denied the surgery as well as denied the appeal. It is literally without a legitimate reason to deny. And their opinion, it is not medically necessary, but cosmetic to not be in pain. I cannot exercise so how can I maintain weight loss?

Cathylynn DiFrancesco Signed me up for bronze plan. No representative or HEALTH MARKETPLACE could find it ! What is going on???? How am i going from $25 a month to $456. Fix this !

Avoid at all cost. They will let you and your family die before covering anything. Overpriced, a typical scam of a government enforced system.

Complete scam like all insurance companies. Custom service is deliberately routed to an automated voice that purposefully makes it impossible to get a hold of someone. Coverage also sucks.

They fraudulently charged me near $400 over a health plan I NEVER selected they ASSUMED I would spend $450 a MONTH, without my consent. No email no text to verify. But they charged me in the middle of the night while I was asleep worst service ever I tried calling my father spoke to them, customer service only told LIES!

Besides the directories not being up to date, long times between appointments. Customer Service is awful. Unlawfully charged me for the 2026 policy event, though I canceled and chose another plan before the deadline. They say that they can't take a verbal cancellation because it is through the ACA government plan, which is total BS. I spoke to three agents because, as a former licensed health insurance agent, I knew this was incorrect. Would not accept the printout of my new Blue Cross plan with dates proving I canceled. No resolution and no way to cancel over the phone. "I must go through the government." Update: I contacted a representative at Healthcare.gov on 12/16, and she dialed Ambetter because she said the information they were giving was false, and I was not the only one calling in with this false information from Ambetter. She remained silent while the agent repeated I must contact the government, even though I had purchased Blue Cross HMO for 2026, and it was before the deadline for enrollment (meaning I am not enrolled with Ambetter), and they were NOT authorized to debit a payment. Ambetter repeated that it was up to the government. The Healthcare.gov agent(who had been silent but listening) spoke up and totally read him the riot act and stated he was giving out false information and that Healthcare.gov has nothing to do with my premium and my payment to the insurance company. Therefore, Ambetter unlawfully took from my account. He backtracked and said he would refund my money in 30-35 business days. Could not explain why it would be so long when the payment was still processing in the bank and should be easily reversed (it is a debit card). I called the bank to report fraud and stopped payment. I believe they charged lots of customers on autopay the new, inflated premium, even if they canceled. Then they are slow-rolling the payback. Beware.