Ambetter from Home State Health
Reviews and Complaints

This Insurance company is a joke. There's no way to talk to a supervisor and apparently, most of the representatives working for them don't speak good English. I called to find out if molder foot orthotics were covered by my plan and was on hold for over 30 minutes while she tried to find out and then was disconnected without an answer. Unfortunately, I have had this insurance since I became self employed and it's the only option offered for southwest Missouri (thanks ***). I have had nothing but trouble with them and am fed up!

My son,*** passed away on 7/31. Home State Health continues to send bills in his name. The bills state that he doesn't know anything. I have called them to tell them to stop sending these statements. They told me they would stop. The statements still continue to come to my house. I want to make sure they are not collecting any money for his insurance premium. Policy#

I have been suspended for non payments on my health insurance, but I have been over paying since February . I've made over 14 calls and they agree I owe nothing and actually have over paid. But no one has lifted the suspension. I'm diabetic and have not had my medication for over 2 months. I'm literally dying daily. I need help with this please. Ambetter blames it on the Market Place and vice versa. I can't get this resolved and have no idea how or who to contact for help. I've made multiple attempts contacting Ambetter and multiple attempts to with the Market Place to no avail.

This insurance company fails to pay promptly and putting us in financial troubles. I have disability, ortho problems and I have had for years and getting worse to the point I can't work. Can't stand. My neck is in bad shape. I have done everything and then some requirements for an MRI of the spin as shown on the multiple deferments to my doctors. Get denial forms. At least six of them to different doctors. On disability now. I also have a bill to ***l for colonoscopy and esophagus dilation. Ambetter has not paid anything. I owe $2110.00. The hospital refuses to help me with any aid. Living on our salary I can't afford all these bills. My husband also on medicare and diabetic. We are not getting any help from this insurance company. Have heard from many who also have this insurance and having the same problems.

I cancelled my insurance on 01/18. On 03/22 Ambetter takes 536.65 out of my checking account. I called on the 22nd and was told that autopay didn't get the cancelation. That it could take 10 to 15 days for my money to be returned to my account. I wait but it never gets put back. This repeats probably 3 more times before I get a supervisor who says billing says they don't owe me. They need to get with Market Place and do a "Status of Escalation" and that will take 30 days. Finally I get a letter stating Ambetter granted me a refund in the amount of 950.41. Not sure where that amount came from but I'm not complaining. But I still haven't got my money. I have called so many times and just keep getting the run around. I don't see how what they are doing is legal. They say i have to wait I wait. They say they will call, they don't. I guess I'm gonna have to see what a lawyer can do.

Never received my MLR check for 2019, according to my records. I have called to ask 5 times now. MLR checks are refunds mandated under the ACA when insurance companies take in "too much" money and have to issue refunds. They are issued to all policy holders in the region that were charged "too much". Responses: 1) "You didn't have insurance that year" - total lie 2) "There is no such thing" - total lie 3) "We'll get back to you in a few days" - ha! Nope. 4) "the checks are all rolled into one year" - total lie, they are required to be issued yearly. 5) "The check is tied to an individual account about your health you have with us" - total lie, it's not based on my personal health! The bottom line: the phone customer service people don't know what they are talking about, and make random things up. Nobody follows up. I want an explanation about my check for 2019. According to the gov't, there was one issued to ALL policy holders in my area.

I received an email stating my payment was late. That was impossible since I had just joined Ambetter with a start date of 02/01 via the Healthcare.gov Marketplace. I emailed Ambetter, and the customer service rep said to ignore the email about my $91.39 balance since I had already paid February's premium of $91.39. This was on 02/16. I logged in to pay March's premium on 02/24 even though payment wasn't due until 02/28. At this time, I noticed the balance due had changed from $91.39 to $391.39 - with no notice sent to me. I emailed Ambetter for clarification and on 02/25 they said it was because I received a Medical Loss Rebate of $541.88 and that I hadn't paid February's premium payment of $91.39 or March's payment of $91.39. Ambetter also claimed I had a prior balance of $208.61. It's impossible for me to have a prior balance of $208.61 since I didn't join Ambetter until February and my monthly premium is only $91.39. I even clarified with Ambetter on 02/16 that my $91.39 was already paid for February. Also, I shouldn't be billed for a Medical Loss Rebate check. That's a government check that lots of Americans received in 2020. Aside from that, I DID pay my February premium of $91.39 on January 4th so my coverage could begin on 02/01. Ambetter is attempting to bill me twice for February's premium, and they're threatening to cancel my coverage if I don't pay $391.39 by February 28th even though I should only owe $91.39 at that time. I even have documentation from Healthcare.gov proving I didn't enroll in Ambetter for January. I enrolled with a start date of February 1 and paid my premium in full during my enrollment on January 4th. Healthcare.gov even says the payment made on January 4th was for February's monthly premium, as I was not an Ambetter member yet in January. Despite this, Ambetter is trying to bill me twice for February's payment, plus bill me for an additional balance that does not exist.

