ComplaintsforAmbetter from New Hampshire Healthy Families

• Initial Complaint

  01/22/2024

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  Tried unsuccessfully to cancel 2023 policy for 3 months. Had to threaten an ambetter supervisor with harressment in April . Now I owe taxes for supposed tax credit premiums for insurance I didn't want or ask for. They tell me it's my problem.

  Business response

  02/13/2024

  Please see attached letter. An Ambetter representative will contact the member directly to assist with the concerns. 

• Initial Complaint

  01/12/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  On November 20th 2023 i went on the market place to get a new health insurance policy for 2024 and ended up with the same company i had in 2023 same plan just a lower premium here it is 1/12/24 and i still have not been sent a way to pay the 1st premium and have been on the phone with them 3 times since November for at least 1 hour each time and still have gotten no where closer to being able to make the 1st payment this company is very bad about resolving issues had nothing but problems every time i called

  Business response

  01/29/2024

  Please see the attached letter.  We are in contact with the member to address their concerns. Thank you.

  Customer response

  01/30/2024

  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ******04, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  ***** ****

• Initial Complaint

  03/14/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I paid most of my premium in total of $800 in 2023 for 2023 totals. My health care was cancelled without my knowledge. The payment was received. I have called twice and been on the phone for two hours each time. Each time I am given a customer interaction number. They tell me I can't get an email confirmation. They tell me I must fax or email proof of payment. I do. I ask to speak to a supervisor to get verbal confirmation and an email that they have received my proof of payment. No supervisor is yielded. Then I am hung up on. It has been a couple months. I need this $800 to help me pay for the hospital bill I now have because I didn't know I was uninsured when I went to the hospital and now owe Dartmouth Hitchcock $1500. Ambetter owes me $800 for a payment I made to their company on February 6th. I called on February 14th to see why I couldn't access my client portal any longer and found that my health care was cancelled. The first incident occurs then when I am told to send proof of payment for a refund which would come within two weeks. I call today 3/14 to see what has happened as a result of the previous conversation; no proof of previous conversation. A new dispute is lodged, but no email confirmation is given. No supervisor is yielded and I am hung up on. Thank you for taking your time to help me resolve these issues.

  Business response

  04/04/2023

  April 4, 2023
  Better Business Bureau
  BBB serving New Hampshire
  ** ******** ****** ******** ** *****
  Attn: ****** ****, Trade Practice Specialist
  Re: Consumer: ******* **********
  Complaint Case #: ********
  Dear ******,
  Ambetter from NH Healthy Families received your correspondence on 03/14/2023 concerning ******* **********, BBB Complaint Case # ********. Due to federal and state privacy and confidentiality regulations,
  we are unable to disclose any protected health information, including, but not limited to eligibility, claims, and
  billing information. We will be sending a detailed response directly to ******* **********, BBB Complaint
  Case # ********.
  If you have questions, please call us at ###-###-####.
  Respectfully,
  /s/ Lisa C*********
  Lisa C*********
  Director, Grievance & Appeals

• Initial Complaint

  02/27/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I contacted Ambetter in February, 2022 to cancel my insurance policy through the health insurance marketplace. I recently received a 1095-A showing premiums for the entire 2022 year. I contacted the marketplace on 2/25/23 to request a correction and was told that they were never notified of the cancellation request. The Marketplace customer service rep explained that this is a common mistake. Ambetter should inform subscribers that this additional step is needed. Instead, they continue to receive funding for services they are not providing. I am on a fixed income and this “common mistake” cost $500 of my anticipated IRS refund. I would like to see a resolution that includes: Ambetter to share insurance cancellation forms with the health insurance marketplace or inform subscribers that they need to. I would also like my 1095-A adjusted to reflect the cancellation in February 2022

