Ambetter from MHS
Reviews and Complaints

Refused to refund my money after I called to cancel my insurance. When I signed up with them, I told them that the insurance was needed only until Sept 30, 2021 and they assured me that they would end it then. I called them 2 weeks before the end of Sept and told them again that the insurance needed to be cancelled on Sept 30th. The lady assured me that she put in the request for cancellation and deleted the auto pay function. Then on Oct. 5th, I saw that the payment was pending in my bank and asked them to stop the payment and they told me they could not. After speaking with 2 representatives on the phone they told me they would not refund my money, only cancel the policy and that they had no notes on the previous call to cancel. I would would definitely suggest that you not chose Ambetter for your medical needs.

Ambetter is horrible. They cover nothing. The website is so outdated. No, and I mean NO doctor accepts Ambetter where I am from. Their answer for when I told them the oncologist I have been using for 5 years doesn't accept them, even though the website claimed they did, was that I am welcome to find a new one. Please do yourself a favor and do not go with Ambetter.

I have never had such a hard time trying to communicate with a representative in my life! Every time I call them with a question they NEVER know the answer. Just called today to ask what is included in an annual wellness visit since the website is so vague. What is covered and can be checked for in a blood draw? She puts me on hold to check. Comes back and says it's covered! What?! I know that bloodwork is covered but that's not my question. What exactly is covered? She puts me on hold again and this time after about 2 minutes a recorded message comes on saying the call center is open 8:00-5:00 but they are closing now and hangs up. I had so many other things to ask her. Like why are the emails about my insurance going to my husband. She had listed the wrong name for my PCP when my screen clearly shows the correct name. I wanted to get that cleared up. I requested a new card in Oct and it never came. Wonder where that is? The customer service at this place is HORRIBLE! I only gave one star because someone did answer the phone...originally.

If I could give a zero rating, I would. I canceled my plan and requested a refund of my payment, yet I am still struggling to retrieve my funds. Every time I call, they hang up on me, claiming that it takes a certain number of days to process, but it has been almost 15 days. To whom else can I report this issue? Please help, as I have tried, but their customer service is atrocious.

I was on the phone for a half hour. I could tell the rep was working from home. After being on the phone that long, she lost the ability to hear me. I thought, well she asked for my number so she will call back. She announced that I had quit responding and if I could hear her, I needed to call the toll free number again AND START ALL OVER! I was calling concerning the fluctuating prices on prescriptions. Sometimes we pay three times what we did the last time. Miraculously, I was able to remain on the line for someone from pharmaceutical. She told me that they can charge whatever they want for my prescriptions and the price doesn't' have to remain the same throughout the year! Same dosage, same local pharmacy. This is our third year with Ambetter because there is no one else left on the Marketplace. I feel like we're on a sinking ship.

Cancelled insurance on December 7,2020 still taking out Premiums and will not Refund My money. 9 customer service representative no help. Am owed $1910.38. Theives.. Need help seeing to get my money back.

One star IS generous! I have tried to work with them for 5 weeks trying to get the name of the "in-network" distributor that supplies insulin pump supplies. I have been on the phone with numerous (at least 25 different representatives) and get a different answer each time. When I finally am able to speak with a supervisor they assure me they will get an answer. The process they operate under doesn't work. I'm never able to speak to the same person twice therefore, no one is held accountable. There is no communication within the company so each time I call, I tell the whole story again. I'm on the phone on average 1-2 hours every time. They typically have a set script they read rather than critically thinking the situation through. I was finally told I would be assigned a case manager that I would be able to speak with every time I called going forward. That was weeks ago and I've still not heard back from my "case manager" that it takes 3-5 days to assign. Not impressed with Ambetter yet... Think twice before you sign up.

Terrible Insurance needed to get meds refilled this week, only to find that my prescription that cost me $60 last time (3-month supply) now was going to cost me over $900! I log onto my account online to see what's up. I see that my coverage is suspended and that I owe more than $4000! I have been enrolled in auto-pay ever since I had to purchase coverage from this insurance company. I have seen my rates increase by $300 per month, then last year another $400 per month - so another $3000 this year for nothing. I then get a letter in the mail, dated January 7th, AFTER renewing my coverage, telling me that one of my medications is no longer being covered and will be more expensive this year. Thanks for the heads up and changing my coverage - JUST ONE DAY AFTER RENEWAL!

