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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.
 
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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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267 Customer Comments & Reviews

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J
Jones
3/8/2023
The customer service you get on this insurance is nonexistent. I have had to call three times and each time the call is routed a call center and all they do is read from a script. They cannot answer a single question for you. The ID cards they send you in the mail fade with a month in your wallet. You will end up paying a lot more than you are saving with this "insurance."

detailchef
3/8/2023
DO NOT BUY THIS INSURANCE. I was attracted to the company from the Stride(the contracted service) who posted this company as a viable alternative to expensive coverage. You're not saving money, but creating heartache for yourself. First of all, they stated that certain doctors were accepted under this plan. However, when I went to call my provider who was on Ambetter's list of providers, that doctor stated that they did NOT accept this insurance. Do your own research and find a better insurance company. Ambetter is horrible and that's all I have to say about them. Move on and let them go out of business.

S
Scotty W
3/7/2023
OMG! Had I only know what I was in for before I selected Ambetter Health Insurance coverage I would have certainly opted for another provider regardless of the cost. It seems like everything is a battle for coverage. Constantly filling out grievance forms (required for a denial appeal) and spending hours on the phone with representatives, that are obviously located offshore, and generally resulting in no good outcome. Treatment delays waiting for "authorization" are common and can sometimes take several weeks. Any little claim submission error or technicality results in denied coverage. Reasonable attempts to resolve claim issues often result in extreme frustration due to language... Read More

jhowes6901
3/4/2023
Worthless. Do not purchase this insurance. Terrible customer service and their auto pay does not work properly causing extreme aggravation trying to fix it .

shore.robin
2/27/2023
"Weaponized incompetence" is right. I paid my first month's premium and the next premium thereafter, and I got a letter saying my insurance was cancelled due to nonpayment. I have been on the phone with Ambetter for nearly an hour. At first they said, "Oh, you have to talk to Marketplace" - and Marketplace told me they don't do billing, my insurance company handles that. There is no way the CSR didn't know that.

Karon F
2/4/2023
The worst. Plan changed my UC MEDS to tier 3. Can’t pay 150 a month. Nothing else works. Mesalamine is it. BEWARE.

Kelly F
1/31/2023
I couldn't even stay with Ambetter Health Insurance for a month. I never got a correct ID or policy number. They couldn't understand that I was a twin and they had merged my sister and my accounts together. They gave me my sister's Member ID and Policy number so I was never able to even activate my account. They changed my sister's account name to my name without any permission from my sister (she had her account for over a year). They would not fix these issues so I had to terminate my Ambetter Health Insurance completely and move to a better insurance company. Save yourself the headache and DO NOT CHOOSE AMBETTER HEALTH INSURANCE.

Eva A
1/27/2023
This company utilizes weaponized incompetence to deny valid insurance claims. I have been going around with Ambetter for close to 9 months trying to resolve two medical bills that should have been paid. It has been impossible to get any help, the customer service agents, who I can barely understand (I know that sounds awful, but its just true) refuse to escalate my issue to someone above their pay grade. It is beyond frustrating. I had a policy for January and February 2022 for myself and my family. Two of my children had appointments with their pediatrician during that time period. My family and I got behind on the payment for January and February, so when the clinic billed the... Read More

J
Jen
1/26/2023
Customer service sucks!!!! Every time I call them, I never get any one that speaks or understand English and they do not understand my concerns. The entirety of the call is trying to get the pharmacy-Envolve--included in on the conversation since online, in my profile, the drug I need states covered and all I need is a prior authorization. I've been denied twice! When I signed up for this damn insurance, I specifically got this one plan because this drug is covered. WTH--they suck--All I want is this specific medication, because all others I have tried and that have been prescribed aren't working--come on man, do better!

tina.perkins89
1/24/2023
customer service sucks.... been on hold 1:45 and still counting. refuse for authorization of MRI.... I guess that wait for u to become unalive

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