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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.

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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huffed3100
12/10/2022
Total rip off! Run from this sleazy outfit. None of the tests your doctor orders will be approved in any reasonable time, if at all. High deductibles. The" crooks", IMO, who run this company must laugh at the suckers who enroll in this so-called plan and pay good money to get totally ripped off and disrespected. "Am-Sleazier" also underpays the providers less every year so nearly all the doctors in my area have dropped this fraud. IMO this is a fraudulent company and should be reported to the state dept of Insurance for consumer fraud.


dermatologistname
12/9/2022
Really terrible insurance. Will not approve any tests your doctor orders. Causes me, a patient, a tremendous amount of wasted time to get even a simple test approved, leaving me holding the bag and effectively with ZERO medical service. Underpays the provider for service, which is why my doctor will not take this insurance starting this year. This company is a FRAUD.


gina.scpac
12/6/2022
Ambetter, needs to do better with the customer service center. The representatives don't have a good handle on understanding or speaking English. They don't understand what your needs are as well as it is always a loud background, either from working in what sound like a small room with hundreds of people in it all talking at the same time, or backgrounds from home with children and animals. It is discussing, to spend hours to get an answer to a simple question. I fault Ambetter for trying to have cheap labor without respecting your clients by equipping the works with basic knowledge. I feel for the worker who are trying to earn a living for their families and are being stressed out by... Read More


M
Marie
12/5/2022
OMG...Good to know I'm not the only one frustrated with this company. On April 24th I called to update the hours I worked, as instructed, so I don't get penalized at tax time, nothing else changed. The idiots changed my status to having other insurance and have denied every single claim after that date due to having 'other primary insurance'. No matter how I tell them they are my primary, and even sent documentation proving it, nothing changed. I emailed them, no response, I have been calling weekly and the calls drop 98% of the time and NO ONE CALLS YOU BACK. This week I was so pissed I asked to speak to a manager at least 10 times and the rep would not transfer me. Eventually, that... Read More


suziet34
11/29/2022
I am sick of this company ,I al flying internationally for xmas and my doctor has been concerned for my heart and ordered a echo for me , I have had my appointment cancelled twice because Ambetter won't approve it unless it is really necessary !!!! Of course it is that is why the heart specialist ordered it in the first place , if anything happens to me on the plane my husband will be suing them .Also they have suddenly decided that they won't pay for Humira anymore even though if stopped in the middle of treatment it can be dangerous for me .This is the WORST healthcare I had ever had the misfortune to be with ,I am appealing to the state attorney about this awful company !!!!


petreysharon
11/11/2022
Boy am I frustrated.... thought the whole reason for confirming my contact info was to call me back if disconnected. Guess not - 2 times now. I actually was making (I think) progress on the second call. Not sure why there is a VMS option is to enter rep # because no one has ever shared a way for me to follow up with a customer care agent. The coverage is fine for my needs... the customer care is lacking.


hackettps0
10/26/2022
Ambettor assured me that my coverage was cancelled with their affiliate Sure Bridge when I became eligible for Medicare. I continued to see charges but I was told that was for my wife’s coverage. Well two years later when my wife became eligible for Medicare they assured her it was cancelled. Charges again appeared and we called. We were told it was for both of us. After assuring me it was cancelled they charged me for two+ years. They will refund me two months or I can go through a lengthy appeal process. Scam company. “ You can quit at any time without penalties” because they charge you anyway!!!


nadina.g7
10/15/2022
As most, we don't take the time to give a good review, unless we are really unhappy. But I had a great experience with Melisa, a CSR at Ambetter (Oct 12, 22), after I talked to another one for 1 hr., as I had a few questions, and who was just not too experienced. Melisa, on the other side, was the one who made me decide to leave at least a review, as appreciation for her excellent customer service skills. I come here and I see all these bitter people, and they might be right, or they might see things just from their side of the world. All I can say, I had about 45 claims within 6 months, and they were all solved and covered, as per policy benefits, including surgery, MRI etc. They... Read More


janhartmeyer
9/15/2022
Garbage government affiliated insurance. Won't cover an mri for back pain. Garbage insurance...garbage insurance...garbage insurance. 1 star is too many. Criminal. Called in to ask why. answered immediately. They cut me off and now won't pick up. Obumacare garbage insurance...some legacy


chad.allen.meyer
9/6/2022
Terrible. Nobody accepts it. All the doctors they list actually do not accept it for the specialized services they offer. It's a lie. They denied my tests requested from my primary. They sent a letter, to me, so I could "appeal" 2 MONTHS after the denial. (wow, thanks) Their upload system for doctor is so terrible, it actually creates "loopholes" because they don't "receive requested paperwork". This is a cash grab. Deny anything/everything until the year is over. Make it so hard to use, nobody can, then disappear with the monthly payments after the year is up. Trash company, trash service, bordering on criminal. I am 3.5 months without a diagnosis for my health issue... Read More



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