Complaints
Need to file a complaint?
BBB is here to help. We'll guide you through the process.
Complaint Details
Note that complaint text that is displayed might not represent all complaints filed with BBB. See details.
Initial Complaint
01/24/2025
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
Calls come all day long...they know I have health insurance, and they are just trying to sell me an Amebtter policy. My name is on the do not call list FOR YEARS. Every day, I field 6 or 7 calls from each provider, which is Ambetter. I will not change my insurance policy from ******* Blue, and you still keep calling. So, now I will record EVERY phone call, and have you prosecuted for fraud. (Fraud is when you say you aren't selling something, but then try to sell me a policy.)I am DONE with you.Business response
02/03/2025
Please see attached response letter. The complainant appears to reside in ******* which is outside of the service area for Ambetter from Coordinated Care and as such this complaint does not pertain to this business. We forwarded this complaint on to the Ambetter health plan in *******. Florida ********************** plans are issued by a separate entity other than Ambetter from Coordinated Care.Initial Complaint
01/21/2025
- Complaint Type:
- Billing Issues
- Status:
- Answered
They keep sending me a bill for over $3000. And I don't even have any account with them plus I have wrote them a letter telling me, I'm not responsible and I want a copy of the original agreement and they have ignored that and continue to send me bills for 3000 and some odd dollars.Business response
02/03/2025
Please see attached response letter. Ms. ****** received invoices from an affiliate health plan in ********. We forwarded this complaint to that states for further review and resolution directly with the complainant.Initial Complaint
01/10/2025
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
I paid the full deductible $7500.00 ********************* said that after i paid the deductible, they would pay all fees afterwards but i was charged co-pay insurance costs that total to over an additional $4000. And they gave me the run around on why i was charged that. They said it is my responsibility to contact all the doctors and have them call the insurance company. They gave me a reference number but i called the insurance company back and gave them the reference number and they said it was an invalid number. They said they could only discuss the bills with the patirnt, my wife but she is deceased. They know she is. I sent them a death certificate but they said cant talk to me. Its bad enough that i lost my wife but then to be cheated by the insurance company is outrageous.Business response
01/29/2025
Please see attached response letter. We do not show Mr. ***** as a member of any health plan issued by ********************** ****************. It appears that Mr. ***** may be a customer of our affiliate health plan in *******. We forwarded this complaint to that health plan for resolution directly with Mr. ************Initial Complaint
12/17/2024
- Complaint Type:
- Customer Service Issues
- Status:
- Answered
The health care provider dropped my wife's PCP without any notification. We cannot load it back, after escalation to a Tier 2 supervisor was told it would be done on the backend and it may take 7-10 business days. This was after 7 attempts to have the tier 1 member service agent escalate. Now, December 17, 2024, still no PCP showing on the policy. Called member services, they could not assist, requested escalation to supervisor, none available. I asked to file a grievance for the supervisor not following through, I didn't have a name, I asked to file a grievance on the 2nd phone call, was placed on hold and after almost 45 minutes was disconnected.Business response
01/28/2025
Please see attached response letter. This issue was resolved directly with the consumer and through a similar complaint filed with the Office of the Insurance Commissioner.Customer response
01/28/2025
Complaint: 22701471
I am rejecting this response because I'm the one who followed up on getting this issue resolved. I was able to escalate to a manager who confirmed they made the change, noting that the first ********* attempt to make the change must have failed. A proper response would have been 1) what is being done to correct the consumer concern that the Tier 1 who was being concurrently trained was told not to escalate to a supervisor and 2) why this took 2 attempts with no feedback when the first change failed. I spent hours trying to resolve a somewhat simply issue and this is consistent every time I contact member services. It's quicker to either scan the hard copy booklet or search the .pdf booklet online.
