Reviews

I have been trying to get my PCP updated to somebody in the same town where I live for MONTHS now. STILL NO RESOLUTION. This isn't a complicated request. I picked a provider from a list suggested to me by them on their website. I keep being reassured it's taken care of, so I made an appointment. The claim was denied because it wasn't my PCP. The new doctor is asking me to pay the bill. That was early June. 8 phone calls and 3 months since and still getting the same "it's been manually changed" and give it 7 -10 days to update. How broken can this system possibly be? My husband is a Type 1 Diabetic (insulin dependent) same problem with PCP. Luckily ******* saw him and gave him a prescription for insulin. Went to the pharmacy to pick up a refill the other night and we were told that Ambetter no longer covers the 2 insulins he takes everyday. They couldn't notify us BEFORE we are standing at the pharmacy window? Thanks, Ambetter! We have to get a new prescription, from a doctor that is more than an hour's drive away, each direction. Called to make an appointment and they can't see him until 2025! So we ended up paying cash for his insulin. We would be far better off with no insurance than paying $149 plus the APTC of $1100/mo. This is the most garbage health plan I have ever had or ever had to deal with. I have worked both as a medical billing clerk and a claims adjudicator and I cannot understand for the life of me what the heck is going on with this company. To say I am frustrated and disappointed are beyond gross understatements... Stay far away from Ambetter health if you care about your health at all. I am not going to give them another penny until they can assign their doctor I saw to my plan and pay the claim. Hopefully they can pull it together before the end of the year, but I'm not holding my breath....

If I could give zero stars I would. We have paid for this insurance monthly for the last three years and when we needed the insurance for my husband to go to skilled nursing no one would take him because of Ambetter. They said they won’t take him because they don’t EVER get paid even though Ambetter says they are a preferred provider. We have sat in the hospital for the last week trying to find anyone at this point to take him and no one will. My only option now is to self pay just so we can get him out of the hospital.

Worst insurance company ever!!! I wish I could give 0 stars. Their customer service is even worse. Now I'm being denied surgery that I need! I pay my premium every month and for zero results! Do NOT waste your time and money on this nonsense insurance company it's not worth your time and money!!!

Update: I received a call from Lisa at Ambetter corporate office. She is addressing my concerns and helping me. My doctor's office has also been helping by filing a dispute due to a denial. Thank you Lisa, and Nevada Orthopedic and Spine I appreciate you, and hope for a positive outcome.

ZERO Ambetter Clear Value Silver….DON’T DO IT! Just don’t! They select a PCP for you that is 40 minutes away from your location even though there are PCPs in network closer but then they need a referral from one of two choices 40 minute away PCPs…doesn’t make any sense! Don’t even get me started on Specialists and trying to get them covered! The old saying, “you get what you pay for” holds true here!! Even on the marketplace the premium (although ok at under $100/mo with a subsidy) and a $4900 deductible…it is denied, denied, denied. Customer Service is overseas…so if you can understand them, they only speak what they are taught to speak with zero thinking outside of the box and trying to actually resolve the issues is non-existent. Frustration beyond frustration!! Tired of the run around with these people! It’s cheaper to be uninsured at this point! Beware of this scam plan!!

I chose the Ambetter Health Plan (Silver Value) through the Nevada Health Exchange. The premiums were over $800 per month (subsidized in part by my APTC). I tried to use the telehealth feature covered under my plan when I had a health issue and wasn't able to use it. I was told by Ambetter Membership Services that I didn't have telehealth services (not true, it's on my policy) and when I tried to connect with Teladoc (through the link on Ambetter's website under my personal coverage) I was told that my health plan wouldn't authorize it. I'm done with this insurance company, the customer service was terrible.

Zero stars. The absolute WORST customer service. My insurance was fraudulent cancelled, and they told me day after day after day they would reinstate. It has been a month now, paying all doctor visits and pharmacy for my children cash. No resolution. They all have a reference id # for all of the calls I’ve made, which is no use. The only notes they write are that they spoke with me. ABSOLUTELY NO other details in the notes. If you have an opportunity to use a different health insurance company, I urge you to do so. WORST INSURANCE COMPANY I have ever dealt with. Worst company ever. This company should never be allowed to operate. Read all the other reviews, they are accurate.

The worst insurance company I have ever had. They should not be allowed to offer plans on ****** ****** ****. I pay my premium on time every month and yet I cannot get the company to approve medical procedures that my doctors request. I spend hours on the phone trying to get to the bottom of the problem; however, none of their representatives seem to have the answers and they just keep pawning me off onto someone else. They tell me to check my Online Portal, however, they do not keep that updated so my information on there is not current. And of course, when you call you have to deal with their long automated service until you can finally get to talk to a person. And then, you have to repeat all the information you already entered into the automated service. And then the person tells you they need to transfer you to another department and they hang up on you. And then you begin the process all over again. Ambetter has the worst customer service and it's the worst insurance company. They should not be able to offer plans on the exchange because then we are stuck with them until the next enrollment period.

This is a horrible service and 100% DO NOT recommend. I recieved a bill for a doctors visit. I called Ambetter to find out why and an agent told me that I do not have to pay it and that its already been paid. I continued to receive a bill for it. When I call again, other agents say its part of my deductible. I Al have called numerous times to have a supervisor pull the conversation and listen to it. No one ever calls me back and every time I call, I have to go through a 45 minute process to re-explain and its still not resolved. They are just trying to scam me into giving up and paying and I refuse to do it.

Worst insurance I have ever been on. Trying to get a refund is like arguing with a trash can. They dont cover anything and their customer service reps are bottom of the barrel. They are over priced and nothing goes towards your deductible. They need to be put out of business.