Complaints

The complaint text that is displayed might not represent all complaints filed with BBB. 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.

• Initial Complaint

  Date:05/21/2025

  Type:Sales and Advertising Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  My wife purchased ambetter Oklahoma through marketplace after moving from Florida, where she had ambetter sunshine heath she had paid 3 mos ahead. Once we moved to Oklahoma she notified them so the insurance could be switched over and she was supposed to be credited the overage and a new premium for her new policy was issued. We paid the premium and was told the credit was already credited to that. We then received another bill saying we owed what we were supposed to have credited as well as the new bill. Which again we paid. Weeks later we attempted to get into the online account and couldn't. We called and was told we were locked out because the plan was cancelled on the first of April even though everything had been paid. My wife has type 2 diabetes and has been a week without her insulin and blood pressure medicine which is extremely dangerous for her and a life or death situation. After calling and fighting with a rep daily, we keep getting told everything is paid correctly and the policy is being reinstated. However still today there saying we owe money, though we were cancelled since April 1st and had no coverage and were actually over paid. And they still have not reinstated the policy.

  

  Business Response

  Date: 05/22/2025

  05/22/2025
  
  Better Business Bureau serving Central Oklahoma
  ** ***** *****
  ******** ***** ** *****
  
  Re: ******* *******
  Complaint ID: ********
  
  To Whom It May Concern,
  Ambetter of Oklahoma received your grievance on 5/21/2025 concerning ******* *******, BBB
  Complaint Case# ********. Due to federal and state privacy and confidentiality regulations, we are
  unable to disclose any protected health information, including eligibility, claims, and billing
  information, with anyone other than our members or their authorized representatives.
  
  An Ambetter representative has attempted to contact Ms. ******* ******* to discuss her concerns;
  however, a voicemail was left with our representative’s direct contact information as well as an
  outreach email was sent to the complainant. We will be sending a detailed response directly to
  ******* *******, addressing BBB Complaint Case # ********. If you have questions, please call us at
  ************.
  
  Respectfully,
  
  **** ****
  Member Relationship Liaison
  Ambetter

• Initial Complaint

  Date:01/08/2025

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I bought an ambetter policy for my daughters through a broker. The ambetter Company has been horrible. Most of the doctors on the list of providers would not accept the insurance. We could not find appropriate doctors. I went to cancel the insurance and they keep saying they can't cancel the policy, that it must be done on the marketplace. However, I spoke to the marketplace and they have no record of the policy because I didn't buy the policy through the marketplace. I bought it through a broker.

  

  Business Response

  Date: 01/13/2025

  Ambetter of Oklahoma received your grievance on 12/09/2024
  concerning ******** *****, BBB Complaint Case# ********* Due to federal and
  state privacy and confidentiality regulations, we are unable to disclose any
  protected health information, including eligibility, claims, and billing
  information, with anyone other than our members or their authorized
  representatives. 
  
  An Ambetter representative has attempted to contact Ms. *****
  to discuss her concerns; however, there was no answer, and a voicemail was left
  with our representative’s direct contact information. We will be sending a
  detailed response directly to ******** ***** addressing BBB Complaint Case
  #*********  If you have questions, please
  call us a* ************* 
  

• Initial Complaint

  Date:12/13/2024

  Type:Customer Service Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  A previous PA approved by Ambetter of OK, the manufacturer dc'd the Freestyle Libre 3 so I attempted to fill the replacement ******************************** of OK denied the ** fill request & said to resubmit a new PA for the new Libre 3 Plus in order to be covered. My ** has submitted that multiple times & continues to be told different reqs by ************ We spent several hours attempting to follow the directions of Ambetter, however every time we speak with them they give us different directions & continue to run us in circles denying the ** which is critical to control my blood sugars. This ridiculous game that the insurance is playing to drag their feet & not approve claims as usual is not the first time this has happened to me. Today, 12/13/24, I spent 2 hours on a call with Ambetter customer service attempting to fill my **. I had no choice, but to attempt to communicate with people who barely spoke English & could not understand what I was saying. I was transferred 6 times between customer service & ** services. Each employee, including the pharmacist, her name was **** (which should violate ethical practice licensing laws which I'm going to file a complaint about), says the other person, ******* *. was the other employee, but they transferred me back & froth with the cycle repeating itself several times. After 2 hours on the phone, I asked 4 times very calm & politely for a supervisor, boss or someone that was in charge, I was ultimately hung up on. This type of service is absolutely ridiculous! The lack of patient care is compromising my health & leading to more complicated future health problems. This is not the first time that we've had to deal with these bogus ************** needs to be addressed. I understand your primary focus is shareholder profits & not patient care, but wasting patient time is demeaning and disrespectful. I realize this likely falls on deaf ears, but other potential patients should understand how your organization actually operates.

