ambetterhealth.com Reviews 

Thieves, bullies and dont even honor their rewards system . i have recorded all my phone conversations with them to protect myself and plan to take it to fullest extent. THIEVES! Please ALWAYS record your conversations with them they will lie. 0 stars is what they deserve. they double billed me multiple times in a matter of 4 months

Customer Service is terrible. My log in won't work all of a sudden. 2 calls to support which is obviously not in the US. Neither call was able to get me access to my account. 2.5 hours so far on the phone. Now a support ticket was created and I am to hear back in 5 business days.

Worst health insurance ever. They cover nothing. The deductibles are high. The co-pays are high. Glad I'm going on Medicare in less than a year.

I signed up for Ambetter specifically because they said they would cover my one, very expensive, medication. Without insurance its almost $500 a month.

The first time I tried to use my Ambetter insurance to pay for it, they required prior authorization. That's fine. My doctor communicated with them about my prescription and why I am on it. They denied coverage. For the medication THEY SAID they would cover.

They said they wanted me to try other medications first. My doctor sent them a list of five other medications I had already tried and which did not work at all. They denied it again.

For this medication, I have to do a check up with my doctor once a month to make sure side affects aren't too serious. I then have to fill my prescription within seven days of that check up. If I don't, I have to have another check up before I can get a refill.

This whole runaround took almost two weeks. So not only would they NOT cover the medication THEY SAID THEY WOULD COVER (which is the ONLY reason I signed up with them in the first place), I then had to pay for two doctors visits for a one month supply of my medication. Out of pocket, of course, because they wouldn't cover my doctor's visits, either.

Insurance is a scam.

I'm confused about the terrible reviews here. Ambetter is fine. It is very hard to find providers that are in network -- the search functions are an abomination. Otherwise, they pay claims.

my name is Mary confron,I am a member with am better.i have really enjoyed the plan thus far,but here lately I have received to bills one for 150.00 and another for 189.62 it says my insurance is denied toward these two bills.my monthly balance is correct.i called the company they said that i'm in good standing, I don't need and trouble with my insurance because i'm a single mother of five childrens, test done 12-23-25

Absolutely pathetic!!! Paid premiums didn't receive coverage!! They are a SCAM!!!!!!

Ambetter insurance is a joke, they don't cover anything!!! Between copays and office visits, blood test , medications, it's ridiculous, We pay more out for fees, co-pays and tests than we do our insurance payments, I've had breast cancer in the past and cancer in my lymph nodes, I can't even afford to get my test that I'm supposed to get cuz they want too much up front. Totally ridiculous, my medications keep going up. I can't even afford to take those which I'm weaning myself off of. I will find something natural, if I were you I would stay away from this insurance company.

I really don't even think that they deserve one star but I had to put one star in order to leave a review. When I call customer service they give me names of people that don't exist in the offices of the phone numbers they give me. And they don't take ambetter after being told that they do. Most of the tests that I need are not covered when I finally find a doctor. The customer service people have been very nice however they do not have adequate information. The copay for a specialist is $90. I understand this is a free policy but come on guys this is ridiculous. I spend all of my time calling doctors to find out who takes ambetter only to find out that nobody does. This is the worst insurance anyone could ever have.

this company is charging for health insurance they should not be. someone take notice . Florida is being scammed

I've dealt with numerous insurance companies over the years, including on the exchange; this was the absolute worst. My wife and I experienced several problems in the less-than-a-year we were covered by them through the Georgia healthcare exchange.
On paper it looked ok, but then practically useless when we tried to use it. It felt like we ended up paying more out of pocket than if we'd paid the higher premium with a better company. Some examples:
- When we went looking for service, many of the providers the insurance company listed told us they no longer accepted the insurance, so difficult to find providers for various specialties. Any provider list is always a bit out of date, but this was not even close. Their actual provider network is much smaller than it appears.
- A screening colonoscopy had a huge copay/coinsurance that previous insurance companies didn't charge. This cost us several hundred dollars.
- Prior authorization was denied multiple times for vague, confusing and contradictory reasons, despite our doctor providing test results that very clearly met the insurance company's stated criteria for approval.
- A doctor ordered ultrasound was denied, still not sure why.
- Repeated instances of what felt to us like delay, deny, defend behavior. This is the first time I actually feel the need to say this.
- Multiple experiences of really poor customer service provided by what appeared to be poorly trained overseas staff. I don't care where they are, you still need to train them.

Biggest fraud and they don’t have answer and they just hung up the call and be ready to wait 1 hour on call and then those idiots will just tell you some inappropriate story which doesn’t match your insurance details . Up on asking details they get mad and hung up the call .

