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Ambetter Health Insurance Review

275 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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275 Customer Comments & Reviews

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orr1873
10/15/2024
We have had the worst experiences with this company. They do not pay anything and it seems that they will go out of their way to make your life way more difficult that it needs to be. I spent 4 months trying to get a payment that had been applied to our daughters account moved to our account (which is where the payment should have been applied to in the first place) I had to email all kinds of documentation and had to keep going back saying that they have the payment wrong. Then finally they corrected the payment only to find out that they don't cover anything. Any referral isn't covered under no circumstances. I would use this insurance company for nothing. Once this year is over... Read More


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Clifton h
10/11/2024
I only read a couple of comments, but agree. If it is possible to avoid this company and get any other insurance, you're better off getting the other insurance. The correct name for these plans is "you cannot be stupid enough to think we will payout or provide any coverage". But, in all fairness, I signed up for it. I must be that stupid. Hence I am taking the time to write this, do yourself and run and get a different plan. This one doesn't pay for anything. Prescriptions are much more affordable with GoodRX. If you get blood drawn, etc., you should tell them you are a cash patient, it costs less. Simply put, horrid insurance. Horrid.


J
J.Mlr
9/25/2024
Ambetter Health Insurance put "No Referrals Necessary" on my insurance card but the sad truth I discovered this year was that does not mean diagnostic care that you need will be paid without prior authorization. Virtually any care you need that is not an emergency or preventative falls into no mans land where the physicians and medical office staff have codes that don't say prior approval is required and therefore will not submit requests, but without prior approval Ambetter will not pay for it. Not only will Ambetter not pay for it, but they told me I wouldn't even get a discount!!! This includes the chiropractor I went to, who was told I needed prior approval but again, doctors office... Read More


m.calijp
9/16/2024
This company is only a front for the Marketplace. My son went into the Navy, we cancelled the policy and they kept billing us anyways, said we had to call back to the Marketplace to cancel. My son is in the military so he can't call. Joke of a company.


joolss52
8/7/2024
This is THE worst fucking insurance company I’ve ever had to deal with in my life. Do NOT get this insurance. I have had gastrointestinal issues for a month and a half. There is not a gastrointestinal doctor within an hour and 15 minutes that will take the suck ass Insurance. I want to sue them so bad.


shihaploy
8/2/2024
If I could give this ridiculous company 100 negative stars, I would. I wish I had ten dollars for every hour I've spent on hold or tried talking to one of their CSRs, who I can never understand. I could probably buy a new BMW. Absolute slow leaks, all of them. For four years, they have messed up EVERYTHING humanly possible. HORRIBLE, HORRIBLE, HORRIBLE, HORRIBLE, HORRIBLE, HORRIBLE, HORRIBLE, HORRIBLE, HORRIBLE, HORRIBLE, HORRIBLE, HORRIBLE, HORRIBLE, HORRIBLE, HORRIBLE!


H
Holly
7/24/2024
I can't get an appointment because no one takes Ambetter. The website isn't updated, customer service admitted this. I called them and they were supposed to call me back with doctors that will accept insurance from them. No one called.


rachele.e.julian
7/3/2024
Absolutely the worst, a ton of bureaucracy and they decide what is covered and what is not!


B
B. M
5/31/2024
AmBetter is the absolute worst insurance company that we've ever had! My wife was diagnosed with a ruptured disc in her back that is pressing on her nerves, has left her completely disabled, and requires emergency surgery. Now we have top wait 10-14 days for a 3rd party to authorize her surgery while she's in complete agony?! This is what we're paying nearly $700 a month for on a gold plan?! This is what happens when the government is involved in make health decisions for us!


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.



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