Skip to content
  • Login
Ambetter

Ambetter

www.ambetterhealth.com
What is your customer experience with Ambetter?

Ambetter Overview

The aggregated data is based on reviews and questionnaires provided by PissedConsumer.com users.

  • Ambetter has 1.5 star rating based on 412 customer reviews. Consumers are mostly dissatisfied.

  • 36% of users would likely recommend Ambetter to a friend or colleague.

  • Rating Distribution
  • Pros: No pros, Price, Price and affordability.
    Cons: Inconsistent information, Customer service and could not get help, Poor customer service.

View full overview ›

Media from reviews

Ambetter - Payment
Ambetter - I'm having trouble activating my rewardsAmbetter - I'm having trouble activating my rewards - Image 2Ambetter - I'm having trouble activating my rewards - Image 3Ambetter - One month in and can’t get an answerAmbetter - Pain doctorAmbetter - I need to speak to somebody about a denial
View all media ›

Top Ambetter Reviews

Positive Review

"Reading other reviews"

stars-rating stars-rating stars-rating stars-rating stars-rating

I have been reading the reviews and I just hope I dont have any of those problems going forward however since I have been with Ambetter I have had excellent...

Critical Review

"Damaged watch"

stars-rating stars-rating stars-rating stars-rating stars-rating

I order the watch from Ambetter rewards. And upon receiving it. It was damaged called Ambetter. They gave me the manufacturer number called them they say they...

Show reviews that mention
number reason incompetent emergency husband spot contact scam text member
Filter review
Sort by
Anonymous
map-marker Fort Worth, Texas

I'm so sorry! I accidentally used this not realizing what it was for. I'm not upset at all about any of your services

Nothing! Using this platform was totally an accident.

I'm sorry for wasting your time.

Have a very merry Christmas.Your staff have been wonderful to me . No complaints at all .

View full review
Calvin V Zos

This review is from a real person who provided valid contact information and hasn't been caught misusing, spamming or abusing our website. Check our FAQ

Verified Reviewer

I think a check was mailed to me and it got thrown away

I talked to someone, but I don't think they understood what I was saying. I received letters from AM Better, and they got thrown away. It was more than likely a check, but she wasn't understanding it.

View full review
Loss:
$298

Preferred solution: Deliver product or service ordered

Wendy L Zhy

This review is from a real person who provided valid contact information and hasn't been caught misusing, spamming or abusing our website. Check our FAQ

Verified Reviewer

Trying to find out what pharmacies I can get my Covid shot with

The agent could not have been more helpful. I went to Walgreens in Austin on Justin Lane to get my free flu shot. It was out of network for $45.00.

View full review
Loss:
$45
Pros:
  • Helpful
  • Low deductible
Cons:
  • Hard to contact
  • Had to have drs resubmit claims

Preferred solution: Full refund

User's recommendation: Make sure to check to see if your insurance covers where you want to get your shot.

Tired of being ignored?

PC collective complaint

Start a collective complaint today and gather other consumers facing the same issue with a company. By collecting 20 signatures, you can raise awareness, and your complaint will be sent directly to the company.

Start Collective Complaint
Carl d Nsc

This review is written by an individual who has purchased the reviewed product/service and/or confirms being a paying customer of this company. Check our FAQ

Verified Buyer
|

This review is from a real person who provided valid contact information and hasn't been caught misusing, spamming or abusing our website. Check our FAQ

Verified Reviewer

Damaged watch

stars-rating-full stars-rating-full stars-rating-full stars-rating-full stars-rating-full
Contains 1 confidential file for company representatives

I order the watch from Ambetter rewards. And upon receiving it.

It was damaged called Ambetter. They gave me the manufacturer number called them they say they don't know who I am. Even though I gave them my number.everything.

they still won't replace it 30 bucks down the drain. I think I will never order from them again.

View full review
Loss:
$30

Preferred solution: Full refund

User's recommendation: Don't go there

Emma H Wqz

This review is from a real person who provided valid contact information and hasn't been caught misusing, spamming or abusing our website. Check our FAQ

Verified Reviewer

Need help with plan

Help me get an affordable plan for my medical. I applied for gold, and it was supposed to be $230.

Now they are saying that it's $360, and I can't afford it. When I applied on December 27, 2024, it was $230 and I paid that. Now, I cannot get insurance because it went up to $360, which is out of my budget. Penny made the arrangements with you guys for my insurance.

All I ask is that you guys get me some insurance that I can afford. Penny sent me to Ambetter, and Betty sent me to Penny. Send me back to Ambetter. That's enough.

Please help me. Ambetter has $230. All I want is that you guys give me some insurance for my $230, which I can pay a month.

Instead, I get a headache and I can't breathe all because you guys made a mistake. Please help.

