ambetterhealth.com Reviews 

no provider can be found in great Houston. What hell do you provide without any doctor in network?
I still do not receive refund after cancellation a month ago.

My insurance broker signed me up for Medicare December 16 and ✔️ ed the box to discontinue Ambetter. He called me today as I and 3-4 other clients were not discontinued and he went in to do it and they won't allow him. He called and I had to call marketplace. They will not back date the discontinued date to 12/31/25 so I have to wait on an escalation process and review. If approved they will back date stopping insurance. My review could take 30 days. The market place phone line states "Coverage DOES NOT start till I pay my premium". Obviously that's incorrect as my broker and marketplace employee both said they could take me to collections for a 2 week premium. This is absolutely wrong!!

What is really happening here? With hundreds of 1 star reviews on their worthless app and their lack of covering ANYTHING, it sure seem that this is purposely done because nothing EVER gets fixed. I pay $911 a month for what?? I am paying for all the people who get ins for free! I get NO benefit whatsoever having this fraudulent company for instructions! They know what they are doing and it is disturbing AF!

The service was SO bad. I tried to call the 24/7 Nurse Line that is stated on the back of my Ambetter card, and that number was incorrect. I was connected to the some other department and were so unhelpful to redirect me to the right place. I was redirected to 3 different phone numbers, and got help so late. In the admits of my medical state, I was not given the help/advise that I pay for and needed in that situation. It’s very disappointing and disheartening to receive this type of treatment when I am also going through physical pain.

In December 2025 they took out an auto payment of 10 times the amount it was supposed to be, the plan he had during 2025 was no longer available so I switched the plan and their system "did not take" the changes, on 12/22/25 I called and was told he was going to be refunded, that same day I switched the plan again. 1/7/26 still no refund and they claim he owes almost $600 because they left the higher tier insurance that costs almost $900 a month due to his cheaper plan not being available, convenient right?!?! I called today 1/7/26 and spoke with Carrie from member services and she was very polite but apart from processing the refund again was not able to help with the other matters, after being in the call with her for 27 minutes she transferred me to sales and Daniel picked up the call she did not explain to Daniel the reason for the call as I asked her to and Daniel sounded like he was in bed in his PJ's and had no desire to take anyone's call, I requested to speak to a supervisor and he said that they are too busy to take care of any customer, he put me on hold and came back a few minutes later, I requested the same thing again and he did the same thing once again put me on hold I was on the phone for a total of 44 minutes and 22 seconds and was not able to resolve anything.

This company is a scam! Very unhelpful reps and they double charge your credit card. I have been trying to have them reverse one of the charges for 3 weeks now! They keep saying give it 10 more days, but it has been escalated for 3 weeks already! I finally just disputed the charge with my credit card, Ambetter can deal with my CC company since they do not know how to resolve any issues. Makes me nervous if I have an actual claim (I have only had this garbage insurance company for about 2 months and it's already a disaster). Even the "managers" are a joke. They will take your money (twice) but they do not know how to put it back. Do yourself a favor and run the other way unless you enjoy dealing with incompetent, rude liars! And if you do decide to wreck your life and use this horrible company, make sure you put it on a credit card so you can dispute it later and then it is not coming out of your checking account.......because you may never see that money again!

This company is simply the WORST! They do not honor their promises. And they want to second guess the Doctors. My Dr. prescribed me a necessary medicine and they denied it and wanted me to try other medicine first - which I was SICK. I got SICKER because of this company.

Horrid company
Horrid customer service
This company works on very shady practices
I am surprised that they are allowed to do business at all

I am extremely disappointed with Ambetter Health. My insurance plan had already ended, yet they enrolled me in a new plan without my permission and charged my credit card through auto‑pay without any authorization. This is completely unacceptable and feels like a deliberate misuse of my payment information.
Trying to fix the issue has been frustrating and time‑consuming, and I still haven’t received a clear explanation for how they were able to charge me after my plan was finished. No customer should have to deal with unauthorized charges or surprise enrollments.
I would strongly caution anyone considering Ambetter—double‑check everything and monitor your billing closely.

Checked the site for Urgent Care places who accept my insurance. Received a bill almost 4 weeks after my visit telling me my insurance covered nothing. After talking on the phone with an agent, I was told the physician wasn't covered but the location is. The woman was the only physician there. I was still able to pay my copay during the visit and told everything was fine. Now the urgent care place is demanding payment right after the new year. I regret getting and paying for health insurance I clearly couldn't use.

