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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.
 
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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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275 Customer Comments & Reviews

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dorisselle
5/5/2020
The plan is a scam, they never authorize any study or mris. Is a joke of a plan don’t buy it go with other compsny. I am a patron that suffers from multiple dislocations and subluxations due to my rare disease Ehrlers Danlos Syndrome. I need MRIs of my shoulders and they never approve anything. Is a nightmare! Consider other plans.

Rusty C
4/24/2020
Health insurance ran by circus clowns. Ambetter loves taking money from their customers and they make it almost impossible to get approval for any procedure that is above a basic checkup. They continually deny any procedure, regardless of what type of physician (general practitioner, specialist, surgeon, etc.) requests it. On their website, they list a ton of doctors in any area of practice you can think of. However, this is a fraud as well. A majority of doctors, who Ambetter list as in network, refuse to accept the trash known as Ambetter. After fighting alongside my doctors against Ambetter trying to get required & necessary procedures approved, I understand why most doctors will... Read More

Debra C
4/9/2020
This is my second year on the Basic plan. I went in with my eyes open expecting low monthly rates, but high deductible and out of pocket max. However, the max was only $2000 higher than my company plan was 3 years ago before retirement. With the ACA, the cost was 1/4 of the cobra cost. This year I had a major surprise with a cancer diagnosis and so far the physician visits, CT scan, surgery and initial post op has all been covered and my portion is as expected. I have yet to hit the radiation event, but approvals for all portions of the recommended care have come through without a hitch. At the moment I have nothing negative to say. The coverage has been great. I am in NH.

Shawn S
3/12/2020
So far we've paid our bill on time. Their system online is janky and cheaply made it allowed me to pay my premium twice and I've never been compensated for the extra payment I sent. I called their line and was on hold for an hour before I gave up. So far all I've done is pay them money and they do nothing for me. Recently they've threatened to raise my premiums if I don't send information that they already have access to. They are bullies and they have no customer service.

olympusbrad
3/5/2020
This insurance is the worst I have ever had. I signed up because the rates were good and the benefits appeared great. The problem is you cannot get any Dr. or dentist to take this stuff. Most of the Dr.s they have listed on their site as approved providers don't take ambetter. I called their customer service about not being able to get a dentist and they called back and said there are none in my area. And left it at that. I live in a pretty popular area of Florida. It seems they are just cashing in now before the regulators shut them down and have a class action lawsuit. but that is just my personal opinion.

T
tulimafat
3/1/2020
Terrible customer experience. How come GEICO is more capable and willing to help fix my car, than Ambetter is to get me the medical care that I need? Isn't that insane that my car is being better-taken care of?

Kc M
2/28/2020
They denied my med treatment, we appealed & won. Then they said they wouldnt pay for medical botox for migraines, but they will for cosmetic botox( no good for migraines). They won't pay for diagnostic mammogram, but will for prevention once a year. My medical treatment was due Jan.1 and 3 months later, IM STILL WAITING. Worst ins. ever. Higher premiums and lower coverage. My friends husband is still fighting to get coverage dor surgery he must have for skin cancer! Ambetter has been a nightmare for me & others.

kqlincai
2/20/2020
This insurance is a fraud!!!! I called 10 doctors that were supposed to be in network. 8 of them said they are not in network. Only 2 of them said they accept this insurance but the first available appointment is 6-10weeks away. paying for health insurance that basically have everything out of pocket, no doctors accepts. WASTE OF MONEY!!!!

kiyoko423
2/19/2020
I have contacted this company 6 times in the span of a month simply to get a letter stating that my insurance ended with them December 2019. Every representative I have spoken to was incompetent. Either they gave me incorrect information, or disconnected. They sent out the wrong letter twice, and 3 times I called and asked for a supervisor and not one would come to the phone. They would claim to all be busy, but they weren't too busy to give the rep instructions to come back and forth to the phone to tell me, but would never get on the phone directly. My company cannot finish processing my insurance application until they have a letter of termination from Ambetter which I just can't seem... Read More

A
A. K
2/14/2020
I will never use Ambetter again. I have been in a 2 year battle to get money back after calling to cancel (and being told it was but it actually never was) and even though it was not my fault no one has been able to help me get my premium back. This has been going on forever. The insurance is also not taken many places and the places it is are not steller. I wish I had never used them and I recommend everyone stay away!

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