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Ambetter Health Insurance Review

268 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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268 Customer Comments & Reviews

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clareblubaugh
1/28/2021
Quite awful customer support, online portal, auto-pay (riddled with errors and disorganization), and no help with any questions about coverage - how, what, where, how much, etc. This has been the worst insurance company I've ever dealt with. I'm paying quite a lot for "gold" level coverage and am unable to get any prescriptions, any answers, any information, etc.

S
Steven S
1/26/2021
See comment dated 01/15/2021. This is exactly right and I believe they know that it isn't accurate and they could careless.

R
r r
1/15/2021
It appears Ambetter fraudulently shows doctors as "in network" to get you to sign up and purchase their insurance, when in actuality the doctors are NOT in network. When I reported this situation to ambetter, the customer service rep on the phone accessed a database he said was different than what is accessible via their website to identify a medical provider for me. The provider he found is nowhere to be found in the list of providers on their website. The guy on the website couldn't have been any less interested. Infuriating.

R
Raquel
1/12/2021
Attention: Ambetter is a very unpopular health insurance company. I can get my ADD medication I feel sick they are not at all helpful, I have to spend hours on the phone every day and they are no help at all I see why they have such bad ratting It has received a 1.4/5 star rating from reviews left on Best Company. Roughly 88 percent of the Ambetter reviews on Best Company gave a 1-star rating. Complaints against Ambetter include poor customer service, difficulty with pre-authorization, and high costs for limited coverage. Most customers do not recommend buying healthcare coverage from this insurance company.

stevendhayes1
12/21/2020
Still waiting for teledoc to call me. Customer service useless. If you want to die--- this is a good choice for chauffer to the graveyard. I give it a half star because they are proficient at answering the phone. They just cant provide too much more.

J
John D
12/18/2020
The worst I have seen in my 30 yr career as a cardiologist. They deny more than 75% tests ordered by cardiologist despite presenting overwhelming evidence that the tests ordered are indicated and recommended by our professional organizations (Am College of Cardiology, Am Heart Assoc, etc.). Look somewhere else.

K
karen
12/14/2020
I've been on Ambetter Balanced Care 11 for two years and I have had multiple surgeries, a sleep study, allergy shots, an oncologist appointment, lab work, and xRays. I had physical therapy which limits 20 visits per year. My prescriptions are free except for my asthma inhalers which are $25 apiece, which is about the standard. My out of pocket is a little more than $1500 and I've reached it both years, the fist two years my premiums were zero, this year it would be about $60 per month. I have never had them deny a procedure or coverage, you have to get the procedure done within a certain time frame, but if necessary the doctors will request an extension. I probably would have been... Read More

B
Bill K
12/8/2020
This "insurance" is horrible. It is nothing more than Medicaid that you have to pay for. The absolute worst doctors if you can find one. When I initially enrolled with dental coverage, there was only ONE dentist accepting the coverage in the entire state of Florida. I have a 6" scar across my stomach from the only surgeon who would accept this crappy insurance for an umbilical hernia repair. I told him at my first follow up that the repair was not corrected and he told me that it was just fluids. WRONG! Oh and the incision he made, looks like he was drunk when he made it. It is literally in the shape of an "S". If you care about your health care, DO NOT use Ambetter.

rob.rogersassociates
12/3/2020
Terrible policies as it relates to Breast cancer. My wife received notice 48 hours in advance of her surgery that one of the two surgeons in the team handling her Masectomy and initial reconstruction was out of network. So the initial reconstruction portion of the procedure was canceled. This not only eventually adds an additional surgery for my wife to recover from in the future but additional cost of a third surgery for the insurance company. It also adds months to the overall recovery. To make matters worse we were notified by mail 48 hours before the procedure! We filed a grievance and heard back days after the procedure that they were "sorry". Nothing more. Next we verified... Read More

Chris H
12/1/2020
This is the absolute worst insurance. THEY COVER NOTHING. Their pharmacists who have no actual access to your health history determine life saving meds are NOT medically necessary. Pay over $11,000 for coverage and not $.10 was cover. ZERO STARS, but they are making me pic one in order to post the review. BUYER BEWARE!

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