Ambetter is quick to take my premiums on time but delays when I need them to actually deal with my healthcare on a professional level. From start to finish was frustrating, stressful, and ultimately unacceptable—especially for someone with serious medical needs.
My coverage ended December 31, 2025 at 11:59 PM because Marketplace premiums were raised to nearly five times what I had been paying, making the plan unaffordable. I secured new insurance through my employer and simply needed written documentation confirming my coverage termination—something that should be routine.
Instead, I was told I would have to wait 7–10 business days just to receive proof that my insurance had ended.
This would already be inconvenient—but I repeatedly explained that I am diabetic, have multiple chronic health conditions, and take approximately 13 medications. I made it very clear that being left without documentation could delay care, prescriptions, or coverage transitions. Despite this, I was met with indifference and scripted responses.
I asked multiple times to speak with a supervisor or someone with more system access. That request was denied. The representative could only “create a ticket” and promised a callback at some unknown time. There was no attempt to escalate, no workaround offered, and no sense of urgency—despite knowing the medical risk involved.
Beyond this call with Kai, my overall experience with Ambetter was subpar:
Many medications I had previously been prescribed required excessive prior authorizations
Coverage approvals felt inconsistent and restrictive
Finding in-network doctors was difficult
Services were often denied or delayed
I constantly had to “jump through hoops” to receive basic care
For an insurance company that markets itself as helping people stay healthy, the reality felt very different—especially when immediate help was actually needed.
Being told, essentially, “We were happy to take your money, but now you can wait,” while dealing with diabetes and multiple medical conditions is not acceptable.
I would strongly caution others, particularly those with chronic illnesses or complex medical needs, to think carefully before choosing Ambetter. If you need flexibility, responsive customer service, or timely documentation, this may not be the right plan for you.

Ambetter is barely more than a scam. They are expensive, have high co-pays/ deductibles, don't like to cover services... I paid for a plan this year that was over $500 per month out of pocket, had a deductible over $6k, and was a massive headache at every turn. When I had to go to the ER for a medical emergency, they sent me a letter telling me I should have gone to a walk in clinic... for an issue which, if they had taken 10 seconds to review, they would have seen was not appropriate for a walk in clinic. But the worst was when I went to look at 2026 plans. The cost of a similar plan to my 2025 plan went from 500 to nearly 900 dollars per month. I can't afford that, so I didn't sign up. Ambetter decided on their own to enroll me without my consent and charged me. It's now been well over a week, and even after many phone calls, they have not refunded my money. Ambetter is terrible.

The insurance got me out of their system, before my insurance with them ended, not allowing me to use my rewards of over $200
I guess, the Amber is $200 richer ….It’s all about what is benefiting the insurance

Low (as low as they ever get) premiums but also they change covered services & in-network providers with no communication. I have now had 4+ instances where I sought healthcare by in-network providers for covered services only to receive bills 6 months later claiming they are out of network and/or not covered. In one instance I literally booked through the Ambetter site because it said "get 24/7 virtual care -- $0!" and am now receiving bills for it. Have had to spend hours sitting on hold and getting the runaround from customer service reps trying to get it fixed.

Terrible health insurance. If you have ANY other option for coverage you should take it. Customer service is the worst I have ever experienced. The agents tell you the wrong answer constantly. They read off a script and cannot go beyond that. They literally tell you "trust me" and after several poor experiences there's no way I can trust them. Hold times are long and then you have an unsatisfactory and very frustrating conversation where you receive no help and waste hours of your time. You get a different answer depending on who you speak to each time. The network is misleading. Many doctors listed as "in network" don't actually take Ambetter. For example they showed hundreds of options under a certain specialty as "in network" - when I called through literally every doctor listed only ONE actually took Ambetter and they were terrible. They are such a waste of money and their poor reviews clearly reflect that. Take the time to read through them they provide a good representation of what you will receive.

This will be my third year with Ambetter sunshine health through healthcare.gov marketplace. Earlier this year in 2025 I was approved for Zep bound and lost almost 50 pounds. I sought the opinion of a plastic surgeon regarding rashes/infections and pain in the areas of my breasts as well as my abdomen. I lost almost 50 pounds and had an apron belly as well as sagging breast. I went from a size D to a size B with a massive amount of under arm boob. My plastic surgeon was able to get a Panniculectomy approved. She has since submitted a prior authorization for mastopexy which is a lift. She believes this is medically necessary to alleviate the pain that I am experiencing as well as the rashes and infections underneath my breast. Ambetter has denied the surgery as well as denied the appeal. It is literally without a legitimate reason to deny. And their opinion, it is not medically necessary, but cosmetic to not be in pain. I cannot exercise so how can I maintain weight loss?

Cathylynn DiFrancesco Signed me up for bronze plan. No representative or HEALTH MARKETPLACE could find it ! What is going on???? How am i going from $25 a month to $456. Fix this !

Avoid at all cost. They will let you and your family die before covering anything. Overpriced, a typical scam of a government enforced system.

Complete scam like all insurance companies. Custom service is deliberately routed to an automated voice that purposefully makes it impossible to get a hold of someone. Coverage also sucks.

They fraudulently charged me near $400 over a health plan I NEVER selected they ASSUMED I would spend $450 a MONTH, without my consent. No email no text to verify. But they charged me in the middle of the night while I was asleep worst service ever I tried calling my father spoke to them, customer service only told LIES!