Well, I am hoping the $900 medication was just because my coverage was suspended. My frustrations are: - WHY WAS I NOT INFORMED MY COVERAGE WAS SUSPENDED?! - Why no notification BEFORE it was suspended? - Online, it says that my coverage could soon be terminated without payment. (MY PAYMENT INFO IS UP TO DATE). - Why was my auto pay suddenly stopped?

Now I get to pay a chunk of over $4000 to reinstate my insurance because you had somehow stopped my autopay and had NOT INFORMED me - putting me at risk for not getting medicine. I get alerts about getting a flu shot, scheduling an appointment to see my primary care doctor... but NO ALERT about my account being suspended?!

I called to correct the situation. I tried to figure out how to write my frustration to customer service and that was a challenge. I am good with computers, but you have made it very difficult to write to. The chat function referred me to 'Inbox', but the link it gave didn't take me there. I had to re-navigate my way there. No intuitive way to contact you.

I never received a text, email, phone call, or even notification on the website account - I checked, nothing there. You are happy to remind me to use services, but no warning that it's suspended. Great.

I realize I am at your mercy. I am required to buy insurance and options are terrible. This is just awful and I will do all I can to find coverage elsewhere - unfortunately, I still have to waste almost $25,000 more on this company this year.

One star is generous. My coverage started on August 1st and already I have issues and I am not able to get anyone at the company on the phone (real person). When you are given a choice with the phone menu - the first choice is always "pay your premium", interesting because at this point, that's the last thing I would do. My husband finally got a person on the phone, and when I asked him a question on an authorization my doctor sent for a medication, he said he would have to transfer me to that department. I was on hold for about 5 minutes and got a voice mail saying her computer was down and I would have to call again but did not even give a phone number. With the number of awful reviews and the complaints, I think this should be elevated to the Indiana Secretary of State for review. This company doesn't seem to be run very well...

Is there a way to give a half star rating? First of all, I requested a document from the company that showed how much I was paying for my medications in order to receive help from the pharmaceutical company to pay for the medication. It had to be on the company letterhead and I called repeatedly. I was told that I needed to call someone else, then when I called that person, I needed to call the first person. They gave me the round-about. I was never able to get help paying for a medication that Ambetter didn't cover from the pharmaceutical company. Another problem I have with Ambetter is the fact that they don't cover my psychiatrist. They expected me to drive 2 hours away from my city to start with a new psychiatrist. Then they wouldn't cover my therapist despite the fact that they had told her that they would. Ambetter kept telling her she was using the wrong billing code. So when she asked for the right one, she used it and was then told that it was the wrong billing code. She had to write off six months' worth of appointments and did not get paid for them. She even filed two complaints with the state. Each time, Ambetter promised they would pay her and never did. Eventually, she gave up on even trying to get paid. This was after Ambetter wanted me to have to travel 2 hours away from home again to start over with a new therapist who does not specialize in ADHD like my therapist does. It's bullcrap. Ambetter won't cover one of my medications because it's indicated for the use in schizophrenia. However, it's also used to treat Major Depressive Disorder and that is what my psychiatrist was prescribing it for. The medications itself costs $1,126 for a thirty-day supply and it won't go towards my deductible because it isn't covered. They also won't cover the full does of mydais that I need to take in order to work. So I have to pay $279 for a thiry-day supply, which again does not go towards my deductible. I spend $387 as my premium each month for them to not cover my therapist, two of my medications, or my psychiatrist. At this point, what is the point of having them at all?!? This is literally the worst company for insurance that I have ever experienced. I actually switched to the insurance my work provides despite the fact that the deductible is $6,750. It's still less overall, by $1,000, than how much I pay for Ambetter when it's all said and done. Every time Ambetter asks me to complete a survey on how I like my coverage or whatnot, I never fill it out because it doesn't ask the right questions; for instance, when it asks about mental health coverage, I laugh because the first question should be: "Do we cover your mental health needs?". Not, "How do you like your mental health coverage?" And of course there isn't an option to answer that it sucks because they don't even cover what I need. I hate Ambetter with every fiber of my being. DO NOT USE THEM EVER FOR YOUR INSURANCE COMPANY!