Reviews

Review Details

• Review fromAaron M

  Date: 07/29/2025

  1 star
  This is the worst insurance. I have an injury to my hip. The Orthopedic doc orders an MRI. The 3rd party ********* who is contracted through Ambetter denied my MRI. Said I need to have the issue (pain) for six months before MRI. Said to send me home with exercises. Now Im a Corrective Exercise Specialist for a living. I have no problem doing exercises that can help the situation but I dont want to do something contraindicated for a problem that we dont know exactly what it is. If there isnt any imaging how do they know what exercises to send me home with. How do they know they arent doing more damage? They are careless with their clients health.

• Review fromLatashianna J

  Date: 05/19/2025

  1 star
  They have been absolutely no help. I've been on a plan with them since January and it is now May. I have yet to have one doctor's appointment for myself or my father. Though they continue to bill me. I call continuously and get sent in circle with ticket numbers no one wants to take when you call back. Worst company ever. Im in tears as I type this. My father suffer from sezuires and again AMBETTER HAS DONE NOTHING!!!!! I pray nothing happens to the families of these soulless employees because Karama is real. This company needs to be investigated. As well as the agents that claim they are placing notes in your account and absolutely do no nothing.I am looking into a lawyer on this company. This is heartbreaking, traumatic and emotionally draining to deal with.

• Review fromShaunte P

  Date: 04/17/2025

  1 star
  If I could leave no stars I definitely would about having AMBETTER PEACH STATE, they are awful, I have ****************** and receive infusions every 5 months, after switching to them in January 2025 when it came time for my infusion I didn't think there would be any problems but there were, they denied my infusions twice saying they aren't medically necessary!! The infusions are what help keep me from having relapses, so AMBETTER PEACH STATE is awful! Don't get this insurance!

• Review fromAaron S

  Date: 04/01/2025

  3 stars
  At this time, their coverage is reasonably priced. You DO have to switch plans every year as they JACK the rates up on your existing one (hoping you won't notice and just pay the 300% increase). Our family doctor is in-network fortunately, so at least we can keep seeing him. My issue comes up with authorizations as well as their 'Rewards' ********** doctor is at his wits end because he'd like to take me off of my generic cholesterol meds and try a more expensive name-brand that does not have a generic yet. He has been attempting for OVER A YEAR to get this authorized. Ambetter just keeps sending letters that is it a covered med, but with a list of things he must do first...which have all been done...over and over. Every time he requests the med, I get the exact same letter in the mail 2 weeks later. He's pretty much given up and says I need to shop for a different insurance company.The second issue is their Rewards Program. You get small rewards for watching videos and such, but they offer much bigger rewards if you do regular screenings. I have followed them to the letter (A1C every 3 months, colorectal screening, liver function testing, diabetic eye exam, ect ect). They will only give me credit/reward for these if I call and email them repeatedly, often having to threaten going to the Insurance commissioner. Then I'll see a couple of them appear in my account. Currently waiting on 6 large credits where the procedures have been done months ago, some nearly a year, but they still won't issue the rewards.

• Review fromItai S

  Date: 01/13/2025

  1 star
  RIP to Ambetter. I was with Ambetter since 2018 when I was still a dependent on my mom's health insurance. Then, I became an independent member in 2024. The everyday silver plan I had as a dependent changed to focused silver. Ambetter's customer service was never good but the coverage was always reliable. In 2024, my monthly premium was $131.64 cents so I was content. My entire perspective on the company transformed at the end of 2024 when they raised my ********** December 2024, Ambetter increased my insurance rate to $417.98! I didn't learn about this until Thursday, January 2nd after they had already taken the money from my checking account. Having autopay on was a mistake. On the same day, I called up customer service to notify them I never expected my coverage to increase so exponentially and that I wanted to cancel my coverage and receive a refund. I ended up speaking with three representatives on the same day. They each said that I would receive a refund within different timeframes. The second and third ****** even said that the only way, I could cancel my subscription would be through the Marketplace (Georgia Access). Reluctantly, I took their word for it and called GA. I spoke with an agent and he told me I got inaccurate information. After that call, I redialed Ambetter CS and the fourth representative I talked to exclaimed that I would receive my refund within 3-20 business days.A week ago, I got a call from another representative saying that my account had been canceled and that I would receive my refund within 3-5 days.On Monday, January 13th I called them again. The agent I spoke with said that my coverage would last until the end of the month and that I wouldn't be able to receive my refund. Ambetter used to be an affordable health insurance but not anymore. They proved to me that they don't care about the American people's financial or vital well-being they only care about profits. They have destroyed their business solely for greed.

