ambetterhealth.com Reviews 

Besides the directories not being up to date, long times between appointments. Customer Service is awful. Unlawfully charged me for the 2026 policy event, though I canceled and chose another plan before the deadline. They say that they can't take a verbal cancellation because it is through the ACA government plan, which is total BS. I spoke to three agents because, as a former licensed health insurance agent, I knew this was incorrect. Would not accept the printout of my new Blue Cross plan with dates proving I canceled. No resolution and no way to cancel over the phone. "I must go through the government."
Update: I contacted a representative at Healthcare.gov on 12/16, and she dialed Ambetter because she said the information they were giving was false, and I was not the only one calling in with this false information from Ambetter. She remained silent while the agent repeated I must contact the government, even though I had purchased Blue Cross HMO for 2026, and it was before the deadline for enrollment (meaning I am not enrolled with Ambetter), and they were NOT authorized to debit a payment. Ambetter repeated that it was up to the government. The Healthcare.gov agent(who had been silent but listening) spoke up and totally read him the riot act and stated he was giving out false information and that Healthcare.gov has nothing to do with my premium and my payment to the insurance company. Therefore, Ambetter unlawfully took from my account. He backtracked and said he would refund my money in 30-35 business days. Could not explain why it would be so long when the payment was still processing in the bank and should be easily reversed (it is a debit card). I called the bank to report fraud and stopped payment. I believe they charged lots of customers on autopay the new, inflated premium, even if they canceled. Then they are slow-rolling the payback. Beware.

Save yourself. When it's time to cancel you plan, you will not get anyone on the phone. I have been on hold for 2 hours at this point but I refuse to pay another month because of their scammy behavior.

I would have given negative star, but it is not available.
Ambetter has the worst customer support I’ve ever dealt with. Nothing works properly, and the system feels completely broken. Many doctors refuse to accept this insurance due to its inefficiency, and I’ve personally been turned away by providers the moment I mentioned Ambetter.

I had a physical exam done by my own PCP, yet Ambetter denied the claim saying a referral from my PCP was required—when the provider is my PCP. After multiple calls and appeals, the confusion only got worse. What’s unbelievable is that the same PCP referred me to a spine specialist and Ambetter approved that referral, while denying the physical exam claim saying he wasn’t my PCP. Total contradiction.

The system is disorganized, customer service gives conflicting answers, and even doctors are clearly frustrated dealing with Ambetter. I would give a negative rating if it were allowed.

I would strongly not recommend this insurance to anyone.

You are stuck with low Quality doctors or and you must travel miles for constructive healthcare. If you need Phycological Health do not obtain this plain. If you just need check ups you good' and there are rewards to watch healthcare videos. Also look out for charges after care and end of the year bigger charges Thanks to the Ballroom man.

If I could give them zero Stars I would they try to force you to do their telehealth thing even though you tell them you're not interested they don't want to pay for any kind of prescriptions honestly they're worse than United healthcare have to fight tooth and nail just to get anything done

Never had a worse experience dealing with ANY company in my 61 years on this planet. Horrible on everything from coverage to rates to customer service.

The only positive thing about having Ambetter is that some places won't even see you if you don't have insurance. With the Ambetter insurance card, at least you can be seen by a doctor.

I’ve been paying the full price for the Elite Gold (QualChoiceLife) plan through the Government Insurance Marketplace and this has been the biggest rip-off I’ve ever experienced with insurance.

Despite having no deductible and coverage that’s supposed to pay a percentage of most services, Ambetter has denied almost every claim we’ve submitted. They’ve forced us to redo my child’s occupational therapy testing (which we already completed just months before switching), and we were told the testing cost would be out of pocket even though our primary care physician and previous OT test said it was necessary. My OT center said Ambetter was the worst insurance they have ever worked with. My other child has a significant speech delay and is nearly nonverbal — Ambetter has denied every claim for speech therapy.

To make matters worse, my husband’s cancer screening, which we were told would be covered, wasn’t paid for either.

For a plan that costs as much as ours (about 1.5x our mortgage), Ambetter has failed to cover even the most basic, essential medical services they promise to. Their app and website constantly crash — the app froze eight times yesterday alone, and the mobile site repeatedly leads to dead pages.

We’re switching as soon as open enrollment begins. If you’re considering Ambetter, think twice before trusting them with your family’s health.

I would leave the ZERO stars if possible as that is what they deserve. WORST HEALTH PLAN EVER!!! If you need a Healthcare.gov health insurer, pay more and get a real health plan. You'll appreciate it when you need to access health care if you do not have these fools. My wife and I have nicknamed them "Am-not-better" which is what you and your family will be if you enroll with them. Health plans in general are anti-patient and anti-payment (for claims) but in a sea of bad health plans AmNotBetter achieves the lowest of the low. All I can keep saying is "enroll somewhere else!!!" This plan sucks to high hell!!!

