ambetterhealth.comReviews of ambetterhealth.com

Was trying to ask why my insurance always gets denied at drs and it was AI and no help at all. It was terrible. Switching insurance come January

They use customer service from India which every time my husband and I have called in they are almost completely unable to be understood through their very thick accents. I've mailed in multiple authorized contact forms so that my husband could speak on my behalf when I am at work and yet somehow, they "never received them". They keep increasing the premiums for their plans while at the same time decreasing what those plans offer showing they would rather just collect money than actually offer a decent product to consumer. -10/10 Biggest scam ever that only exists because the ACA subsidies made the majority of their plans free to no cost.

This company deserves less than one star. This is theft and I’m extremely pissed! Do yourself a favor and go with ANY other company! The only reason I enrolled with them in the first place was because even though the coverage SUCKS on the front end, it’s great on the back end if you end up in the hospital. I unfortunately do quite a bit. I am a type 1 diabetic, and I have been getting the same medication with them for a year. Nothing has changed. My plan hasn’t changed, my premium hasn’t changed, etc. All of a sudden, the pharmacy is telling me that a pre-authorization is needed for my medication. This is medication that is keeping me alive by the way, it is medically necessary, and now I will be out of medication in 3 days. You might be wondering why I waited so long to get a refill, but again…no pre-auth was ever needed. I have a call in to my doctor but tomorrow is Friday, they say they can take up to 48 hours to get back to you, and I will run out of medication by Sunday. According to the customer service rep…pre-authorizations can take up to 72 hours JUST FOR A DECISION TO BE MADE. We all know how that goes. I’m sure after 72 hours, it will still be denied. The icing on top of the cake was that I called Ambetter to ask why it had changed and nobody could give me an answer. The first girl I talked to kept putting me on hold just to come back and say, “so I see here that that is a non-formulary prescription and so Ambetter won’t cover it. The good news is that after you get a pre-authorization from your doctor we will “. First of all, you can’t guarantee that. Second, that’s not what I asked you! I got angry after about 30 minutes on the line with this girl. I asked to speak to a supervisor. She says “my supervisor is in a meeting right now”. Yeahhhh. Okay. So I said “I don’t care. Get them out of the meeting”. She kept telling me they were in a meeting and couldn’t take my call. I then told her I needed to be transferred to someone else, and she then said “I’m the only one available to take your call”. I lost it at this point and I said “I know you’re not the only person available at that company. You can either transfer me to someone else or I will hang up and call back to reach someone else that way”. She put me back on hold for another 5 minutes or so and then transferred me to someone who claimed to be in the resolution department. I’m not going to go into what all we talked about, but it didn’t resolve anything. She ended up telling me that I could pay for my medications out of pocket and then if my pre-authorization went through and was accepted, I could then apply for a reimbursement from Ambetter. I just laughed at this point and said “does that actually work?” She couldn’t answer me. The part that’s theft is that I asked her about my deductible. I only have $130 left until I reach it, however, that’s only because I paid over $1,000 to a third party medical company for some diabetic supplies. My entire year of paying for my medications at the pharmacy WAS NOT BEING COUNTED TOWARDS MY DEDUCTIBLE. I have proof of that as well. I asked this girl if I could just pay the $130 over the phone and move on. She sarcastically said “that’s not how deductibles work”. To which I said “no you’re right. They’re supposed to be counting all of the prescriptions I’ve been paying for up until now, and yet here we are “. She told me that if I paid out of pocket for a prescription that was over $130, that my deductible would make it only cost $130 max. I then asked about this prescription in question. She treated me like I was a moron which…yes, sorry. Should have been specific apparently. She said “that medication isn’t covered!” I said “yes, I got that part. I meant after this pre-authorization goes through. It’s non-formulary, so even with a pre-authorization, should that be counting towards my deductible once approved?” (We all know health insurance companies have loop holes for everything). All she said was a sarcastic “sure”. Really? Yeah. I’m done. Do better Ambetter. There are people who need medications to survive. I understand not covering all of them but at the very least answer people’s questions. As a business owner myself, I can honestly say, this is not the way to gain customers or their loyalty. You need to hire people with customer service abilities. Also, Ambetter has been cutting people checks left and right due to not paying things the way they should (look it up!) If I have proof that my deductible hasn’t been met yet and I’ve been paying towards it all year, they’re about to be in a world of hurt. I have a call into my lawyer as we speak actually. Just steer clear of this company. There are so many better options for mediocre health insurance.

Ambetter health insurance doesn't deserve a 1 star. The worst insurance ever. They customer service just lie to get you off the phone. They won't let you talk to a supervisor or manager. I have been waiting for a refund check for over 2 months. I moved over 1 year and 6 months never have a problem getting their mail monthly for billing and when they don't want to pay my doctor bill but haven't received my refund check yet. So I called like 8 times and each representative has something different to say but won't let you talk to a supervisor or manager. Well yesterday I received an ambetter letter stating they want pay my doctor bill but today when I call, all of a sudden my address in their system is changed to my old address, the address I changed over 1 year ago but I'm getting their mail at my new address for over 1 year. They are so full of shit and I'm reporting them for keeping my refund check for no reason. I'm calling market place and healthcare commission over ambetter. They are lying and they are never getting money from me again. I suggest anyone else to stay away from them because no one accepts them because they don't pay. I wish I would get another bill from them.

Ladies who get annual mammograms (and the men who support us), if you have the common sense.beliet that all annual mammography screenings should be covered at 100%, do not choose Ambetter. I am a healthy woman with no history of breast cancer. My annual mammogram was a contrast enhanced mammogram due to dense breast tissue, which required an accompanying ultrasound to get a baseline reading for accurate readings for future mammograms because it was my first one, and Ambetter made me pay for it. I have this documented, including the denial of my insurance claim, of which I was given no notice and learned about from a conversation with my doctor's office months after the fact, and my appeal which was also denied, not to mention the many discussions with a collections agency that the imaging center sicced on me as I navigated through several months of an insurance claim process. Save yourselves the stress, insomnia and anger caused by having to deal wirh an insurance company's discriminatory practices against women and look elsewhere.

I'm self-employed and paying for Ambetter from the marketplace, which is commercial insurance and supposed to be decent for the co-pay about $400. Everything about this insurance is bad. 1. ZocDoc, the largest online scheduling system for doctors, doesn't even recognise Ambetter in my state and I can't use the convenient website to schedule any of the appointments. I can't overstate how inconvenient that is. 2. Impossible to find providers - the website doesn't update them frequently, you have to call multiple times to find someone who actual is in network. The number of providers is so tiny you have to wait for weeks to get an appointment. 3. Does't cover anything! Refused to cover my yearly mammograms (prescribed by my doctor based on my personal medical history!) and covers literary ZERO of anything fertility-related. Not a single fertility test is covered. This insurance is a punishment for women, please stay away. I'm leaving 2 starts because customer service actually was trying to help me and I was able to reach a human being relative easy.

This is the worst insurance company possible. Their own case manager assigned to me on their Wellframe app provided me a dermatologist that accepted Ambetter. I have skin cancer. They have since denied all my past visits saying I chose an out of network provider. I didn't chose Ambetter sent me there. I appealed their decision and they still refuse to pay the doctor. I now have a $1500 bill just dumped on me and now don't have anyone to treat my cancer. I'm getting a lawyer. They now at the end of the year sending me bills for almost every medical appointment I've had this year. They changed their policies in March without telling anyone.

Scam company tried to charge me 600 for a month I didn't even have a cold? Lawsuits up the wazoo to boot. Yikes. Just spent the last 2 days jumping through probably 20 hoops but I am finally free of this god awful company.