On September 24th, a credit of $3,842.76 was applied to our billing account. Ambetter was going to apply this balance to future premium payments. However, my husband's employer now pays for our insurance. On September 25th, I asked that a check be mailed instead of the credit to avoid confusion with my husband's employer. The AmBetter Representative (Confirmation # ***) stated that it wouldn't be an issue and a check would be mailed after 7-10 days of processing. On October 6th, a check was supposedly sent by AmBetter after it was processed. However, we never received a check. I followed up with a phone call on October 17th to inform them that we still had not received a check. The AmBetter Representative stated that the check would have to be stop paid and that another one would have to be issued. She stated there would be another 30 day waiting period before a check could be reissued. I followed up with another phone call on November 23rd to check the status of our refund because it was over the 30 day period. I was informed by a supervisor named *** that another 30 period would be added for processing time and that on December 31st a check would be issued. I again followed up with another phone call on 1/4 and was told that the refund had not been process and that it would be another 7-10 business days before it could be sent. I became very frustrated and told them it was not an acceptable answer and that we had waited over three months for the refund to arrive and that I had no choice but to file a ComplaintsBoard.com complaint. I called again on 1/7 to again verify that the check had been processed and was told it had not and that it would take another 7-10 business days. AmBetter keeps telling us a refund is in the mail and keeps increasing the processing time for over three months without issuing a refund that is owed to us. Confirmation Numbers associated with this problem are:

I purchased an Ambetter Home State Health Missouri plan through the Healthcare.gov marketplace via Ambetter Secure Care 5 2020 with adult Vision and Dental. I paid for the plan, and have the receipts. The plan was to start Nov 1 and go THROUGH November 30th, which is today. The plan CANCELLED at 12:01AM today. My online access was cut off and when I called, at 8:06AM central time today, Ambetter confirmed that the plan had been cancelled earlier in the day. I even printed off the certified letter of coverage dated today, Nov 30, that coverage was THROUGH November 30th. I had an eye appointment Saturday with a provider listed as CURRENT on the Ambetter website - keep in mind that these appointments are VERY difficult to get due to COVID and because it is the end of the month. I went to the provider, ***, was there for 1.25 hours only to be told that they do not accept Ambetter. I have a screenshot of Ambetter's website verifying that this provider was on their list. HOWEVER, Ambetter cannot be reached/is CLOSED on Saturdays and Sundays so there is NO way to reach anyone and I could ONLY rely on the providers listed on Ambetter's site. I called this AM, and after waiting on hold and being put back in the queue, I finally reached a representative who, after 37 minutes, told me that the coverage was cancelled and there was NOTHING Ambetter could do about it. I wasted my dental and vision benefits...vision being a free exam and lenses with $130 towards frames NOT subject to deductible. But now I get NOTHING because my coverage only went through November 29, NOT November 30. FRAUD. The representative told me that she was going to escalate the matter, then put me on hold without asking then I was sent back to the queue then I was disconnected. Ambetter says they record all calls...so I hope they enjoy hearing every single thing as I have outlined. Including randomly being out on hold. I ALSO had to cancel my dental cleaning, which took 3 weeks to get in the first place! I had no intention of waiting until the last day of my insurance coverage, BELIEVE ME, but I should 100% be able to use my benefits AS CONTRACTED AND PAID FOR THROUGH November 30! I want a refund or I will get an attorney as this is total fraud. BUYER BEWARE!