First ambetterhealth is an umbrella and you MUST talk to the correct subsidiary. They will forward you but most engagements take *hours*

Agents often don't forward correctly - just to get you off their queue (and perhaps some mis knowledge)

Numbers that used to work might no longer.

issues that required intervention - such as web site issues and auto pay - may suddenly break

Website(s) use entry-key - which can only handle ONE current plan - which is often NOT the case when finishing one year and starting a new one the next year (think ACA/Healthcare.gov)

Agents I never felt confident could assure me that I *was* paid through end of year even though I couldn't verify online (due to entry-id issues they could not resolve).

In summary
- website frequently doesn't work and entry-id is often half an issue
- website might not (depends on subsidiary) have accurate or complete information on payments etc
- website doesn't allow you to check both current and future (think ACA) plan accounts
- autopayments frequently dropped (which then gets to web site issues)
- friendly agents are often very incompetent in doing anything other than maybe looking up one payment? Maybe? Nothing further?
- Just overall crappy and if I wasn't stuck with them with ACA/HealthCare.gov I would never ever ever consider them again.

Ambetter insurance is harming my husband's health. He suffered a massive stroke a year ago. They are denying him MRIs and pain injections, which he needs to continue his therapies, which are also being denied. Who should we contact to resolve this?

Ambetter
The worst insurance plz don't get it you will be billed every where you go they give your wrong information all the do is take your money while you pay for your own bill you will be in debt with them like I am

Pay 753 dollars a month and have had nothing but denied claims,I had COVID and doctor gave me a Prescription for plaxlovid and they denied it then a week later they sent me a letter saying they would pay for some of it.you have 48 hours to take it or it's to late.had X-rays done on my back hospital said they take Ambetter insurance and ambetter refused to pay,said out of network.im stuck with 1300 bucks for it.horrible insurance company.and good luck talking to anyone you can understand.

I don't have this insurance but they keep spam calling my phone at least 4 time a week. When I did call back to try and figure out why they are calling I got hung up on twice after the representative said, "I'm done helping these stupid people" second time she said "these people are f@cking dumb." Worst company ever!!!!! and I don't even use them!!!

Do not get this insurance if a lawyer can read these reviews would be great. People are being denied diabetes medication, 40 yr old mammograms, brain MRI, Covid medication THIS INSURANCE IS ONLY GOOD FOR DOCTOR VISITS ANS IF YOU NEED AN ANTIBIOTIC!

Was trying to ask why my insurance always gets denied at drs and it was AI and no help at all. It was terrible. Switching insurance come January

They use customer service from India which every time my husband and I have called in they are almost completely unable to be understood through their very thick accents.
I've mailed in multiple authorized contact forms so that my husband could speak on my behalf when I am at work and yet somehow, they "never received them".
They keep increasing the premiums for their plans while at the same time decreasing what those plans offer showing they would rather just collect money than actually offer a decent product to consumer.

-10/10 Biggest scam ever that only exists because the ACA subsidies made the majority of their plans free to no cost.

