Ambetter of Illinois
Reviews and Complaints

This company is the worst insurer on the planet. I've had issues with day 1. Although I paid all premiums, each time I went to see a doctor, my policy was inactive. Finally, I gave up. Avoid at all costs.

Horrible insurance provider! Called to check if the urgent care was covered by them, they said yes. Later sent me a *** saying the doctor that saw me wasnt covered. How would I know that. Youll have *** luck with any other provider.

Family member needed home health care. Hospital phone 12 agencies. None took ambetter. We contacted ambetter. Their representatives hung up twice. Located five agencies on their website. None take ambetter. Very dissatisfied with their customer service and false information.

Anyone lookinng for insurance, i been dealing with insurance companies for over 30 years, Ambetter is the worst of the worst. Customer serive is horrible. list of doctors they have dont take new paients. I been looking for doctors for 3 weeks, called cusotmer service they gave a doctor whom i would not send my enemy. PLEASE STAY AWAY FROM AMBETTER.

i work for a provider and we do not contract with this plan. it is terrible i continue to call the line to get status update on authorizations since we are not in network and consistently get disconnected. even had direct line to employees and have left 4 messages in last 4 days and no return call. do not purchase this plan if you are looking through exchange. move on

Absolutely horrible. I searched their website to be sure providers were available in my area before enlisting. However, my mistake was not calling them. Many of the providers are listed in my area were either no longer accepting this insurance or had gone out of practice. The customer assistance line was very unhelpful, often waiting on hold for extended periods of time with employees eventually not able to answer basic questions, such as where could I get a flu vaccine paid for. Additionally, the dental and vision websites are through a second party and websites are difficult to navigate. Would NOT recommend.

If I could give 0 stars, I would. As a member, you cannot get ahold of ANYONE. You go through the automated messages for 10 minutes, enter all of your information, then they say please hold while we connect you. Then, the line goes silent for 3 minutes and it hangs up on you. TERRIBLE customer service. Their list of providers that are covered is not up to date. I have scheduled multiple appointments since having this plan and 90% of the time when I showed up, the doctor that was listed on the AmBetter website said that they do not take my insurance. AWFUL insurance, do NOT work with them or purchase their coverage. Most horrific customer service I have ever dealt with.

By far the worst customer service available. 3rd world country reps and no knowledge of how the health care system works. Charged me out of network coverage for my hospital stay in my approved hospital stay. You can't understand a word these people say and when you request a person you can actually understand so you can have a conversation they deny you and say they aren't allowed to transfer calls. My plan increased as of jan 1 of *** the beginning of December. That's a huge increase i recieved and it should have been deducted next year not this year. Something needs to be done about this c*** company. Its disgusting that they can continue to try and get away with this.

Ambetter of Illinois fraudulently deducted $545.06 from my checking account on 1/15, despite the fact that I called them prior to the deduction that same day to cancel my coverage. On 2/11 I called them again to request that the charge be refunded to my account and was told verbatim that the refund would be processed in 7-10 business days, and that the error was due to autopay not being turned off. When my refund was not processed in the 7-10 business days explicitly conveyed to me on 2/11, I called Ambetter on 3/3 to inquire again and was told that due to my not having canceled coverage through "the marketplace" there was no way to return the funds. The representative stated that I should have been advised in the course of my previous two calls to Ambetter that such a step was necessary, but I was not so advised. At this point my funds have not been returned.

This insurance company is absolute garbage. In addition to submitting this review, I will be filing a complaint with the appropriate government agency. I pay $300/month for an HMO plan that is supposed to include dental and vision. I located an in-network dental provider using the Provider Search feature on the company's website. However, when I tried to make the appointment, I was told by the provider that they only accept Ambetter PPO, even though they are in network. And, as predicted, the Provider Search function does not let you narrow down providers by which type of plan they take--you just have to call around and waste your time figuring out who accepts the HMO. I tried calling customer service and sat through all the prompts to reach a customer service agent, and I got a weird fax-sounding dial tone; I was unable to get through to their customer service. I've already wasted my money, so I'm surely not going to waste my time. I will be letting the insurance lapse. Do yourself a favor and go with a different insurance company.

