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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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bren.sanabria21
8/24/2021
They cancelled my insurance and then deducted $895, which you cannot speak to anyone in billing. Over 10 times the refund was processing and it is not 3 weeks later with another story. TERRIBLE INSURANCE. ANYONE READINS THIS, PLEASE VOICE YOUR CONCERNS AT https://www.bbb.org/file-a-complaint/0633-90552379/form. Maybe there will a recourse.


Lori B
8/20/2021
Ambetter should be investigated for fraud, they are not that low cost either. They will deny all requests for medical procedures right off. My doctor asked for an MRI to see what was wrong with my knee. Ambetter denied it, then it got so bad I could not walk. So my doctor said that I need orthoscopic surgery. Ambetter denied it because it because I did not have an MRI. Every time I called Ambetter I was told that they had no records of what I was talking about so I had my doctor send me proof of all of their filings. Ambetter will lie and cheat to and what ever they have to in order to deny medical help. They pay almost nothing on doctor claims even it is covered so you will get a... Read More


typhooncomputers
8/19/2021
Ambetter is the worst company on the face of the planet. Their 3rd party authorization department does NOT approve any procedures that my doctor requests. Now I have to pay cash to get injections, MRI's, or anything else that costs money!


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Paul M
8/10/2021
It is near impossible to speak with a live person at Ambetter TN. Our dentist has also tried to contact them, without any luck. Their given numbers redirect to a number that is not in service. Made a complaint to TN BBB and TN dept of commerce and insurance.


jesse.j.horn
7/31/2021
I had to buy insurance off the market, and chose ambetter. Should be called amworst. I have a prescription to refill of my PrEP and they refuse to fill it because they claim I am not preauthorized by them. Even though I have had two other insurance carriers within the last year (employer switched) in which one had authorized and the other had filled. I have been surviving in a global HIV pandemic for 40 years, and they have the nerve to say I'm not approved by them for PrEP. I have unfathomable amounts of queer rage in me right now.


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Rick C
7/28/2021
Absolute terrible company - worst customer service I have experienced in my 61 years of life. Do not follow through on their word. BTW - this is the first online complaint I have ever submitted, but people need to know about this company - STAY AWAY!


robert.r.donovan
7/19/2021
This company is an absolute FRAUD! They changed my wife's plan 30 days after we signed up. They said the only way to get her inhalers was to go back to the doctor and have them rewrite the prescription for HALF of what the DOCTOR RECOMMENDED! This company should be shut down and investigated by the feds. Double-check with your doctor to make sure they're basing YOUR care off of what is needed NOT what the insurance company tells them.


Jessica G
6/30/2021
I wanted to leave a review for Kelly A. as she was the most helpful representative I have spoken with at Ambetter. She was patient, kind, and offered several tips and options to assist me. She even took the time to call a company I was dealing with to confirm about a claim and the coverage I had. I really appreciate her assistance, as insurance can be so confusing. So far my experience with Ambetter has been pleasant as I am expecting my first child next month. I can only hope that I can leave the same kind of review once the hospital bills and claims go through after the baby comes. Until then, I'm very satisfied with the coverage and assistance I have received so far from Ambetter.


rsd.737.rsd
6/24/2021
After reading the reviews, there is nothing I can add that hasn't already been said that they suck. I was told after having Ambetter for 9 months that the turn of a new year meant that I needed to re-apply for a new year and could not use the same email address. Really? This lead to a delay for 3 months due to processing. As that happened, the bills rolled in. Thanks. Too many other things to mention. We then found that we could not be approved for a CatScan beginning 30 days prior to the appointment. It meant we had to cancel. She is still sick and not getting better. Run away. Do not get involved with this group. Consider you have been warned.


James E
6/23/2021
Ambetter must have an entire team devoted to finding ways NOT to pay a claim. I had several problems with them but the worst is this: In an attempt to feel confident in what I was told, I called Ambetter THREE times before my anti-skin cancer treatment (photodynamic therapy--PDT). All THREE representatives told me I only had to pay my $60 copay and NOTHING else. The doctor's office received a pre-authorization letter stating the same thing. A month later I get the bill and am told that I haven't met my deductible yet. For 1.5 years I fought this, going all the way to the Texas Insurance Commission. They ruled that even though Ambetter told me verbally AND wrote a letter to me (after... Read More



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