• Review fromRicardo L

  Date: 10/21/2024

  1 star
  A better is completely horrible Im been wait for past 2 week for the representative to call me and she see my messages and she ignored me and the other guy let me hanging for almost 1 hour on the phone for nothing to come in the end and tell me sorry but we are so busy and we cant help you now ?? Im NOT recommend this health insurance to no body from me they have a big 0

• Review fromThomas J

  Date: 09/24/2024

  1 star
  Hello. My name is ****** J and I am frustrated to the point of leaving this insurance provider. I made a payment towards my premium on 9/5. My wife had an appointment within the next 24 hours. Ive made payments online before and within 24 hours the account is updated. This time, the amount I paid ($1455.90) was said to have been refunded that same day or the very next day. Ive spoken to several representatives for the past 3 weeks trying to get this resolved. My current activity credit card statement shows the payment debited and did NOT refund. I was told last week that the payment was in fact received and applied but the online portal does not reflect this. The doctors my wife has to see state that the account is suspended as I see online and they will not see her. We have had to cancel and reschedule appointments 3 times. NOW, I called to check the status and am told the request to escalate was sent to the wrong department yesterday so NOW we have to wait ANOTHER 24 hours for a response. This is UNACCEPTABLE!!! I cant afford to pay another $1500 just to get the account reflected properly and need this resolved ASAP! She has another appointment tomorrow and it looks like we will need to reschedule this one too. Im at the point of looking for another provider. This is the second time a payment was screwed up from using the online process but this is the worse. The first time the system took two payments. If we decide to stay with Ambetter I will never use that online payment portal again and suggest someone take a very close look at the process as it doesnt work properly. We need to have this resolved before tomorrow at noon. We've pleaded with customer service, the escallation department and whoever else will listen but continue to be told that it will take another ***************************************************************************************************************************************** remission. We've explained that this is PAST CRITICAL!!!

• Review fromPeggy H

  Date: 07/26/2024

  1 star
  As others have said, Id prefer to give Ambetter Peach State ZERO stars. Their business practices border on outright fraud. After suffering a shoulder injury, I saw my PCP who ordered an MRI, as this appeared to be a soft tissue injury. Ambetter denied coverage and recommended that I get a plain x-ray of the shoulder. Not surprisingly, the x-ray was unrevealing. My symptoms were progressing, and my range-of-motion was worsening. I couldnt raise my arm above horizontal. I went BACK to my PCP who AGAIN ordered an MRI (standard practice in this situation), and once again, Ambetter denied the claim. I ended up paying for an MRI myself. It showed a severe rotator cuff tear. In addition, Ambetters provider network is ABYSMAL. Most reputable physicians and hospitals in my area (******/*******, **) are out-of-network. When we attempted to reach a customer service representative, we were met with agents who were obviously told to delay, delay, delay. My monthly premiums are $813. DO NOT BUY AMBETTER INSURANCE.

• Review fromTahirah S

  Date: 07/15/2024

  1 star
  In 2022 I was diagnosed with Edema and Venous Reflux. My doctor ********************* that I would need compression socks or surgery. After speaking to Ambetter multiple times, I was then told to purchase them out of pocket, and I will be reimbursed. I along with the Nurse who assisted me, reached out multiple times to the claims department. As well as spoke with them about which form needed to be filled out. They then had us access the website to download the form. We then received a response stating that information was missing. We then added the missing info requested per conversation with the claims department and a supervisor. Then we got another response saying more info was needed again, and then another response saying that the form was old or outdated, which was the only reimbursement form online. We filled another form after speaking with another rep, that was denied as well stating that it was the wrong form. I then spoke to someone from the escalations department, in which he ********************* that my claim was approved in January of 2023. He then started that there was just a form that needed to be filled out in order for me to receive the funds, he also ********************* that I will receive my refund within thirty days. No funds was ever disbursed, so I called again and the rep was able to pull up the last conversation that took place. She ********************* that she wasnt sure what he was referring to nor what he did, but she will investigate and get back to me. I havent heard from her ever since then, and its been over six months now. Now Im having really bad cervical spine issues, and have been denied my MRI. Ambetter ********************* that at least six weeks of physical therapy will be needed for approval, Ive done it for three months, and was denied not once but twice. They are now denying my physical therapy stating that its not medically necessary. How when Im in pain every single day, and the more they deny my PT it pushed my healing further back. I would never recommend this insurance company!

• Review fromDominick D

  Date: 07/13/2024

  1 star
  Difficult to work with. Refuses to cover their "preferred" brands. Very frustrating and overpriced.
  

  Ambetter of Peach State Health Plan

  Date: 07/16/2024

  We regret any inconvenience you may have experienced. Our primary goal is to provide our members with high quality services. When members share their experiences with us, it gives us the opportunity to improve our services. A ****** Services Representative will contact you to assist with your inquiry.