Sincerely,
******* FaithInitial Complaint
12/14/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
Automatic withdrawal has been set up 5 times on my wifes ambetter account. Do we have to set it up over and over and over and over and over and over and over again each month or is the concept of automatic withdrawl too huge to grasp? Its when you take ALL of our info for automatic withdrawl and STOP losing it. Please call ************ with an English speaking representative. That is my wifes number.Business response
01/28/2025
Please see attached response letter. Ambetter from Coordinated Care health plans are available only for residents in Washington State. As Mr. ***** does not appear to be enrolled in any health plans issued by **********************, and has indicated a contact address in ********, we forwarded his complaint to our affiliate health plan in that state for further investigation and resolution directly with the consumer.Initial Complaint
12/10/2024
- Complaint Type:
- Billing Issues
- Status:
- Answered
Yeah my insurance company has always been star plus superior health. Someone hacked their account and set me with ambetter texas and they told me it was canceled in February 2024. Well, now I'm getting a bill saying ambetter did not cancel it and I never received a letter. Idk how to get ambetter to remove my name and information. I've always been through star plus superior health, now I'm getting bills stating ambetter is my primary health when it is NOT. I need help because ambetter was supposed to cancel my name. I never even applied for ambetter because I am through star plus. Now I'm getting bills and idk what to do. Star plus is saying I'm still insured by them, meanwhile certain ** offices are saying ambetter is the insurance. HelpBusiness response
01/28/2025
Please see attached response letter. The complainant is not a customer of **********************. Her contact information indicates that she resides in *****, and we have forwarded this complaint to our affiliate health plan in that state for further investigation and they will resolve the matter directly with the consumer.Initial Complaint
12/02/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
They are getting paid almost $700 a month to basically pay nothing. They have been pulling my chain all year, I have had to file a complaint at the ************************** and they are still pulling my chain. Ambetter was purchased with the sole purpose of covering my ****** shots which they have yet to cover. They always have an excuse as to why they aren't paying. First it was because it had to be denied through **** first, which was a load of doodoo because Ambetter is now my primary insurance not my BCBS. I proved to them in September that they are the primary yet they keep denying the claims.Then, they decided they were going to deny because the "claim was not submitted within required timeframe". Yes, it was submitted but they denied it saying it had to me rejected from **** first in order for them to pay. By the time it came back to them "it was out of timeframe". They have yet to pay any of my bills before September of this year and I noticed just this morning that they have denied both October and November's bills even though one set of shots covers all out of pocket and deductibles.Business response
01/09/2025
Ambetter from Coordinated Care received your grievance concerning ****** ********* BBB Complaint Case# ********.Coordinated **************** does not serve Ms. ********* as she is not enrolled in any Washington State health plans. We forwarded her complaint to her health plan in *******, and they will contact her directly to resolve her concerns. We are unable to provide additional information regarding any case outcomes due to ***** privacy requirements.Initial Complaint
09/04/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
I spent 2 days on the phone with Ambetter seeking to get an appointment with a doctor in the next couple of months. Ambetter's list of doctors is deceiving, because after calling 5-10 providers they don't take this insurance or new patients. After multiple calls to Ambetter, I was finally given a number for a doctor to get an appointment, but this doctor can't be found on their provider list and after calling again I can't assign the doctor as my PCP. This insurance service is stealing my money because I can't get even the simplest of services.Business response
10/11/2024
Please see attached response letter.Initial Complaint
05/06/2024
- Complaint Type:
- Customer Service Issues
- Status:
- Answered
Got a notice of cancellation letter from Ambetter insurance due to non payment. I actually sent 2 checks and both were not cashed. After calling Ambetter, the 3rd party person did not understand how to pay a bill by way of mailing a check. I ended up giving them another payment over the phone to keep from being cancelled. What happened to my checks I mailed to their Atlanta address on the statement ? I have not cancelled the checks I mailed but they are incompetent so I will have to spend money cancelling the 2 payments I mailed.Business response
05/20/2024
**************** is not enrolled in our plan. We forwarded her information to an affiliate health plan in **************, ******************** health plan.Initial Complaint
03/28/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
I picked Ambetter Coordinated Care for the Washington Health Plan Finder because my primary, ***************************************, was supposed to be in-network. After I get the insurance I can't find her in my network, but the clinic she works at, *********************** was. Somewhere this changed. I find out the day I'm having an asthma epiosde that requires immediate treatment that I can't see a primary doctor at ********************** because they no longer take my insurance. No one notified me. I check the Ambetter Coordinated Care website to find out what urgent care I can go to. It was either Providence in ******** or Monroe. I went to Monroe. There I find out that they in fact are no in-network and I will have to file an appeal afterwards with Ambetter for them to cover it. I went ahead and got treatment because it didn't seem like I had an option. I had to get treatment that day. I now am in fear of the bill from Providence and this appeal process. Accoding to Ambetter I need to wait till I get the bill before doing the appeal.Business response
04/11/2024
Please see attached letter.
*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩
Customer Reviews are not used in the calculation of BBB Rating
Contact Information
Business hours
Today,Open 24 Hours
| MMonday | Open 24 Hours |
|---|---|
| TTuesday | Open 24 Hours |
| WWednesday | Open 24 Hours |
| ThThursday | Open 24 Hours |
| FFriday | Open 24 Hours |
| SaSaturday | Open 24 Hours |
| SuSunday | Open 24 Hours |
Want a quote from this business?
Get a QuoteCustomer Complaints Summary
32 total complaints in the last 3 years.
16 complaints closed in the last 12 months.
BBB Business Profiles may not be reproduced for sales or promotional purposes.
BBB Business Profiles are provided solely to assist you in exercising your own best judgment. BBB asks third parties who publish complaints, reviews and/or responses on this website to affirm that the information provided is accurate. However, BBB does not verify the accuracy of information provided by third parties, and does not guarantee the accuracy of any information in Business Profiles.
When considering complaint information, please take into account the company's size and volume of transactions, and understand that the nature of complaints and a firm's responses to them are often more important than the number of complaints.
BBB Business Profiles generally cover a three-year reporting period. BBB Business Profiles are subject to change at any time. If you choose to do business with this business, please let the business know that you contacted BBB for a BBB Business Profile.
As a matter of policy, BBB does not endorse any product, service or business. Businesses are under no obligation to seek BBB accreditation, and some businesses are not accredited because they have not sought BBB accreditation. BBB charges a fee for BBB Accreditation. This fee supports BBB's efforts to fulfill its mission of advancing marketplace trust.