One star is generous. BEWARE: THIS COMPANY IS THE DEFINITION OF A LEGAL SCAM. They are somehow allowed to list an unlimited number of practices on their website as accepting their insurance when in fact those doctors/dentists/etc. do not. I have been trying to find ANY dentist in my area who accepts the plan. After several hours of calling the list posted online only to be told by all that they do not accept AMBETTER. Called AMBETTER and was told that I needed to tell them that it's actually ENVOLVE insurance not ambetter. This company is not listed on the insurance card anywhere. Taking the bait, I call ENVOLVE, and low and behold, they cannot find anyone on their own website that accepts their insurance and I was told I would need to refer back to the Ambetter website and their list. THIS IS A SCAM and I'm not sure how they can legally do business this way. Ambetter claims they only update their website twice a year. How are they allowed to list businesses that don't accept their insurance? I only wish I had checked here before purchasing a plan with Ambetter.

I've had ongoing billing issues and repeatedly told by Ambetter staff I owe money despite that I have paid early every month. When I call, they blame me and make it hard for me to get anywhere and I'm getting tired of it so decided to lodge a complaint.

I also had a dispute with them at the start of the year - I signed up via Marketplace in Nov 2022 and paid for Jan 2023. When I called Ambetter in Jan to find out where my new card was they said I was not a member. It took Ambetter till the end of Jan to sort out their backend and apologise because they found my November payment. Then they said they wouldn't charge me for Jan, refunded me, then asked me to pay it back later claiming they couldn't refund me, at which point I gave up.

I have been recently diagnosed with cancer. I have to freeze my eggs before I receive treatment. I contacted Ambetter this past Wednesday aug 11th to see if they covered this service. The rep said that I have fertility coverage but they didnt know for what. I ask for a in-network provider as I was unable to find one online. The rep put me on hold for 45 min and then said he could not find one either. He said a department of Ambetter would call me and help to find a provider and they would make a one time in-network deal. On Friday I still had not received a call from Ambetter, so I called back. This time the rep said I needed to go to my pcp and get a referral and have them request coverage for a fertility clinic, but that coverage was not guaranteed. So Ambetter says they offer fertility services, but has no providers and they are telling me 2 different things. I would like to speak to a rep in the department specializing in one time in-network deals. So we can better move forward

My 2 year old son was hospitalized at an out of provider hospital and no charges were covered by Ambetter for his 2 day hospital stay. He was transferred there because there was no pediatric facility that was in network for Ambetter in our area where he was taken by ambulance. I was told by the hospital that insurance companies will cover out of network providers as long as proper documentation is provided because of the cause.I have contacted Ambetter over 10 times for this issue. They have forwarded my calls to different customer service agents that have not provided any help. They have hung up/dropped calls on me and never returned phone calls. I was even forwarded to the registration department at one point to purchase Ambetter health insurance again instead of someone who could help resolve a previous issue! Initially, their department told me to resubmit claims from the out of network provider. Then, I was instructed to submit paperwork from the original hospital stating that there was no pediatric facility available. After I was given the run around, I finally was able to submit the paperwork and was told to wait 45 business days for the dispute department to give approval.I called after 45 days and was told that no paperwork was submitted or emailed to the department. I told them of the specific Ambetter customer service member that I emailed the appropriate hospital paperwork to, and they told me that there was no email received and the dispute and been rejected. I then asked to speak to a supervisor/manager as this issue has not been resolved in over a year and no one is willing to speak to me directly to get answer. I was told that there are no supervisors available and that there is no email/direct number to contact a higher authority. I was told that I would be contacted by a supervisor and was never contacted. There has been no resolution to this issue and I have spent countless hours on the phone with them.