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Ambetter Health Insurance Review

266 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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266 Customer Comments & Reviews

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pamelamhowell
5/7/2024
This is my first and last year with Ambetter. They have denied every procedure requested by my Dr. Eventually, they approve them. If you are not careful and read the EOB, they will deny payment on these preapproved procedures. I think they are fraudsters.


Jak C
4/9/2024
The worst insurance company ever. The customer service reps have no idea what they are talking about and leave you completely stressed out.


Kimberly S
3/22/2024
Unbelievably horrible. I have a torn meniscus, varified by an MRI, and they continue to refuse to cover this even after 3 appeals. I am now having to pay out of pocket to have my knee fixed in order to continue to work and go about daily life. How can this even be allowed to exist? its inhumane.


lilsantiago2011
3/15/2024
Worst insurance ever! Employees don't communicate with each other so no one at Ambetter can help. If I could give them a zero, I would. I have filed a complaint with the BBB and will file a complaint with the health insurance commissioner as well.


ccpryor25
3/4/2024
THE. WORST. INSURANCE. IN. LIFE. Nothing routine is covered, and no one speaks English. I have spent the last 4 days trying to find an optometrist and after 10 calls to doctors today alone and 5 calls to the member services line, I still don't have a single appointment ANYWHERE!


W
Wwallin
2/7/2024
Worst insurance ever. Visit their FB page and that will tell you everything. Their denial of claims are almost fraudulent and have been reported to the BBB.


lmush18
2/7/2024
Although Ambettee covers the cost of a routine screening colonoscopy, if you have any polyps it will not cover the removal of the polyps. This non-covered cost can be thousands of dollars


grumpygillsmom
1/31/2024
We had coverage 2023. I thought that we had picked out coverage for 2024 Unfortunately they said the coverage lapsed. Called week before end of month. Payment made at that time. They said we would get the info in 2 business days and that coverage was reinstated. Need to get blood thinner and we are told no coverage until 2/1. That would be ok except it will not show we have coverage 2/1 until a week or more after it starts. So in that regards we have paid for insurance that we cannot use. This is not right!


booksplusmore1
1/26/2024
I spent over one hour between being on hold talk to an Ambetter representative and escalation team member with marketplace on the line. Here is the unprofessionalism I am experiencing. After waiting hours for them to send me a message, directing me to go ahead and create a new account with the new email. I could not get the verification code because they have an unknown email address in their system. I hope that they are not exposing my personal information to the wrong email address they have on file. The craziest thing is they email me other information on the correct email address.


D
DawnC
1/25/2024
They deny routine physicals. Keep sending back with bogus reasons. Then they finally accept your claim but deny it saying you waited too long to file claim. Then, they deny procedures that had a predetermination on file before proceeding. Customer service is horrible. They talk in circles and never answer for their denials. Find another insurance provider. Don't be fooled by them.



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