Ambetter

They will give you the run around day after day with no resolve while they collect the credit from the government. I have been trying to get a PCP from them since 8/2/24 I live in Orlando.

They do not have one accepting new patients. I have had to go to the ER to get refills on my medications for diabetes(Insulin) and Synthroid due to not having a thyroid. They claim to escalate it but they never did and now they are demanding that I pay my premium or they will not help me. I told them I will pay the preminum once they give me a PCP I cancelled them through the marketplace just now.

BUYER BEWARE!

They will not cover CGM unless you are on insulin 3 times a day, They did not cover my Insulin. I ended up paying for everything out of pocket anyway while they collected the tax credit and my premium!

Every time you call you will be told something different, they will lie to you and tell you it is escalated when it isn't.

This company seems fraudualnt.

This is the worst Insurance EVER! They do not have a PCP that is accepting new patients in my area (ORLANDO!!!) and I need PCP prior authorization to get my prescriptions of Insulin for blood sugars over 400 and Synthroid because I have no thyroid.

I keep having to go to the ER to get refills that cost $820 co-insurance payment after a $20 copay. I have had to go twice.

I call them and get zero answers, first I was told that it would take 3 to 5 business days for someone to call me back now I am being told it will be 7 to 10 days before they get back to me. Now I am not able to access my account at all.

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 that it was impossible for that to happen and the previous rep made a mistake because only the Marketplace could switch from virtual to in person--not an Ambetter employee.

So Then I called Ambetter a day or so later for more hours on the phone with them, and this time the rep told me that Babylon (virtual care) would be my PCP. However, on Ambetter's own website, it says that Babylon is no longer in existence, and that all appointments through Babylon had been cancelled. Ambetter continued to give me the incorrect info to contact Babylon for PCP coverage, even though Ambetter's own website said to no longer contact Babylon. So I did call Babylon as the incompetent Ambetter rep instructed me, and Babylon told me that they are no longer in existence, and that all appointments scheduled with them had been cancelled.

So then I called Ambetter again (each of these calls lasts for hours because they put me on hold for at least 45 min each time, and then I'm mysteriously disconnected, then I call back, etc). Then after a couple hours, the Ambetter rep confirmed what their own website says, that Babylon is no longer in existence so therefore I can see an in person PCP. They gave me the name of a doctor that accepts Ambetter, and when I asked them to confirm, the next rep said that I had been given wrong info by the previous Ambetter reps, and that I do have to see a virtual dr through Teledoc since Babylon is not in existence So then I spent hours setting up a Teledoc call by following the instructions of Ambetter. When I had my Teledoc appointment, I told the Teledoc doctor that I needed to establish as a new patient with Teledoc.

However, the Teledoc doctor told me that NO doctors through Teledoc can be PCPs, and they have NEVER been able to be PCPs. So then I called Ambetter then next day and of course the rep denied that Teledoc cannot be PCPs, even though Teledoc specifically told me that. Then after a few hours of being on hold, the rep told me that it's true that Teledoc cannot be PCPs. HOW IS IT POSSIBLE THAT AMBETTER REPS TOLD ME TO CONTACT THEIR PROVIDER FOR VIRTUAL (Babylon), AND AMBETTER REP WOULD NOT KNOW THAT COMPANY IS NO LONGER IN EXISTENCE.

This was their ONLY COMPANY for virtual...but the reps did not know the company was closed. I've wasted literally hundreds of hours on the phone because of Ambetter's incorrect incompetent uninformed uncaring protocol. THEN HOW IS IT POSSIBLE THAT I WOULD SPEND MANY MORE HOURS ON THE PHONE WITH AMBETTER REPS (after the first disaster of their incorrect, or possibly lying info about Babyon)WHEN THEY THEN TOLD ME THAT I MUST CONTACT TELEDOC FOR A PCP, WITHOUT THE AMBETTER REPS BEING AWARE THAT TELEDOC ABSOLUTELY CANNOT BE PCPS?? Are the reps lying to make their job easier and get the customer off the phone?

Are the reps that uninformed and complete lack of training to not even know the Teledoc CANNOT serve as PCP (as they insisted to me for hours that I must contact Teledoc for my PCP). Fact: the representatives have no idea what is going on in the company or how to help their paying customers get the services that they are paying for . They don't care. Complete untrained, uninformed incompetence and apathy.

Next day: After hours more on the phone with Ambetter, they finally admitted that Teledoc cannot be PCPs and Ambetter gave me the number of a local dr that can serve as my PCP. I went to that Dr yesterday. Today I called Ambetter to update that Dr THAT AMBETTER SENT ME TO as my PCP, and Ambetter told me that THE VERY DR THAT AMBETTER REFERRED ME TO GO TO THE PREVIOUS DAY TO BE MY PCP IS ACTUALLY NOT A PCP, and that his entire practice are specialists. Note: this is the exact dr that Ambetter told me the previous day to go to for a PCP, but the next day, Ambetter is denying the claim and saying that he is not a PCP...mistakenly saying that his entire huge practice are all specialists.

