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Ambetter Health Insurance Review

278 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.
 
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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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278 Customer Comments & Reviews

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DANIEL R
1/25/2022
My name is Daniel Rodriguez and I have been an Ambetter client for the last 3 years. The TERRIBLE SERVICE that Ambetter provides only compares with their advanced capacity to deny most claims, calculate deductibles in forms nobody understands, never provide a definitive answer or solve a problem (for good or for bad). Since Nov 23, 2021 I have been trying to get Ambetter to explain why they deny payment to my psychologist for therapy sessions. To this date (Jan 25, 2022) at least 7 different persons in Ambetter have provided 7 different explanations and none of them have been able to prove that they were telling the truth or solving the problem. From customer service persons saying... Read More

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Sara G
1/14/2022
DO NOT select this insurance. Prior to selecting the insurance I checked to see that our doctors were in network but now that the new year has started most of them are no longer accepting Ambetter but the Ambetter Directory does not reflect this. I called and asked for the updated directory and was told they could not provide me with that and the only way to get updated info was to speak with them directly. I have never heard of an insurance not providing a directory! The next issue is the customer service is terrible. IF you can even get through on a line without being disconnected multiple times they will give incorrect information as they are using the same online search options as you.... Read More

wshaw14
12/17/2021
Ambetter- no one wants to take it. They gave me a list of providers in my area to find a new GP because my doctor wouldn't take it - Obama lied I guess. Then I called all 40 phone numbers they gave me and not one was a GP. Several were diagnostic centers, or a Dr. in another state, or if they were here they said - I don't know why our name is on that list - we are NOT taking Ambetter!. Then i did find a bone Dr. that took it one time and she said they wouldn't pay for an MRI on anyone, even if it was Dr. requested. She said they were the worst company. So they have a lot of work to do to be respectable. Also , There was only ONE Urgent care place that they took it in my town - Chattanooga,... Read More

tarja.anchor
12/8/2021
I have never dealt with more incompetent staff and health insurance in my life. After a month from an emergency visit and a referral to a doctor in 2 days max, I still haven't seen a doctor. I have to drive an hour to next city to be even seen... lol crap all together. You can't find a doctor who accepts this joke of an insurance.

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Amanda D
12/1/2021
I applied for an off exchange plan for my husband and I and was quoted $1400. I enrolled in the policy and paid for the plan online. When I logged in on November 1st, it only showed myself on the plan. I called the customer service line and they told me I had an exchange plan after I told them that I did not. They said to talk to sales who also insisted that I had an exchange plan and told me to call the exchange. I knew it wasn't an exchange plan but I called the exchange anyway so they could tell them it wasn't. The lady from the exchange agreed that she could not find an application for us on the exchange. I then made a three way call including the exchange and ambetter. We spoke to at... Read More

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sharon
11/19/2021
Every time I've attempted to utilize my plan, I'm told by customer service either the service, lab, or doctor isn't covered. The Balance Care 11 (2021) plan Summary of Benefit and Coverage document says my deductible is $6000 and $12,000, but my initial application had $2850 and $5,700. Recently, I requested to change my primary care provider and was verbally told the doctor wasn't in-network. The doctor's office provided their NPI # verifying their affiliation, then I was told by Ambetter customer service that the number was wrong and provided a different NPI# and the change wouldn't be effective until Dec 2021 after my scheduled doctor's appointment. The rep told me he would make my... Read More

okkyoung1
11/17/2021
Call to finish set up because website won't let me, hold for long time, just get hung up.

jamesandrewa
11/17/2021
Their entire customer support has the combined IQ of a shoe. Literally 8 hours total on the phone with these people being passed around to mouth breathers who cannot do anything or see anything on their side.

xx.terminator.xd
11/15/2021
The insurance is useless. My dad took me to the emergency room because I felt heart palpitations. I thought I was having a heart attack. They did an electrocardiogram. The insurance did not cover the $110 elecectrocardiogram, nor the $1,957 emergency room visit.

jakecoy88
11/15/2021
I wanted to try Ambetter out because they were a new company that I had never heard of and they were very reasonably priced and the deductible and out of pocket max were very low. My husband and I have a plan with them through marketplace. It was very easy to apply and sign up. I paid my 1st few months premiums and everything was going great. They even paid for thesurgery on my shoulder, which had me almost meeting my yearly individual deductible. Around July, I realized that our yearly income was going to be higher than anticipated at the beginning of the year. I went into marketplace and changed it. When I did this, I still qualified for the same Ambetter care 12 plan, but I would be... Read More

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