  Business response

  03/13/2023

  Dear ****** ****,
  Ambetter from NH Healthy Families received your correspondence on 03/03/2023 concerning ****** ******,
  BBB Complaint Case # ********. Due to federal and state privacy and confidentiality regulations, we are
  unable to disclose any protected health information, including, but not limited to eligibility, claims, and billing
  information. We will be sending a detailed response directly to ****** ******, BBB Complaint Case #
  ********.
  If you have questions, please call us at ***** ********.
  Respectfully,
  /s/ Lisa C*********
  Lisa C*********
  Director, Grievance & Appeals

• Initial Complaint

  02/21/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  My issue is with Ambetter from NH Healthy Families. Ambetter charged my credit card that they have on file every month of 2022 except for December 2022 for the coverage period of 01/01/23. I was unaware of this until I received a bill from Ambetter on 01/09/23 for $1,468.32. It said on that bill that I was past due for January's coverage. I then wrote a check on 01/21/23 for the full amount due of $1,468.32. That check was deposited on 02/02/23. Shortly after that I received my credit card bill for January 2023. In that statement it showed Ambetter charged my credit card $734.16 on 01/15/23. I called Ambetter that day and explained what was happening. They told me they were sending the problem to accounting and would fix the problem. I asked if I could speak with that department and was told no but rather call back in 10 business days and they would then explain to me what happened. Within those 10 business days I received another bill from Ambetter on 02/05/23 for the amount of $734.16 due on 04/04/23. I receive another bill from Ambetter on 02/09/23 for the amount of $1,468.32 due on 02/28/23 again telling me I was past due. I call Ambetter again and they tell me it does show that I paid $734.16 on 01/13/23 by a check. The only check I gave to Ambetter was for $1,468.32 on 01/21/23 that they deposited on 02/02/23. Which mean $734.16 is missing. They did admit charging my credit card for $734.16 on 01/15/23. That means they now have two payments for January and a missing $734.16 from the check. The last time I called I spent a few hours on the phone with Ambetter getting passed around with no resolve. The last person I spoke to told me my account is now terminated and hung up on me.

  Business response

  03/03/2023

  Letter attached. We are in direct contact with the member.

• Initial Complaint

  02/10/2023

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  On 11/10/2022 I cancelled my health insurance policy for the 2023 year. I received a January 2023 bill and called Ambetter on 1/10/2023 to inform them the policy had been cancelled. On January 25, 2023 Ambetter charged me $1,344.20 for January and February 2023 on a policy that had been cancelled. When I called Ambetter on 1/27/2023, they informed me that my policy was cancelled and I would have a full refund in 7-10 days. On 2/9/2023, I called to check the status of my refund. Ambetter stated that not only was I still enrolled in the health insurance policy but I was now enrolled in automatic payments. This was verified by the Healthcare Marketplace, who told Ambetter, on a three way call, that the policy was cancelled on 11/10/2022. I never gave permission to charge my credit card, nor did I EVER give permission to be enrolled in automatic payments. I was never enrolled in automatic payments for the 2022 year. Even the January health insurance bill that I received (after canceling) stated that my policy would be cancelled if payment was not received. After three hours of being on the phone with Ambetter on 2/9/2023, I still do not have confirmation that I will be receiving a refund. In summary, I was charged fraudulently for a policy that had been cancelled two months prior. My credit card information was stolen by Ambetter and used without authorization.

  Business response

  02/17/2023

  Dear ****** ****,
  Ambetter from NH Healthy Families received your correspondence on 02/10/2023 concerning ******** *****,
  BBB Complaint Case # ********. Due to federal and state privacy and confidentiality regulations, we are
  unable to disclose any protected health information, including, but not limited to eligibility, claims, and billing
  information. We will be sending a detailed response directly to ******** *****, BBB Complaint Case #
  ********.
  If you have questions, please call us at ***** ********.
  Respectfully,
  /s/ Lisa C*********
  Lisa C*********
  Director, Grievance & Appeal

  Customer response

  02/22/2023

  
  Complaint: ********
  
  I do not accept the business's response as a resolution to my complaint because: my refund was not received. Ambetter acknowledges that the insurance was cancelled through the marketplace on 11/10/2022, Ambetter spoke with three different agents at the marketplace and they still refuse to issue my refund. 
  
