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Ambetter Health Insurance Review

267 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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267 Customer Comments & Reviews

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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

D
Debbie
6/15/2021
I am fuming. After being approved for stress test, echocardiogram and heart monitor. My cardiologist diagnose me for SVT (supraventricular tachycardia) my blood pressure is already low, (my primary dr. prescribed metoprolol prior to tests, the side effects were horrible, I was sweating all the time, tunnelvision, could not drive, had massive headaches) therefore my cardiologist prescribed corlanor on May 18, 2021, Ambetter has yet to approve the RX. The Cardiologist had given me 2 week samples, which this is my second week and my heart seems to be relaxed not beating out of my chest. I called Ambetter, who claim they have not received PA requirements from doctor. WTF? I am 60 yo... Read More

Melly S
6/7/2021
I am so frustrated. On June 1, 2021 my doctor ordered a stress test for my heart and marked it ASAP. When I called to schedule the procedure, they booked it for a week away, June 8, and my doctor agreed that it was ok to wait. I was notified this morning that my stress test had still not been approved by insurance and they were asking did I want to reschedule int he hopes that it will be approved, or did I want to self pay? I called Ambetter, waited 18 minutes on hold to get a live human to talk to, who got all of my information, then transferred me to another department where I was on hold another 30 min or so, had to give all of the pertinent information again, and was told that my... Read More

bobply
6/2/2021
I'll add to all of the comments here. We have little choice other than Ambetter on the healthcare exchange. My husband and I pay $1864 per month (no subsidy) with a deductible of 5000 each. Ambetter denies most claims of any sort. My partner had heart surgery last fall. Ambetter paid the surgeon but denied the entire hospital bill saying it was "not medically necessary". Left us on the hook for $122,000. They have even recently stopped covering my generic statin medication. Run away from them as fast as you can. Most of my stress over the past 4 years has been over Ambetter and I cannot wait to reach Medicare age. Unless they kill me first.

agarwalheart
5/25/2021
I am a cardiologist. I am seeing a 70 years old diabetic patient who gets out of breath with limited walking. She has high cholesterol and high blood pressure as well. She has abnormal ECG also. Her insurance, Ambettor, denied echo and stress test on her. No reason given except this does not meet their criteria. It meets all other insurances criteria, but not Ambettors. This is absolutely a travesty. Patient continues to get worse and will now have to go to hospital to get care that could have been avoided. What a frustrating experience for patient and myself.

changelyng
5/24/2021
I am a provider. I took an ambetter client once. Never Again! I advise my clients that if they are offered ambetter to run. and if they are chased, to turn around and use their pepperspray. I had a weekly standing date with one of their agents for 5 months to try and figure out why my claim was rejected each week. things we had fixed were literally being 'unfixed' after 5 months she literally 'gave up'. I got escalated to a senior person. As a solo practitioner, I do not have a "group provider number", but their computer had erroneously assigned me one based on a company I previously worked for. I had this senior in a 3-way phone call with their outsourced provider referral service... Read More

c.smiteee
5/24/2021
This company and its insurance suck! I have yet to find a PCP provider in Dallas, yet their website lists Baylor, Scott & White as providers. I was on the phone 20+ minutes w/ Ambetter this AM and the best doctor referral they could give me was a F'n testosterone clinic....

coco92888.sa
5/20/2021
You might as well have no insurance if you’re going to chose ambetter. I have it through the marketplace and it was unfortunately my only option. I had to chose it because it is the only insurance that is accepted at a clinic I have to go to. However no specialists accepted it, all the doctors listed on their website aren’t affiliated with ambetter. I have to wait months and months and drive an hour away when I’m having serious medical problems to see a doctor. The customer service reps know absolutely nothing when you ask them a question, they give me incorrect information. It’s an absolute joke. Having ambetter insurance negativity affects my life’s every day because of the health issues... Read More

radtech062019
5/18/2021
Ambetter has the absolute worst customer service! I was automatically reenrolled into a insurance plan after I submitted the request to have it canceled at the end of the year. It took 3 months for the plan to be canceled after multiple phone calls. I was also told I would be receiving a refund check, almost 6 months later and still no refund all because of an address discrepancy. Which the address has been changed and updated multiple times with multiple people through Ambetter and Market place as well. Between the two, it has now turned into a blame game, Ambetter is blaming marketplace and marketplace is blaming Ambetter and I am getting no where. Every time I call I get someone... Read More

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