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Ambetter Health Insurance Review

282 Customer Comments & Reviews - see all comments
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Ambetter is a health insurance company owned by the Centene Corporation, which is a multi-national healthcare company that provides programs and services to under-insured and uninsured individuals. Ambetter offers customers affordable health care plans in 14 states including Arkansas, Arizona, Georgia, Florida, Indiana, and Nevada, among others.

Ambetter is Centene Corporation’s option for a health insurance marketplace, so it’s intended for individuals who lack health insurance, and possibly don’t qualify for traditional plans.

What’s Included in Ambetter’s Health Insurance Plans?

Ambetter health insurance plans offer prescription coverage, mental and behavioral health services, integrated care management, maternity and newborn care, 24/7 nurse advice line, Ambetter Telehealth, My Health Pays Rewards, and optional vision and dental coverage for adults.

The company has three plan options to choose from: Ambetter Essential Care, Ambetter Balanced Care, and Ambetter Secure Care, which are classified as bronze, silver, and gold, respectively.

The Ambetter Essential Care offers lower monthly premium payments, but higher out-of-pocket expenses, the Ambetter Balanced Care offers the best balance between monthly premium payments and out-of-pocket expenses, and the Ambetter Secure Care has higher monthly premium payments, but limits your out-of-pocket expenses.

Each plan has a different type of coverage and payment, but all of them include essential health benefits such as emergency services, hospitalization. outpatient or ambulatory services, preventive and wellness services, maternity and newborn care, pediatric services, mental health and substance abuse services, and laboratory services, among others.

Final Thoughts

Overall, Ambetter offers flexible healthcare options that fit different budgets and needs, with a few perks like the company’s My Health Pays Rewards, which allows customers to pay for medical expenses with the money they earn through the program, a 24/7 nurse advice line, and Ambetter Telehealth, which provides 24/7 phone or video access to in-network providers for non-emergency health issues. Additionally, Ambetter members can manage and pay for their account online, and the company’s website offers helpful tools like a provider search engine, and educational articles for those who want to learn more about insurance.

Having said that, Ambetter health insurance also has its drawbacks, like the fact that it’s only available in 15 states, you must sign up during the open enrollment period, and that the company may have stricter requirements to qualify than other traditional insurance companies, so customers should keep this in mind before purchasing.


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282 Customer Comments & Reviews

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Karon F
2/4/2023
The worst. Plan changed my UC MEDS to tier 3. Can’t pay 150 a month. Nothing else works. Mesalamine is it. BEWARE.


Kelly F
1/31/2023
I couldn't even stay with Ambetter Health Insurance for a month. I never got a correct ID or policy number. They couldn't understand that I was a twin and they had merged my sister and my accounts together. They gave me my sister's Member ID and Policy number so I was never able to even activate my account. They changed my sister's account name to my name without any permission from my sister (she had her account for over a year). They would not fix these issues so I had to terminate my Ambetter Health Insurance completely and move to a better insurance company. Save yourself the headache and DO NOT CHOOSE AMBETTER HEALTH INSURANCE.


Eva A
1/27/2023
This company utilizes weaponized incompetence to deny valid insurance claims. I have been going around with Ambetter for close to 9 months trying to resolve two medical bills that should have been paid. It has been impossible to get any help, the customer service agents, who I can barely understand (I know that sounds awful, but its just true) refuse to escalate my issue to someone above their pay grade. It is beyond frustrating. I had a policy for January and February 2022 for myself and my family. Two of my children had appointments with their pediatrician during that time period. My family and I got behind on the payment for January and February, so when the clinic billed the... Read More


J
Jen
1/26/2023
Customer service sucks!!!! Every time I call them, I never get any one that speaks or understand English and they do not understand my concerns. The entirety of the call is trying to get the pharmacy-Envolve--included in on the conversation since online, in my profile, the drug I need states covered and all I need is a prior authorization. I've been denied twice! When I signed up for this damn insurance, I specifically got this one plan because this drug is covered. WTH--they suck--All I want is this specific medication, because all others I have tried and that have been prescribed aren't working--come on man, do better!


tina.perkins89
1/24/2023
customer service sucks.... been on hold 1:45 and still counting. refuse for authorization of MRI.... I guess that wait for u to become unalive


jones.suzjones
1/19/2023
Ambetter considers the generic rosuvastatin a Tier 3 drug so that they can rip you off!


T
TT
1/11/2023
Signed up through healthcare.gov and it's been nothing but a circus act / Twilight Zone looping ever since. First, they had a "system error" so the plan I signed up for in November 2022 was non-existent. I found this out on Jan 4 after calling to inquire about having received no paperwork, confirmation, etc. and after 20 minutes of going over everything with the rep, thought it was resolved. Nope! I found out on Jan 10 nothing AT ALL was submitted after that Jan 4 convo with a rep. After 57 minutes on hold with Ambetter, the "Escalation Team" stated they would escalate the issue and I'd be able to fill my rx in 24 hours. NAHHH, that wasn't true either. Today, Jan 11, I called back only... Read More


unwaveringnapkinpants
1/10/2023
Oh and their customer service is a call center in India. Not knocking on the Indian employees (they are good people I'm sure) but I really wish in this day and age of telecommuting that they would hire AMERICAN customer service reps who are more fluent in the language and better able to communicate with members.


Anita E
1/10/2023
Waiting for radiology approvals has been a HUGE set back on my brain AND hip costing me time money and frustration !! I can't walk without extreme pain I can't focus to train at another field on seizure medicine or another reason and it's been so long my pcp tried ordering an mri and denied she wasn't a specialist so if your sick with common issues the price is affordable but the quality is simply torture a patient till they give up. Saves cost that way .


unwaveringnapkinpants
1/10/2023
Horrible insurance. Was enrolled through Marketplace, and my monthly premium costs changed four times over 3 years of having Ambetter ($150 to $50 to $15 to $80). My primary care doctor kept getting changed on me, and if you live somewhere rural be prepared for a LONG drive to see a specialist for anything because you may not find anyone local who accepts Ambetter. I could not ever locate an OBGYN within driving distance of my house. I do appreciate urgent care visits being covered, but prescription coverage is lacking. I needed prescription eye drops for short-term use while recovering from a severe corneal abrasion and staph infection. Ambetter would not cover my prescription at all,... Read More



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