ambetterhealth.comReviews of ambetterhealth.com

I am paying for the Focus VALUE Silver + Vision + Adult Dental plan. I chose this because it's the only one I could afford (including a $390 a month tax credit) and because it says that it covers dental. The catch is that this insurance plan does not cover even 1 dental location in all of Fort Worth. So I'm stuck here paying way too much without any way of getting my money back and my teeth are still rotting away.

Do not EVER use this insurance, it is a scam. Buckle in. I had this insurance with my husband(at the time) for a little over a year. When all of the sudden I got a letter in the mail of a cancellation notice. I went online and sure enough my account was cancelled. The issue was that it said I owed them over $2,000 and that my premium went from around $35 to $650 something. I called and the person I spoke to told me he had to use an OUTSIDE TOOL to identify what the issue was. He told me my tax credit was removed from my account bringing my premium up to the original price for the insurance. I told him I never changed that myself and my husband didn't even know the information to get into the account so who did it? and he couldn't tell me... I never got an notifaction that my payment didn't go through or that I missed any until the cancllation letter came in the mail. They apologized and offered to set up my account with them AGAIN because that is the only way they'd be able to access my information to forgive those months that were not paid. I didn't want to but I did it. They told me that since this wasn't my fault, they would forgive the payments. Tax season came around(for 2023) and I filed with my 1095-A form and because of that hiccup, I owed over $1,900 for my taxes. I called them to see why that is and they claimed it was because I filed married separate instead of joint with my spouse(we were separated and not talking at this point). However, I don't recall ever recieving notice or even being informed that this would happen and that I would have to file a specific way in order to have those forgiven. Even WORSE, I went to file my taxes this year and they were declined because I didn't fill in my 1095-A form, however, I never received it. When I called to get it, they claimed that I didn't get it because they listed my EX HUSBAND as primary. Although I created the account, I made decisions on the account AND every payment was made with a card in my name. Did they just assume the husband was in charge of the account? This is ridiculous because the reason I had to pay the totality of what was due was BECAUSE I was primary. My ex husband paid nothing because of this incident. Anyway, I went to file with my form and aparently they decided to get every single cent they wanted and charged me the regular amount for jan, feb, and march. So this year I now oww $833 because of something that occurred on THEIR end. Do not trust this insrance and make sure to do HEAVY research before you make your decision.

Im really shocked to see the low rating. I have the silver plan. After 12 years a die hard BCBS customer, I was done with them. If anyone thinks Ambetter is tough, just try BCBS. Initially transferring 3 years ago, there were a few teething problems that upset me, and were at odds with what was on their website. However, they provided me with a dedicated representative and made special provisions for me. Yes I've had issues with them, but less than with others. Also, I've been able to find resolutions and resolve my concerns with ease. They provide telehealth which has been great, they have dedicated nurses and professionals to assist you with most of your needs. I pay far far less, out of pocket. Prior authorization so far have been excellent. Try getting help indicated for weight loss with a BCBS etc. They denied every medical procedure, often only getting approved while im at a medical facility, the stress caused was awful. If you've come here to leave a bad review because you've had enough. I'm telling you to try calling them again. Im only getting the same numbers as you. If you're picking a plan that's basic, because you don't want to psy a premium, knowing it will not cover your complex medical needs, then that's on you. I picked a plan suited to my needs, I have multiple overlapping autoimmune diseases, I scrutinized the plans, searched for in network doctors in my area, entered all my medicines to see if they'd cover it. I researched the plans and opted for what would cover my needs. If you picked a plan because there was no additional premium. That's on you! Your choosing a Health Insurance, everyond should research a plan to ensure it will meet your medical needs. I love Ambetter. My experience is positive.

First off you might as well NOT have insurance dealing with this company! On top of that the last two times, I have received mail with my address and SOMEONE ELSES ACCOUNT INFORMATION! I will be reporting this to FTC(Federal Trade Commission).

Bought the bronze plan through the Georgia access portal. Plan says Ambetter will pay 100% of costs after deductible. Ah but the catch is they have to approve. My hip has gone totally bad and I’m crippled and I can no longer walk without a cane, I have to use the electric cart in any store and I can’t work and I’m in constant pain. Orthopedic specialist says I absolutely need a hip replacement to walk again and be pain free. Ambetter denied my treatment for no reason and denied my appeal again. I’ve been paying them $1000 a month for 3 years and have never needed anything till now. What a total piece of s*** company. Do not expect anything from this insurer. They have one of the highest rates of denial at 19% of all surgical procedures regardless of your need. They do not care about you and they don’t have to cover anything they don’t want to. Their rate of reversal on appeal is half a percent. That’s one out of every 200 cases no matter how much pain you’re in. I feel so stupid that I thought that if I needed them they would be there. Pay attention to the 3 star rating they have. If you were buying something off Amazon would you buy the 3 star rated items, NO you wouldn’t. Next year if Trump hasn’t screwed up my insurance I’m going to get the 5 star rated company plan that I didn’t like because you have to go to their facility instead of going to the doctor of your choice. Turns out now that I’ve looked these things up, that other company plan has only a 6% denial rate which is way lower than Ambetter. Too bad I can’t post a review where it would count on the Georgia access portal where people would see it. Guess I’ll be riding the cripple cart till next year. Thanks for nothing Ambetter

They excel at collecting premiums. If you are sick and need a doctor plan on spending hours on the phone only to find out that their provider list is wrong and/or out of date. I made 7 calls to what seems like their customer torture department and STILL can’t get an appointment (in a metro area of over 250,000 people. The executives must not be aware or care how bad this service is. If ANY of them pretended to be a customer and called their own service they would find out how bad and incompetent they are.

I had to switch insurance companies because the plan I was with left my state. After speaking with a representative from Ambetter, I was assured my medications (all generic) were covered under their formulary. Now that I'm trying to get them filled, almost all of them are requiring prior authorization. To make matters worse, the company constantly lies about getting the prior auth paperwork, reps tells me different stories every time I call, (some say no pror auth required when it does, some say waiting on paperwork when dr has sent numerous times, others say not received, then others say it was received but they already closed the claim, etc). Meanwhile I don't have my meds so I'm sick. It should be criminal to do this to people! can't imagine what will happen if I need a scan or hospital stay.

I didn’t even wanna give them a star, but you have to to write a review. I don’t know who they are, but they said I’ve been having insurance with them for six months of 615 a month. Who in the right mind would pay that I’m fighting this company I don’t even know now For insurance. I never had. It’s ridiculous.worst ever.