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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.

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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Ayaz S
7/17/2019
Terrible insurance company I am dealing with. I started with them this year 2019. They do not cover any prescription which is expansive and I have to fight for going in a lengthy appeal process. Even if the approve t, I have to pay a huge portion out of pocket. When call their customer service, they are not friendly. My 2 prescriptions which my doctor prescribed and I was taking for years and previous health insurance company was paying for it. Ambetter denied and asked me to prove that I need it. Is it not a silly question to the member to provide the proof while my doctor has already submitted the proof. To cut the story short I told them that I will not renew my policy with them when... Read More


Amy J
6/27/2019
What is wrong with your prior authorization system. My daughter is Type 1 diabetic. THAT IS AN INCURABLE DISEASE! You are requiring prior authorization on her DME one month after it was prior authorized last time. You usually require every 3 months, which is still ridiculous. WHY SHOULD SOMEONE WITH AN INCURABLE DISEASE HAVE TO PROVE TO YOU THAT THEY STILL HAVE THE DISEASE EVERY 3 MONTHS? This is insanity! I spend so much of my life trying to save my daughters life because you won't approve her DME for long enough for her to get access to her medications and get her insulin levels regulated. Plus I pay $330 a month for you to treat us like her life doesn't matter. YOU ARE A JOKE!


kid.katz
6/24/2019
I have a Gold level plan costing over $13,000 per year with their Ambetter Health by Celtic Insurance. This company is effectively operating a scam. It may not meet the legal definition of fraud, but it certainly meets the moral definition. I have a $1000 deductible policy. They have very limited options for providers and hospitals with the hospitals being among the worst around per Yelp reviews. Even after getting approved for procedures supposedly covered by Ambetter, I have been saddled with the bulk of the bills. For example, I needed medical imaging work done. Only two hospitals with bad reputations are in-network in a city/burbs with a few dozen hospitals. I got the... Read More


Kathy H
6/23/2019
Am better is the WORST. I spent 2 hours yesterday trying to resolve a problem with no success. On 9-11-18 I was seen at Mountain Medical. I paid my co-pay, all's well. On 11-21-18 I see a physical therapist at High Desert Therapy. I'm told I owe $140.00 to pay off my deductible for 2018, which I pay at that time. The next day I receive a bill from Mountain Medical for, you guessed it, $140.00. I assume, foolish, foolish me, that Am better would see my payment to the physical therapist the day before and rectify the billing/payment snafu. Eight bills later and multiple messages to Mountain Medical the problem is still not resolved and they are going to send me to collections. According to... Read More


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Ann
6/20/2019
Please be careful of Ambetter. I have had problems over a test. Called customer service and was told it would be covered. It is not. Do not buy Ambetter.


cybertalex
6/19/2019
Ambetter from Sunshine: CLAIMS PROVIDERS REP: This is from Today 06/19/2019: Representative Louis: after having me for 25 minutes on hold hag up the call and never call back...why then you guys ask for contact phone number if never call back??? .. then I called again and spoke to Gary, AWFULLY CUSTOMER SERVICE, in a rush, didn't let me finish my request, contact interruption, then hang up the call.


ravikarprasad
6/13/2019
I don't agree at all - about 90% of doctors who are listed in their website are not ready to take this insurance. The main purpose of insurance is not all the facilities listed in this article. I have waited for 9 months then finally got my physician. I would not take this again at any cost because this is waste of money and if you need to go to specialist then still I have no luck. Worst insurance company and confusing to everyone even the government (in exchange plan) . Also this more like scam.


muddygirljj69
6/8/2019
awesome insurance company!! The best I’ve ever had including blue cross


Tony D
6/5/2019
Not sure who the biggest crook is Ambetter or the Healthcare market place. I Corrected their documentation error for the 3rd time this year. Each time they reinstate it, then immediately suspend it w/o notice for the same clerical error of theirs. This time they say I owe nearly $800. to reinstate.... I'm only supposed to pay $4.95 per month. WTH???


S S
5/31/2019
This company has always given me the run around. Weather it is medication and prior authorization, standard care such as doctors visit. Even regular preventive care such as vaccinations are denied. I can't wait to drop this alleged insurance company.



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