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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.

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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DawnC
1/25/2024
They deny routine physicals. Keep sending back with bogus reasons. Then they finally accept your claim but deny it saying you waited too long to file claim. Then, they deny procedures that had a predetermination on file before proceeding. Customer service is horrible. They talk in circles and never answer for their denials. Find another insurance provider. Don't be fooled by them.


jennsman88
1/12/2024
this company sucks big time never any help on the phone they just shuffle you around to different people


Carolyn C
1/11/2024
I been calling Ambetter about my 2024 insurance card. They can send a bill but no insurance card. I been getting the run around since the end of December from Ambetter, about my 2024 insurance card.


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Patti G
1/1/2024
Absolutely the worst insurance I’ve EVER had. Everything my doctor orders they deny. When your health is at a low point you can count on Ambetter to make it worse by denying timely procedures or testing. So very frustrating to deal with. Healthcare providers have to call and beg/prove everything they order is justified to a doctor that is 3rd party. Don’t even think about calling the number on the back of your insurance card because you can’t understand the representative because English isn’t their first language!


scr591959
12/13/2023
I've had a broken ankle for over 5 weeks. The orthopedic surgeon they referred me to was called the day before my scheduled surgery and told the weren't in network yet they referred me to him. Meanwhile I'm on a broken leg still


Kelly W
12/13/2023
AWFUL AWFUL CALL, AND CALL AND THE CUSTOMER SERVICE IN THE PHILLIPINES, THEY JUST READ A SCRIPT, CAN'T ANSWER ANY QUESTIONS. THEN THEY DISCONNECT YOU....THIS IS THE 4TH CALL THIS MORNING ON 1 PATIENT....DO NOT GET THIS INSURANCE EVER


canterbury701
12/12/2023
I give my Ambetter Elite VALUE Bronze NO STARS. An outrageously expensive premium, which provides little health care coverage and medical options. Few, available PCPs, mostly retirement age, plus. Takes more than a year, to book an appointment, with a simple "specialist" like a Dermatologist. Forget getting appointments, with other specialists, during your year of coverage. Customer Service is outsourced to the Philippines, where staff admittedly work from home (Heard a rooster, on one call. Who else has access to our sensitive data?), intentionally keep you on hold, for literally an hour plus, after having passed you, around multiple times, and hang up when they can't answer your... Read More


mfried9141
12/6/2023
This is the worst insurance company anybody could have. Their monthly payments are high and their deductibles are extremely high. They don’t cover a lot of the medication’s and poor communication with their providers.You


csiguy5501
12/1/2023
Good at claims payment. Very poor customer service, you are directed to a third world call center, not an Ambetter employee , very loud and busy background noise. Reps don’t speak fluent English, nor do they understand your fluent English. If they can’t understand or address your needs/inquiries, they eventually just hang up on you and you have to call them back and start the process all over again…… they put the CUSS! in customer service.


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Donna D
11/15/2023
Horrible… took my money and then cancelled me because of no payment. Took payment but was not applied to account. Called customer service ( could not understand any representative as they speak broken English) they took another payment and then had a credit on balance. Went to use it and was denied. Spent 3.5 hours trying to get to the bottom of this only to be told to call back in a week. Is all they can do is put a ticket in. Asked to talk to supervisor, was told they were one. Asked to talk to their superior then told there was non!! So can not fill my prescription because I now have no insurance and with out insurance it costs $1600. And this prescription is vital for my... Read More



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