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Ambetter Health Insurance Review

278 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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278 Customer Comments & Reviews

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R
River
4/8/2019
Today is April 8th, 2019 and I called Ambetter twice and their system was down. I have written six complaint letters to Ambetter concerning their terrible services and none have been answered. I have been denied services and prescriptions after having paid my premiums. I have had to call a total of nine times to establish a primary care physician. Each time I call the representative it is always an incompetent human being who is unable to remember the reason I called or that I had already established a primary care provider on a previous call weeks ago. A supervisor whom I escalated the issues to was rude and nasty to me. After having paid for my insurance, my provider ran my insurance... Read More

B
B
4/3/2019
Terrible customer support service. I have had this insurance for 4 months, and I have never once been able to login successfully to my member account on their website. I called multiple times for help, and each time I got the run around and horrible communication. They would say they are creating a "ticket" and that they would follow up with me via a phone call when my problem was resolved, but they never called back, and the issue after 4 months has still never been resolved. I still cannot login. So, I haven't been able to pick a Primary Care Doctor or see anything related my coverage online. The customer service representatives have been rude, inconsiderate, unsympathetic,... Read More

M
MD
3/9/2019
Ambetter is the WORST ever!!!! They won't cover important tests, surgeries or meds. They employ uninformed stupid people who barely speak English, for customer service. They lie, give wrong information and hang up on you. They charge huge premiums with huge deductibles for services and meds, and will not credit your deductible for services you had to pay out of pocket for.

Ryan M
2/22/2019
No providers are contracted with Ambetter. I lost my doctor, my infusion center and have not had my medication for over one month!

Mike K
2/20/2019
wtf no physical therapists only in a bad hood that people get shot always and too many miles to drive ,no orthopedic doctors or primary care denied this insurance all over , will never buy this plan again

estelamd
2/20/2019
I called asking for a physical therapist I needed to answer all my info before explained what was my question, they couldn't answer anything before they update my info that I just did in the web site, I complain about this the man that I was talking in Spanish say I will write that you refuse to confirm your info and give me 5 min to search for a provider, after I was waiting for 3 min he hung up the phone, INACCEPTABLE, of course I confirmed my phone in the site he could call me back, but No, they did not care... SERVICE? ZERO HALF OF STAR, maybe somebody can call back and give an explanation.

S
Sheila
2/12/2019
Very disappointed to find out Ambetter discontinued their Gym Reimbursement Program, without any notice to current members enrolled in the program. During open enrollment in November, the program was still viewable on their webpage. The weblink for reimbursement suddenly no longer works as of Feb 1st, so I called Customer Service and was told program has been eliminated. This results in $500 unexpected cost to my family in 2019.

Elite G
2/7/2019
I bought an Ambertter plan to save $100 a month on my premium. It wasn't worth it. I have been diagnosed with a Pituitary BRAIN TUMOR, which is believed to be benign. The risk of a biopsy outweighs its benefit. I have to have an annual brain MRI to ensure that the tumor has not changed or grown, which would be indicative of cancer. No insurance company has EVER denied an authorization request for a brain MRI. Ambetter DENIED my BRAIN MRI despite receiving all previous med records, MRI's, and lab results. They wanted my current complaint illness (duh....a brain tumor). I was forced to pay over a $1,100 out of pocket.

S
Sarah W
1/25/2019
New to this insurance I thought I was getting a decent plan. WRONG!!! My first experience was trying to fill Rx that I’ve used for years. Before choosing this insurance plan I checked to make sure it covered both. And indeed indicated it did. Now they claim one is not covered and they insist that I try two other meds before I can have mine approved. The second Rx is covered BUT They say I don’t need the dose I’v used for years and they’ll cover a lower dose. This is disturbing that my insurance company can play doctor and override my own doctors. Do Not use this company!!!

S
Sarah W
1/25/2019
New to this insurance I thought I was getting a decent plan. WRONG!!! My first experience was trying to fill Rx that I’ve used for years. Before choosing this insurance plan I checked to make sure it covered both. And indeed indicated it did. Now they claim one is not covered and they insist that I try two other meds before I can have mine approved. The second Rx is covered BUT They say I don’t need the dose I’v used for years and they’ll cover a lower dose. This is disturbing that my insurance company can play doctor and override my own doctors. Do Not use this company!!!

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