None of them are or have ever been specialists. I"ve been on the phone with Ambetter for hours each day for almost a month JUST FOR THE PURPOSE OF GETTING A PCP, and this still is not solved because of all of the ridiculouly incorrect info, incompetence, and apathy of Ambetter. MY ADVICE: NEVER USE AMBETTER AS YOUR HEALTH INSURANCE. Ambetter has mistakenly listed the entire group of PCPs at Athens Internal Medicine Associates (St Mary's Medical Group) as "Specialists," NOT PCPs as they are.

Therefore, Ambetter will not allow my PCP there (Dr Brandon Taylor) to make a referral to a specialist for me because Ambetter says that Dr Taylor and all of the doctors at Athens Internal Medicine Associates are specialists, which they are not. I've been sent to the "escalation team" at Ambetter, and they've told me the same thing...that all of the doctors at Athens Internal Medicine Associates are specialists, NOT PCPs, which is entirely incorrect. Ambetter does not care to correct this. Each day for almost a month, I'm placed on hold with Ambetter for over an hour, and each day my phone call is mysteriously disconnected.

I call back, and the same thing happens. On Tues Aug 15, I actually got to talk to a live person from the escalation team at Ambetter, and he was supposed to call me back the following dau at 5pm to see if the situation above had been resolved but of course, he did not call me as he said that he would. Ambetter is the most incompetent, uncaring, unorganized scam of a business I've ever encountered. I"ve been on the phone with Ambetter for hours each day for almost a month JUST FOR THE PURPOSE OF GETTING A PCP, and this still is not solved because of all of the ridiculouly incorrect info, incompetence, and apathy of Ambetter.

My advice is NEVER USE AMBETTER AS YOUR HEALTH INSURANCE. I've asked THREE TIMES TO FILE A GRIEVANCE BECAUSE OF THE INCORRECT INFO (or lies) THAT AMBETTER HAS GIVEN ME AND THE 40-100 hours THAT I"VE HAD TO WASTE BECAUSE OF THEIR INCORRECT INFO (or lies), BUT NO ONE HAS FOLLOWED UP WITH ME ON FILING A GRIEVANCE ON THIS INCOMPETENT (Imo CORRUPT) COMPANY.

The fact that when you call you're transferred to a foreign country that makes it hard enough to communicate is one thing, but throw in that their incompetent and no one knows what they're doing. I've been placed on hold and spoke to numerous representatives all to be told lies because they wanted their money.

How are you still collecting your premiums if my account was terminated... mind you I wasn't even aware.

And when I called to find out why I was given the run around and had the call transferred to the market place when I asked for a supervisor. Next open enrollment Ambetter doesn't have to worry about collecting any premiums from me.

I signed up for AmBetter of North Carolina off the healthcare marketplace because I just lost my job and it showed fairly decent pricing. I signed up for June and paid on June 1 and it showed processed by June 3 in my bank but I get email after email on June 4 stating in order to activate the plan.

I need to make a payment. I called the damn line and after four minutes of waiting for a human they tell me I need to make a second payment for coverage for the next month because they do two months together! Was that on the website and where was that on the Health marketplace because I saw that and I would never agree to pay two months worth when I just started the policy!

Ive already sent this to the Better Business Bureau as well because that really *** me off especially since I just lost my job and Im dealing with a dying wife at home who is on hospice. I have no time for this kind of ***

Yes from the minute I signed on with this insurance company ever had nothing but problems I tried to get a primary physician I was on the phone for 5 hours and every number they gave me was the wrong number that was not a primary it was for mental health or opiate addiction or HIV I I tried on again on Monday same thing I have earned 1,255 points as of 1106 it also says they were 1250 points were redeemed I'm not redeemed one point yet on anything also on 10/16 I had 1050 points and it also says that 1,000 points were redeemed and I have not redeemed nothing I have nothing wrong I have called numerous times to get this problem resolved and nobody seems to be able to help me I mean you shouldn't offer your clients things that you're not going to give them so somebody in your company is is using my money my rewards but it's not me I have called your customer service numerous times and got nowhere they have no idea what happened to my points yet because somebody use them obviously but it's right in my email I have the date the time everything I can screenshot it and send it to you I'm sorry if I sound a little upset but I am a little I'm a little bit peeled I mean it shouldn't be that freaking hard for your customer service to provide a primary physician without working phone number not for opioid addiction not for mental health not for HIV but a primary it is not complicated you need to hire people that's got some freaking brain cells but I have not been able to use rewards not one time I tried Walmart to get some bananas that didn't work I tried transportation and that didn't work it's activated the $25 is sitting there which is baloney it should have been like $250 to begin with so I would appreciate it if this problem would get resolved I've only been doing this since what October and then I switched to United and which I haven't used their insurance the only reason I switched is because I could not get a primary physician from your company so I would really really appreciate it if somebody would resolve my problem and figure out what is going on like with your customer service cuz they are terrible I mean terrible

They really should be called Amworse as not only are they worst insurance I ever had, you are worse off with than without insurance. First of all, besides the fact it is expensive, it is hard to find a doctor or even an urgent care locally/close by that accepts them, so expect to pay a lot out of pocket.

No dentists in my state accepts it, so needed extra insurance for that, they suspended me and tried to cancel my insurance without notice due to their own mistake and now they won't really cover my medication, it's almost the same price without insurance when before some were either $0 or at least under $20. Now they want $400 and without insurance, %400.

Do yourself a favor and stay away! I just found out they have tons of lawsuits against them.