  Sincerely,
  
  ******** *****

  Business response

  02/24/2023

  We acknowledge the member does not have the refund yet and a separate communication was sent to the member by mail on 2/17/2023 to advise of the status.

  Customer response

  02/27/2023

  
  Complaint: ********
  
  I do not accept the business's response as a resolution to my complaint because: Ambetter is fully aware the Marketplace cancelled health insurance in Nov 2022 for the 2023 year. They are not operating as a professional business. Withholding my money and refusing to refund me when they fraudulently charged my credit card is theft. I’m expected to suffer for their criminal actions. 
  
  Sincerely,
  
  ******** *****

• Initial Complaint

  02/02/2023

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  My issue is with Ambetter NH Healthy Families, the insurance company we used in 2021 and 2022 through the ACA Healthcare Exchange. In September we got a letter saying that, per law, they owed us over $300 because their profits were too high and the excess needed to be returned to members. I called in late September (I don't remember the exact day) to ask for the refund and was told that they would use some of the money to pay the rest of my premium for the year and refund the rest within a couple of weeks. However, a refund check never came. I called again on November 17 and was told once again I would get the money back (now $284, I believe; I'm no longer able to go on their website to see the exact amount) in the next couple of weeks. I never received it. I called again on January 6 and was told the same thing – they would send the refund by check within 2 weeks or so. It still has not arrived. At this point it seems pointless to call again; I have no faith that they ever plan to refund this money (as required by law).

  Business response

  02/15/2023

  Response in process to member directly.

  Customer response

  02/15/2023

  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  **** *** *** ****

• Initial Complaint

  01/17/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  For months I’ve experienced problems on the Ambetter site. All payments and invoices have “invalid date” and the “latest invoice” is actually 9 or 10 months old, not close to latest. I’m on auto payment, but my account was suspended for owing money not sure how that can happen but I put extra money in and now I’m overpaid. E . For months I haven’t been able to look up any invoices or payments to check, because there’s are no dates-instead printed “invalid date. -. For months I’ve tried to have them fix the problem. Now they are telling me they are having a billing error. And glaze right over the invalid date issue I’ve been having. It seems no matter how much you ask too speak with someone higher who may under stand more of my issues, they don’t like to turn problems over to others. I’ve been trying to have medication sent thru their mail order pharmacy, Caremark. Between Ambetters pharmacy dept, Evolve and Caremark, they have a serious lack of communication. 6 days trying to get medication that way failed. A few hours locally, I have my prescription. Onto the most recent issue, when logging onto my account. I an error telling me my password expired. There is supposed to be an email sent but nothing is sent. This could be from an incorrect email address Iq don’t have that the system has not let me change. I’ve been told I am the one that needs to fix it but the site doesn’t let me-says to try again later 2 other representatives have told me they’ve fixed the email address and I will receive an email to log back on. I still haven’t. If I was a few days earlier,, maybe I could’ve been allowed to change plans. Cuz this is getting impossible to work thru. And calling in is ridiculous. They really want a chance, but the problems are so many messes together. If the website can’t work, I may need a lot printed out for me. Maybe a trip to executive park in Bedford will help

  Business response

  01/27/2023

  Dear ****** ****,
  Ambetter from NH Healthy Families received your correspondence on 01/17/2023 concerning **** ****, BBB
  Complaint Case # ********. Due to federal and state privacy and confidentiality regulations, we are unable to
  disclose any protected health information, including, but not limited to eligibility, claims, and billing
  information. We will be sending a detailed response directly to **** ****, BBB Complaint Case # ********.
  If you have questions, please call us at ***** ********.
  Respectfully,
  /s/ Lisa C*********