View full review
Anahio Y

This review is written by an individual who has purchased the reviewed product/service and/or confirms being a paying customer of this company. Check our FAQ

Verified Buyer
|

This review is from a real person who provided valid contact information and hasn't been caught misusing, spamming or abusing our website. Check our FAQ

Verified Reviewer

Providers list not updated: only a few active providers

stars-rating-full stars-rating-full stars-rating-full stars-rating-full stars-rating-full
Contains 2 confidential files for company representatives

Doctors and specialists, for some reason (I don't know), are abandoning Ambetter. Our GP left, we chose another one and she left too.

My wife and I don't have the annual physical and her mammogram is overdue, but her gynecologist also left Ambetter. We have tried to find a place to go directly to get her mammogram done on behalf of Ambetter, however, we have not been able to find one as Ambetter has not updated their provider list in years (all of our providers who left Ambetter are still on the list).

View full review

User's recommendation: Start looking for a new Health Insurance

Patti S Qmh

This review is written by an individual who has purchased the reviewed product/service and/or confirms being a paying customer of this company. Check our FAQ

Verified Buyer
|

This review is from a real person who provided valid contact information and hasn't been caught misusing, spamming or abusing our website. Check our FAQ

Verified Reviewer

Worst insurance EVER!

stars-rating-full stars-rating-full stars-rating-full stars-rating-full stars-rating-full
Contains 1 confidential file for company representatives
Original review updated Aug 15, 2024

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.

View full review
Loss:
$2146
Cons:
  • Are fraudulent in the state of florida needs to shut them down
  • Given the run around when looking for dr in network
  • Way company did not respond or call back

Preferred solution: I want my premiums back! I want reimbursed for having to use the ER to get prescriptions because they did not have a PCP.

User's recommendation: RUN! No one wants to take this insurance!

Patti S Qmh

This review is from a real person who provided valid contact information and hasn't been caught misusing, spamming or abusing our website. Check our FAQ

Verified Reviewer

NO PCP

stars-rating-full stars-rating-full stars-rating-full stars-rating-full stars-rating-full
Updated by user Sep 11, 2024

They could not supply me with a PCP my prescriptions required prior authorization by a PCP therefore I could not get the authorization so I had to go to the hospital to refill my prescriptions twice causing the bill to reach $1600 and they don’t care. It was escalated to their escalation department who called me back and said nope we’re not doing anything, I paid for service they failed to provide and basically they don’t care. They got their money!

Original review Aug 12, 2024
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.
View full review
Loss:
$1600
Cons:
  • Everything about it

User's recommendation: You are better off with no insurance than this garbage.

Anonymous
map-marker Keystone Heights, Florida

Completely incompetent

stars-rating-full stars-rating-full stars-rating-full stars-rating-full stars-rating-full

I am not a member, my husband signed up through some scam phone call and for whatever reason possibly because I am his emergency contact, and they put my number in the wrong spot... Anyway I am getting text messages intended for him.

I have informed them of the correct number. They refuse to change the number and keep texting me.

View full review
Carol g Kuc

This review is from a real person who provided valid contact information and hasn't been caught misusing, spamming or abusing our website. Check our FAQ

Verified Reviewer

Daily lies or incorrect info. They cannot even guide me to a PCP without conflicting info with their reps. Total incompetence and apathy.

stars-rating-full stars-rating-full stars-rating-full stars-rating-full stars-rating-full

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.

View full review
Pros:
  • No pros
Cons:
  • All cons literally

Preferred solution: A PCP

User's recommendation: DO NOT USE AMBETTER.

7 comments
Guest

Same. Can't get a primary care.

The one they assigned me no longer working for Franklin Primary Care Center. Okay. I then called and asked them to reassign. First, they gave me a name who turned out to be nurse practioner at a uriologist office.

Then, they gave me two names that were pediatricians. I then called Franklin Primary Care myself and verified that all there doctors take Ambetter and made an appointment. I called Ambetter to let them know my new primary care and they don't have her in the system. I told them just o add Franklin Primary Care and that was also an issue.

I had Blue Cross Blue Shield before. I wish I had never changed.

Guest

File a complaint with the Attorney General -Consumer Protection Agency and the Insurance Commission. The more complaints are filed the more awareness is made for a potential investigation .

Keidra Zqn

With Ambetter do you get credits that you can spend every month?

Guest

Same here, lies they are charging aca, I am going to the state with this

Guest

I can also attest that When you get anyone from ambetter in the phone they are in some other country and have no idea how our health system works here. You cannot speak to any American that works for ambetter because there aren’t any.

You get a different answer everytime you call. The deny claims as much as possible even for a flu shot.

Guest
reply icon Replying to comment of Guest-2409532

So agreed. It's really annoying.

They literally gave me a urologist and a pediatrican as my primary care. I mean do they know what those words mean?

Guest
reply icon Replying to comment of Guest-2409532

As soon as they answer I request to speak to someone in the US and they transfer me but it doesn't matter you will still get the runaround and/or lies.