This company deserves less than one star. This is theft and I’m extremely pissed! Do yourself a favor and go with ANY other company! The only reason I enrolled with them in the first place was because even though the coverage SUCKS on the front end, it’s great on the back end if you end up in the hospital. I unfortunately do quite a bit. I am a type 1 diabetic, and I have been getting the same medication with them for a year. Nothing has changed. My plan hasn’t changed, my premium hasn’t changed, etc. All of a sudden, the pharmacy is telling me that a pre-authorization is needed for my medication. This is medication that is keeping me alive by the way, it is medically necessary, and now I will be out of medication in 3 days. You might be wondering why I waited so long to get a refill, but again…no pre-auth was ever needed. I have a call in to my doctor but tomorrow is Friday, they say they can take up to 48 hours to get back to you, and I will run out of medication by Sunday. According to the customer service rep…pre-authorizations can take up to 72 hours JUST FOR A DECISION TO BE MADE. We all know how that goes. I’m sure after 72 hours, it will still be denied. The icing on top of the cake was that I called Ambetter to ask why it had changed and nobody could give me an answer. The first girl I talked to kept putting me on hold just to come back and say, “so I see here that that is a non-formulary prescription and so Ambetter won’t cover it. The good news is that after you get a pre-authorization from your doctor we will “. First of all, you can’t guarantee that. Second, that’s not what I asked you! I got angry after about 30 minutes on the line with this girl. I asked to speak to a supervisor. She says “my supervisor is in a meeting right now”. Yeahhhh. Okay. So I said “I don’t care. Get them out of the meeting”. She kept telling me they were in a meeting and couldn’t take my call. I then told her I needed to be transferred to someone else, and she then said “I’m the only one available to take your call”. I lost it at this point and I said “I know you’re not the only person available at that company. You can either transfer me to someone else or I will hang up and call back to reach someone else that way”. She put me back on hold for another 5 minutes or so and then transferred me to someone who claimed to be in the resolution department. I’m not going to go into what all we talked about, but it didn’t resolve anything. She ended up telling me that I could pay for my medications out of pocket and then if my pre-authorization went through and was accepted, I could then apply for a reimbursement from Ambetter. I just laughed at this point and said “does that actually work?” She couldn’t answer me. The part that’s theft is that I asked her about my deductible. I only have $130 left until I reach it, however, that’s only because I paid over $1,000 to a third party medical company for some diabetic supplies. My entire year of paying for my medications at the pharmacy WAS NOT BEING COUNTED TOWARDS MY DEDUCTIBLE. I have proof of that as well. I asked this girl if I could just pay the $130 over the phone and move on. She sarcastically said “that’s not how deductibles work”. To which I said “no you’re right. They’re supposed to be counting all of the prescriptions I’ve been paying for up until now, and yet here we are “. She told me that if I paid out of pocket for a prescription that was over $130, that my deductible would make it only cost $130 max. I then asked about this prescription in question. She treated me like I was a moron which…yes, sorry. Should have been specific apparently. She said “that medication isn’t covered!” I said “yes, I got that part. I meant after this pre-authorization goes through. It’s non-formulary, so even with a pre-authorization, should that be counting towards my deductible once approved?” (We all know health insurance companies have loop holes for everything). All she said was a sarcastic “sure”. Really? Yeah. I’m done. Do better Ambetter. There are people who need medications to survive. I understand not covering all of them but at the very least answer people’s questions. As a business owner myself, I can honestly say, this is not the way to gain customers or their loyalty. You need to hire people with customer service abilities. Also, Ambetter has been cutting people checks left and right due to not paying things the way they should (look it up!) If I have proof that my deductible hasn’t been met yet and I’ve been paying towards it all year, they’re about to be in a world of hurt. I have a call into my lawyer as we speak actually. Just steer clear of this company. There are so many better options for mediocre health insurance.

Ambetter health insurance doesn't deserve a 1 star. The worst insurance ever. They customer service just lie to get you off the phone. They won't let you talk to a supervisor or manager. I have been waiting for a refund check for over 2 months. I moved over 1 year and 6 months never have a problem getting their mail monthly for billing and when they don't want to pay my doctor bill but haven't received my refund check yet. So I called like 8 times and each representative has something different to say but won't let you talk to a supervisor or manager. Well yesterday I received an ambetter letter stating they want pay my doctor bill but today when I call, all of a sudden my address in their system is changed to my old address, the address I changed over 1 year ago but I'm getting their mail at my new address for over 1 year. They are so full of shit and I'm reporting them for keeping my refund check for no reason. I'm calling market place and healthcare commission over ambetter. They are lying and they are never getting money from me again. I suggest anyone else to stay away from them because no one accepts them because they don't pay. I wish I would get another bill from them.

Ladies who get annual mammograms (and the men who support us), if you have the common sense.beliet that all annual mammography screenings should be covered at 100%, do not choose Ambetter. I am a healthy woman with no history of breast cancer. My annual mammogram was a contrast enhanced mammogram due to dense breast tissue, which required an accompanying ultrasound to get a baseline reading for accurate readings for future mammograms because it was my first one, and Ambetter made me pay for it.

I have this documented, including the denial of my insurance claim, of which I was given no notice and learned about from a conversation with my doctor's office months after the fact, and my appeal which was also denied, not to mention the many discussions with a collections agency that the imaging center sicced on me as I navigated through several months of an insurance claim process.

Save yourselves the stress, insomnia and anger caused by having to deal wirh an insurance company's discriminatory practices against women and look elsewhere.

I'm self-employed and paying for Ambetter from the marketplace, which is commercial insurance and supposed to be decent for the co-pay about $400.
Everything about this insurance is bad.

1. ZocDoc, the largest online scheduling system for doctors, doesn't even recognise Ambetter in my state and I can't use the convenient website to schedule any of the appointments. I can't overstate how inconvenient that is.

2. Impossible to find providers - the website doesn't update them frequently, you have to call multiple times to find someone who actual is in network. The number of providers is so tiny you have to wait for weeks to get an appointment.

3. Does't cover anything! Refused to cover my yearly mammograms (prescribed by my doctor based on my personal medical history!) and covers literary ZERO of anything fertility-related. Not a single fertility test is covered. This insurance is a punishment for women, please stay away.

I'm leaving 2 starts because customer service actually was trying to help me and I was able to reach a human being relative easy.