  Customer response

  02/06/2023

  
  Complaint: ********
  
  I do not accept the business's response as a resolution to my complaint because: I do not accept the business's response as a resolution to my complaint because: 
  
  I do not accept the business's response as a resolution to my complaint because: After my original letter to the BBB, I finally spoke with an Ambetter rep (first rep without a heavy foreign accident,)  who finally found a solution to one of my problems.  The Ambetter site does not work on Safari although it used to.  She was patient while I did all needed to install Google Chrome on my computer and all steps to reset a password and log in.  I asked if there could be a note on the website stating Safari was not supported.  Most sites list common limitations.  

  As for the prescription issues, I cancelled everything I had issues with using their online pharmacy.  I am still not able to change my email address on "profile" after I log in.  I STILL get the same response... unable to change...please try again.    
  
  I waited for the letter from Ambetter before I chose to accept on decline.  Although I am now able to log into my online Ambetter account, at the point of my original complaint, I could not. One Jan 27th, they still sent me an online notification I would be sent a letter in 3-5 days.  I did however receive another "unrelated" letter from Ambetter dated 2/5/2023 (yesterday) in the mail today.  
  Sincerely,
  
  **** ****
  
  **** ****

• Initial Complaint

  10/31/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I am a member of Ambetter NH healthy Families exchange program. I have an online account with them. I can no longer access my account in any way. I have been trying for weeks to regain access. Their account recovery system does not work. I have spent more than 90 minutes on the phone with them, tried repeatedly to reach out by email. Nothing works. I can’t access my account, review my bills, or pay my premiums. I am in danger of losing my insurance because their customer service is so ineffective. As you will see in the attached photo, there is no button to ask for an email to be re sent. I have never received an email regarding my password. I do receive other notifications. Their system is broken and they seem unable, unwilling to help.

  Business response

  11/16/2022

  Please see attached letter

  Business response

  11/17/2022

  November 16, 2022

   

  Better Business Bureau

  BBB serving New Hampshire

  48 Pleasant Street

  Concord, NH 03301

   

  Attn: Parker ****

  Re:         Consumer:  **** *********

  Complaint Case #:  1833****

   

  Dear Parker ****,

   

  Ambetter from NH Healthy Families received your correspondence on 10/31/2022 concerning **** *********, BBB Complaint Case # 1833****.  Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including, but not limited to eligibility, claims, and billing information. We will be sending a detailed response directly to **** *********, BBB Complaint Case # 1833****.

   

  If you have questions, please call us at (844) 265-1278.

   

  Respectfully,

  /s/ Lisa Carmichael

  Lisa Carmichael

  Director, Grievance & Appeals

• Initial Complaint

  09/28/2022

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  I was double charged for my insurance this month. They said they would issue a refund which would be 7-10 days, but had over drew my account and refused to issue it right away so I was charged until I was able to add money. I called today to check on my refund status as it’s been 8 days and they say my account doesn’t exist now they are just trying to steal from me.

  Business response

  12/12/2022

  Please see attached letter. Thanks.

  Business response

  12/13/2022

  December 12, 2022
  

  Better Business Bureau
  BBB serving New Hampshire
  48 Pleasant Street
  Concord, NH 03301
  

  Attn: Parker ****, Trade Practice Specialist
  

  Re: Consumer: ***** *********
  Complaint Case #: 18140088
  

  Dear Parker ****,
  

  Ambetter from NH Healthy Families received your correspondence on 12/06/2022 concerning *****
  ********** BBB Complaint Case # 18140088. Due to federal and state privacy and confidentiality regulations,
  we are unable to disclose any protected health information, including, but not limited to eligibility, claims, and
  billing information. We will be sending a detailed response directly to ***** *********, BBB Complaint Case # 18140088.
  

  If you have questions, please call us at (844) 265-1278.
  Respectfully,
  /s/ Lisa C*********
  Lisa C*********
  Director, Grievance & Appeals

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