View more comments (6)
Anonymous
map-marker Miami, Florida

Poor customer service

stars-rating-full stars-rating-full stars-rating-full stars-rating-full stars-rating-full

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.

View full review

User's recommendation: find a different insurance, save yourself the headachce

Jessica Vvp

This review is from a real person who provided valid contact information and hasn't been caught misusing, spamming or abusing our website. Check our FAQ

Verified Reviewer

FRAUD

stars-rating-full stars-rating-full stars-rating-full stars-rating-full stars-rating-full

This insurance lied about EVERYTHING

THEY JUST WANTED FHEIR SIGN ON BONUS TO SCREW UP MY LIFE! I was told it was free.

I got a 7000 deductible! Im unemployed! I was told I could visit the clinic I need to go 5 days a week and I cant go! All my prescription's I listed were not free nor discounted!

I had better luck with the free discount card! You guys are completely ridiculous

View full review

Preferred solution: I had 5 different people tell me my clinic was covered. FIVE! I want this cancelled immediately! I have 0 income and you guys made up a scam for 7000 deduction

User's recommendation: No don’t do it

Doug M Biv

This review is from a real person who provided valid contact information and hasn't been caught misusing, spamming or abusing our website. Check our FAQ

Verified Reviewer

Already messed with me first week

stars-rating-full stars-rating-full stars-rating-full stars-rating-full stars-rating-full

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 ***

View full review
Loss:
$283
Cons:
  • Trying to rip people off two months in a row
  • Poor policy set up
  • Poor customer service

Preferred solution: Full refund

User's recommendation: Don’t sign up with AmBetter

Insurance Expert Talks

Exposed: Types of Insurance Scams and Fails

Exposed: Types of Insurance Scams and Fails

The insurance fraud: What is insurance fraud? What are the worst cases? How insurance fraud is discovered? How to protect yourself from an insurance scam? In this video, Charles R. Gallagher, an attorney, exposes the most common insurance fraud examples.

Read full article
Charles
Charles

Charles R. Gallagher, an attorney and managing partner with Gallagher & Associates. His practice focuses on insurance litigation, foreclosure defense and consumer law.

Maria A Ore

This review is from a real person who provided valid contact information and hasn't been caught misusing, spamming or abusing our website. Check our FAQ

Verified Reviewer

My health pays rewards

stars-rating-full stars-rating-full stars-rating-full stars-rating-full stars-rating-full

I earned a rewards card that has an expiration date of 09/27. I went to use it and found out it was deactivated.

When I called the company, I was told that because I no longer have insurance with Ambetter, the card was deactivated. This was what I earned while I was a member and should not have been deactivated.

They will not do anything about it. They do not warn people in advance, so if you have a rewards card, be sure to use it.

View full review
Loss:
$75

Preferred solution: $75 card replacement

User's recommendation: Use your card quickly

Luzdaniella D

This review is from a real person who provided valid contact information and hasn't been caught misusing, spamming or abusing our website. Check our FAQ

Verified Reviewer

Pésimo servicio

El peor seguro del mundo. Más de tres meses intentando una cita con mi médico primario y nunca me cambiaron la médico, nunca me solucionaron.

Llamé más de 8 veces. Ya me cambié de seguro.

View full review
Luzdaniella D

This review is from a real person who provided valid contact information and hasn't been caught misusing, spamming or abusing our website. Check our FAQ

Verified Reviewer

Negligencia

Desde mayo vengo intentando que me cambien el médico primario y no se ha realizado el cambio hoy después de haber llamado 8 veces en tres meses sin recibir mi medicación para paciente diabético es que me dicen que el médico no trabaja con mi plan hoy 6 de agosto he perdida tres meses de medicamentos por negligencia del seguro

View full review

About

Related Companies

Centene, Health Net, Ambetter From Buckeye Health Plan, Envolve Dental, Buckeye Health Plan

Summary

Ambetter is a number of health insurance programs offered by Centene Corporation. It a Fortune 500 company founded in 1984. Its headquarters is based in St. Louis, Missouri, United States. All Ambetter health insurance plans are certified as Qualified Health Plan issuers in the Health Insurance Marketplace. The plans offer a wide variety of health options with various coverage and payment rates. Featured plans are as follows: Ambetter Essential Care (Bronze), Ambetter Balanced Care (Silver), and Ambetter Secure Care (Gold). Ambetter health insurance plans may also offer nurse advice line 24/7, integrated care management, optional adult dental coverage, optional adult vision coverage, and comprehensive medical coverage.

Ambetter reviews and complaints

Ambetter is ranked 315 out of 2291 in Insurance category

Area Served

USA

Payment Methods

VISAPayPal

Why Trust Reviews on PissedConsumer?

  • Professional auto and live moderation
  • 100% user-generated content
  • Equal opportunity and protection
  • Zero tolerance for fake reviews
  • Verified content
  • PissedConsumer is on the Inc. 5000 list

For more information read Blog article