I signed up for Ambetter because it seemed like an affordable option on the marketplace, and the rates looked good for my family. Where I live, I only had two choices, and Ambetter seemed like the better deal based on their coverage and deductibles.
But now I’m realizing it’s not what I thought. I took my daughter to her pediatrician, a doctor I specifically checked was covered by Ambetter before I signed up. When I got to the office, the receptionist immediately told me they don’t take Ambetter. Then she said, ‘To be honest, good luck finding anyone who does.’ When I asked her what she meant, she said a lot of providers refuse to accept Ambetter because they don’t pay claims properly.
I started calling around, and I couldn’t find a single doctor in my area that takes it. I even expanded my search to places 45 miles away, and still nothing. When I called Ambetter for help, I spent three hours being transferred between people, and no one could tell me where I could find a doctor that accepts their insurance. I eventually hung up out of frustration.
Then I started searching online and found tons of people saying the same thing—doctors won’t take it, and those who do have trouble getting claims paid. I actually had short-term insurance last year, and it worked way better for me. Now I’m paying more for coverage that I can’t even use. If anyone is considering Ambetter, be careful.
That sounds really frustrating. I’ve seen stories about this happening before. You might want to reach out to a local news station. This kind of thing needs to be exposed.
Orion said:
That sounds really frustrating. I’ve seen stories about this happening before. You might want to reach out to a local news station. This kind of thing needs to be exposed.
That’s a good idea. I’ve already seen that people in other states are trying to start class action lawsuits against Ambetter. It’s crazy that I can’t find a single doctor near me that takes it. I’ve already driven 45 miles looking for one, and I can’t go much further than that.
@Yan
Instead of calling, send them a certified letter asking for a list of doctors that take their insurance in your area. Companies take written requests more seriously because they know it could be used against them later. Just explain your situation like you did here. It might not fix the problem, but it could get them to respond.
@Orion
I might try that. I need to find a pediatrician for my kid soon so they can get their vaccines. Hopefully, I can find one before Ambetter even responds.
I’m in Texas, and Ambetter works through the Superior Health Plan network, which is basically a Medicaid network. I’ve heard enough bad things about them that when a long-time patient asked if we’d join their panel, I didn’t even consider it. I feel bad for the patients, but I can’t put my office through that.
Did you try calling Centene, their parent company, in St. Louis? I had an issue with them before, and I got results when I asked to speak to the President’s Office.
Blake said:
Did you try calling Centene, their parent company, in St. Louis? I had an issue with them before, and I got results when I asked to speak to the President’s Office.
I’m in St. Louis too, and I’m literally on the phone with the fraud department for the marketplace right now. Ambetter is a joke.
@Wren
I hear you. I was stuck with marketplace insurance for five years, and every provider I had was a nightmare. Spent way too much time arguing with them on the phone.
My wife is really sick, and Ambetter refuses to approve anything her doctors request—specialists, MRIs, nothing. We’re seriously worried she might not get the care she needs in time.
I thought I did my research when I picked this plan, but most of what they claim to cover isn’t actually available. Total waste of money.
I have Ambetter now, and I think they leaked my information. I started getting calls from a fake website pretending to be them. I checked, and my physical therapist accepts their insurance, but I’m dropping them as soon as I can.
@Jensen
I just got a weird call today from someone claiming to be with Ambetter, saying they noticed I hadn’t seen a primary care doctor yet. They listed a bunch of screenings I should get and offered to help me find a doctor. It seemed too specific, so I went to log in to my Ambetter account, and suddenly it asked me to change my password. That set off alarm bells for me.
I didn’t use the link they gave me; instead, I went straight to their website. Now I’m wondering if my info was stolen. This all feels sketchy.
@Blaine
That sounds a lot like what happened to me. The fake website I saw looked just like the old version of Ambetter’s site. When I realized the real site looked different, I knew I had been scammed. I reported it to the FBI, but I guess they’re still doing this to people.
I kept getting mail from Ambetter for months even though I never signed up with them. Now I just got a 1095A tax form for my husband—he never signed up either. We had to report it as a scam, and now we can’t even file our taxes until this is sorted out. What a mess.
I live in Philadelphia, and it’s the same story here. They have a couple of providers, but you have to pay up front, and they won’t send you an insurance card. I was told to just go to a doctor and tell them I had Ambetter, but every place turned me away. I canceled it.