Can not understand customer service speaking. Not much covered for the high deductible

Held up reception of meds I had been on, previously under prior insurances. Errors with data entry caused further hold-ups. Still waiting for approval of immunosuppressants, that were prescribed in January (it's late March). "Have you missed a dose," they ask. "Do you need to speak with a pharmacist?" Don't buy from this terrible, inefficient, error-ridden, coverage-dodging, worse and worse the more I have to call them company.

I'm just living on prednisone over here, until someone can do their job, thanks to bureaucratic idiocy.

it is not accepted at any halfway decent place, I got it just to cover for hospitalizations, guess what it’s not accepted at the hospital I went to. Even f it was covered on my bronze plan ambetter only covers 40% after 17000 deductible. I told the hospital I do not have coverage and need financial assistance they covered 70% cost of my brain surgery. So spending 8000$ later I got absolutely nothing form this insurance… I tried to get meds CVS does not accept them, and so I got transferred them to walgreens, walgreens said if you use your insurance charge is 100$ more compared to using Goodrx 😂.

I'm waiting on a third approval on recommendation for MRI that I'm sure they will decline again. This company wants it's customers to die before they will pay for needed healthcare.

They denied a medication so we filed an appeal. Called several times to be told they conveniently did not receive it. I requested to speak to a supervisor several times and was denied. Called multiple times until I finally reached someone who found the appeal and noted they had two more days to process. Very frustrating to spend so much time to get an update. Very poor service.

Absolutely the worst insurance ive ever had in my life if i can leave 0 stars i would

This insurance is very very difficult to use. So difficult, that I'd say I'm not really insured and that Ambetter's claim that I am, is fraudulent.

The network is very narrow, giving me limited doctors within a reasonable distance. Yet, Ambetter does not trust the doctors they chose to work with. So, getting medical issues looked at is very difficult, requiring pre-authorizations that, so far for me, have been rejected. The doctors and their offices don't seem to know how to work the system, so I am stuck just living with my injuries.

It takes a long time to get anything done. I have to contact one of the few primary care doctors near me, wait for an appointment, have the doctors request tests, have those rejected, then, then...Ambetter kicked my primary care doctor out of the network! So now I have to start all over! The doctor's office said that Ambetter came out of the blue and kicked them out of the network. This disrupts my care and forces me to start the medical waiting game, diagnosis game, and fighting with the insurance company game, all over again. I called Ambetter to ask if they could give me any information as to why my PCP who I already saw is not in network anymore, and they couldn't tell me anything. The customer service representatives have no clue.

I've also called their customer service representatives as to all my authorization denials, and again, they can't tell me anything.

It turns out, that Ambetter doesn't even process the authorizations. They farm that out to a company called Evolent Speciality Services. I called them, and they couldn't give me any specifics, other than saying I can go through a laborious effort of trying to prove my medical issues are real and mailing all this in by snail mail. I asked them if it was worth the many hours it would take me to try to gather all these documents and imagings, and they couldn't tell me anything about my chances, or even the best way of appealing. They had no advice or information other than to mail in an appeal. I asked them a direct question for advice, and one representative's response was something like, 'uh huh, yeah'. That response makes no sense to question, showing she was not even listening. A previous Evolent representative appeared to have hung up on me, although we could have been disconnected for technical reasons.

Over the last decade, I've been to doctors multiple times for my knee and bicep. I've had two rounds of physical therapy for the bicep, and even had surgery on it! The surgery doesn't seem to have worked. I haven't gone back to the original surgeon because I'm on different insurance now. The knee has been x-rayed and I've done at home physical therapy based on what a doctor gave me to do. These are real medical injuries that should be looked into and are covered by insurance if the insurance company believed their own doctors in their narrow networks that say the only way to know what's going on is an MRI. For the bicep, pre-surgery, I did about 2 months of physical therapy before that insurance company at the time finally let me get an MRI. The MRI showed that physical therapy was never going to work because the bicep was too far torn. So, I spent a lot of money, hours, gas, wear and tear on my car, and time out of work, doing physical therapy, when an MRI could have shown that was a waste of time. That was under a previous insurance company, that was also bad, but not as bad as Ambetter.

I should have check here first. With a 1.2 rating with over 223 reviews is all you need to know. DO NOT SIGN UP with Ambetter Health. I was assigned a primary care provider that is a Nurse Practitioner. I have been trying to change my PCP to an internal medicine doctor since the end of Januraruy. Here it is March 11 and no where closer to changing my PCP. I had 9 calls with the reps and supervisors all with the same story. Give us 7 to 10 business days. I check and my PCP is still the Nurse Nurse Practitioner. Meantime I'm paying $700 a month. I have spoken and messages their complaint department and all i can say it's a joke. This should be illegal.