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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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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

roselineaugustine.ra
11/3/2023
Well, we can start with the i am better of being better Healthcare insurance arising,not annoying what to do and me. Being CHA MEDICAID LEARNING connected to other health care insurances and experiencing a lot of things going on, and the first schedule is my well-being in particularly financial institution is involved in habit is at all. Then I'm about to feel really, really a long-term

sassychass4
10/29/2023
Absolutely horrible. Wait for weeks for a Pre-authorization and get denied. I have a Gold plan too, I pay a lot for my insurance that covers nothing!!!! Also, they reject everything, say it's not in the network when in fact it is. I had a rep tell me they would send my claims for review as they showed the provider in the network, yet the claims go unpaid!

jimbaker57
10/13/2023
They are terrible Customer service is the worst and they deny everything.

Maria S
10/5/2023
Ambetter/Silver Summit Health is THE worst insurance company I have ever had for coverage and have had to work with. Their customer service representatives are not informed, give boys responses, read of scripts ad nauseam, give contradictory (and typically incorrect) information, and don't call back if the signal to Manila is dropped, even though they ask you for your # in case of disconnection. Also, they have unqualified physicians assessing whether procedures should be approved or not. As my pain doctor said in disbelief and frustration, "What is a pediatrician doing assessing whether an MRI is needed for someone's cervical/back condition?!" The company also requires... Read More

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Paul H
9/20/2023
Ambetter has been the worst insurance in my 30+ years dealing with health insurance companies. There are very few doctors/facilities in my area that are in network and any urgent care or emergency care facilities that are in network are miles from where I live in Seattle. They seem to find a way to charge me for a good portion of my annual preventative care visit even though it states in their plan that "preventative care/screening/immunization" is "No charge." And, calling their 1-877 # to get answers is painful....they ask redundant questions, hold times are extremely long, and the person on the other end always seems clueless and isn't helpful. I went the cheaper route with... Read More

sharonroseciccone
9/7/2023
Be aware that when you sign up for Ambetter's autopay, they will inconsistently deduct your bank account. You will think that everything is being handled because you made the responsible choice, until you are refused service in your doctor's office being told that your insurance has been cancelled. It turns out that somehow it is my responsibility that Ambetter's autopay is not working. Ambetter did not make me aware that there was an issue, nor did they take responsiblity or fix the autopay issue. This happened to me 3 times! The stress and hassle is not worth the savings of a few extra bucks.

ms_dreamhunter
8/31/2023
These people have misapplied my very first payment from the beginning of service. I paid them for August 1 coverage to begin, on 07-31-23. They applied that payment as if I had had their service in July, not August (which I did not). I have called multiple times, been refused a supervisor every time, and the payment is STILL not applied. They are trying to charge me $971.04!!!! That is for two months of service, from my very first month with this company. I don't even know who else to reach out to at this point. In addition, they denied me my maintenance medicines. I have to have a special amount that is has already been appealed by my doctor, and they were well aware of when I... Read More

Linda W
8/22/2023
This insurance is not worth your money. They refuse to pay for any services you need done such as MRI's, deny claims, and the nearest Dentist is 50 miles away! Please do not use this insurance company. Read the reviews! This is a bad insurance company. Please don't waste your time and money with this company. It may look good online; however, they do not provide the coverage, you need you will be denied for medically necessary tests and procedures. I would give a minus score if possible.! These bad reviews are from others who have received the same bad treatment I experienced.

carolshepherd87
8/18/2023
If you are considering Ambetter, please read this. I've been on the phone for hours each day with Ambetter for almost a month since my coverage began Aug 1, 2023 just trying to get a PCP. That's all...I just need a PCP. That should be the easiest thing ever with health insurance, right? First Ambetter told me that even though my policy says "virtual" for certain visits, that I could switch to an inperson doctor, and they assured me in that phone call (on or near Aug 1) that they had done that for me. Then the next day I called Ambetter to confirm the doctor that the Ambetter rep from the previous day had assured me that I had been switched to was now my listed PCP, but this rep told me... Read More

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