Ambetter
Reviews and Complaints
No Ambetter next Time
Worst Insurance EVER
Worth it to pay more
I have only dealt with 2 Companies, Ambetter and Blue Cross. There was nothing special about Blue Cross....except by comparison!
Picked Ambetter by price for 2017....this was my mistake. Turns out the Pediatrician we like who has been our Doctor for 8 years is not in their system. We had no idea. The Customer service is so clumsy and cold hearted that I would have spent a good deal more per month to avoid them.
Simply needed additional ID Cards and it was like I was asking something complicated.
Almost as if they were doing me a big favor! If it is at all possible, I would recommend avoiding them like the plague.
Preferred solution: Let the company propose a solution
Ambetter is a fraudulent company.
They have given me lists of doctors who they claim to accept Ambetter. None do. I've spent hours on the phone with Ambetter and it seems like when questions I'm asking are to difficult for them to answer I get hung up on. I've called several of those Drs and when I tell them I have blue cross blue shield they will make me an appointment to see them. But when I tell them I actually have Ambetter then suddenly they aren't taking new patients. I have a brain tumor and need my yearly MRI. My neuro surgeon no longer accepts Ambetter. They gave me another Neuro who is suppose to take this insurance and told me that it is possible that after Ambetter reviews the MRI request they could deny the MRI because nothing proves that my symptoms have worsened and therefore they don't find it medically necessary. When I asked who makes this determination they said they have a couple of physicians who review it. Ridiculous. I found out from several physicians that they quit taking Ambetter because they are not paying on claims. I'm going to call the Texas dept of Insurance and file a major complaint.
When I had a broken foot and after visiting the ER I was referred to see an orthopedic surgeon. Of course they don't accept Ambetter. It took 2 weeks for Ambetter to finally give me the name of a orthopedic who really does accept this plan,, how ever this only DR is located 2 hours away from me.
They still can't get my info right after 10 months. When I call the automated system says that my member ID is not a valid ID. They still have my zip code wrong so that when I call I have to use my current street address with my past Zip Code! Unreal.
Do not purchase a plan from Ambetter!
Did not pay 100% preventative per policy
I received a colonoscopy that is preventative that I understood per the policy is paid 100% . (I have a history of rectal and colon cancer my family.) They arbitrarily shoved my remaining deductible of 375.41 to me for the colposcopy but no explanation of what specifically was not covered.
(Yes, I received a EOB but it doesn't show anything to find that out. I called Ambetter and the girl on the phone said she "thought" Ambetter "perhaps" made me pay for the anesthesiologist. Isn't that a necessary part of the procedure? The year before last I had a routine annual physical and that is preventative too.
They made me pay for some of the lab tests as said that since I have, a. low blood sugar, and b. high cholesterol, that I had to pay for the lab tests for that part of the physical. This year I had another routine physical with the same tests, and they paid 100%.
I talked with the ombudsman (person?) on the phone and she really beat around the bush with no real basis other that there are a number of "ifs" in the policy that I can get charged or.
She reportedly processed my complaint, but I never heard anything from anybody. I will drop them next renewal, but in the meantime I am filing a compliant to the state board of insurance.
Customer Service - Poorly trained
Read your Policy
In regard to your comments they are incorrect. The government subsidy you received was taken away by the Health Insurance Marketplace.
This more than likely because you did not comply with their requirements as they stipulated in writing to you. In regards to comments of not finding doctors once you are mistaken. They may not have a huge amount of doctors or OB/GYNS but this out of the control of an Insurance company because the providers are the ones that determine what insurance they will accept. Finally in regards to the medication you did not follow the correct procedure of your doctor sending the correct documentation.
In short of complaining read all documentation that your policy tells you.
Educate yourself before you have a legitimate complaint. The only person to fault is you for your blatant lack of reading.
Constant uninformed premium and coverage increases
Ambetter - Health Insurance Review
They refused to pay doctor
Ambetter in Georgia. Avoid!
We have the same problem in Georgia. We did not pick the plan, we were "placed" in it by the marketplace when our previous provider withdrew from the state.
We received repeated emails in December saying the premium for January was "overdue" (none showed an account number or member ID), it was paid in good time and then we have never heard from them again. The marketplace web page shows we are covered, the insurers automatic phone system says we are covered but we have no member number and no ID card. Ordering a card on the automatic system says it will be 7 to 10 days and to print out a card on the web site, which you cannot access with a member number...
Our premium is over $1,300 per month for horrible coverage that is essentially in-network only and we have not had access to coverage for half a month. We are going to see if we can find a class action law firm interested in taking on vultures.
No refund
unless you are desperate don't bother w this one. i've been waiting for my refund for 4 months.
everytime i call they come up w brilliant stories n excuses. every time i call i had to stay on line for minimum 90 minutes. as i'm writing this letter they put me on hold for another 20 minutes. i'm not sure if i will get money money back.
forget about the services. I'm still on hold. When I've reached the manager about a month ago I thought I'll get my money back. He sounded sincere enough but today he won't even answer my call.
I really don't know what to do. About a month ago the manager P ( I don't want to reveal his last name which starts with a letter P) said the company will make a direct deposit to my bank account which will take between 2 to 3 days. I've waited for a week. NO DEPOSIT.
I've called him back. This time he said the company policy is mail the physical check for the refund. He said wait for a few more day to receive the check by mail, a week went by. I called today and the rep who answer the phone said the company sent the e check to my email.
I've told the rep I didn't receive any and her story contradicts to what the manager said. I don't know whose lying but somebody is. See what happens from now on.
If you're curious about the story shoot email to me. I'll give you the follow ups.
- Way the company handle the business
- No reliable way to contact them
Preferred solution: Full refund
Ambetter - Affordable Care Act Health Insurance Review
Ambetter - Health Insurance Review
Run!!! Do not get this insurance!!!
I have had the insurance for three months, and they still have not provided me an insurance card. I have called 11 times and they keep saying they will send it for the last three months and still have not. I am pregnant and my OBGYN needs the actual card but I don't have one. I got sent away today from getting my blood drawn because they need the actual card and not just the number.
I called Ambetter and they won't fax or email a copy of my card to the lab leaving me with no medical services provided despite paying every month. They are a scam, do not get this insurance..
Ambetter - Health Insurance Review
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Doctors and hospitals do not want to accept it because Ambetter is cheap and does not want to pay even an average cost. For example I got a statement from a specialist for $205.00 and Ambetter only paid $9.50.
I was shocked. Every statement received no matter what the medical service has been is the same.