  

  Business Response

  Date: 12/19/2024

  Please see attached response to complaint. Thank you

  Ambetter of Oklahoma received your grievance on 12/16/2024 concerning ******* *******, BBB Complaint Case #********. Due to federal and state privacy and confidentially regulations, we are unable to disclose any protected health information, including eligibility, claims, and billing information, with anyone other than our members or their authorized representatives. 

  
  

  An Ambetter representative reached out to Mr. ******* on 12/16/2024 and left a voicemail with their contact information and advised they will be assisting him with his concerns.  We will be sending a detailed response directly to Mr. ******** addressing BBB Complaint Case #********. If you have questions, please call us at ************** (TTY/DD **************).

  
  

• Initial Complaint

  Date:12/06/2024

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  They keep sending boxes of food to my house for someone who doesn't live here. They don't have an email contact on the website so I can just tell them to stop.This thing with no contact email address on websites needs to end it's absurd. Stop wasting my time I have no relationship w/ you if you send me another box of food I will sue you.

  

  Business Response

  Date: 12/13/2024

  Ambetter of Oaklahoma received your grievance on 12/10/2024 concerning ******* ******* BBB Complaint Case* ********* Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including eligibility, claims, and billing information, with anyone other than our members or their authorized representatives.  
  
  An Ambetter representative has attempted to contact Mr. ****** to discuss his concerns; however, there was no answer, and a voicemail was left with our representative’s direct contact information. We will be sending a detailed response directly to ******* ****** addressing BBB Complaint Case **********  If you have questions, please call us at ************* 
  
  
  

• Initial Complaint

  Date:12/02/2024

  Type:Order Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  We had Ambetter of Oklahoma as insurance through the ****etplace until we realized in April we qualified for the government assistance Soonercare, we applied and we accepted which was supposed to automatically terminate our policy with Ambetter as of May 1st 2024. In August we find out that the policy was not cancelled and that our new insurance would not pay until Ambetter was removed. Contacting Ambetter I find out that the policy was not terminated as it should have been and that they continued charging us through direct deposit but assured me it would be canceled September 1st. I receive a letter in September from ********** stating that Ambetter is still showing primary and that they will not cover bills until they are removed. Ambetter then assured me the problem would be resolved within 30 days and asked me to call the Marketplace, Soonercare, and Oklahoma Complete Health to update them on the situation. This has continued to be the same pattern as I have followed up at the ******************************************* an additional 30 days and to make calls to the other businesses 2 more times. It is now December and my familys bills have not been paid due to this discrepancy and we are having to constantly inform any health care providers of the situation. This is 8 long months of frustrating phone calls and Ambetter is giving me trouble when it comes to paying for the bills through September 1st for the time they did not terminate my familys policy.

  

  Business Response

  Date: 12/09/2024

  Please see attached response from Ambetter. Thank you
  

  Re: ******** ******

  Complaint ID: ********

  To whom it may concern,

  Ambetter of Oaklahoma received your grievance on 12/03/2024 concerning ******** ******, BBB Complaint Case# ********. Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including eligibility, claims, and billing information, with anyone other than our members or their authorized representatives.  

  
  

  An Ambetter representative has attempted to contact Ms. ****** to discuss her concerns; however, there was no answer, and a voicemail was left with our representatives direct contact information. If you have questions, please call us at ************. 

  
  

  Customer Answer

  Date: 12/11/2024

  *
  ********** ********
  
  I am rejecting this response because:

  I have called back *******(?) the agent that contacted me and left messages twice now and no response.  
  
  Sincerely,
  
  ******** ******

• Initial Complaint

  Date:02/21/2024

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  
  Complaint: ********
  
  I am rejecting this response because: ok how do I send this complaint to ambetter of Oklahoma instead of *******?
  
  Sincerely,
  
  *******************************

  

  Business Response

  Date: 02/06/2024

  Thank you for forwarding the complaint you received from *******************************, dated 2/6/24, BBB ID number ********. By reviewing the data you submitted, we believe you may have contacted the wrong health plan. It appears this member resides in Oklahoma state and we have forwarded this complaint to the Ambetter health plan in *******. Please let the complainant know that they should contact ** directly if they believe they have coverage through Ambetter from **************** in ****************. 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 to the BBB.

  Customer Answer

  Date: 02/21/2024

  I paid for my first health care premium on 12/15/23 for coverage to start on 1/1/24. my payment was taken but not credited to my account I paid for February coverage on 1/12 once again my payment was taken but not credited to my account. I have called ambetter fifteen times with most calls taking 45 minutes to an hour or more per call and they won't fix the billing discrepancies. I have been lied to repeatedly and told things like a team will fix it and someone will contact me etc. I have about 12 different reference numbers from all these calls. I have been trying to resolve this issue for over a month. their online payment system is messed up it takes your money but does not credit your payments. when you call the people you talk to can't resolve the problem and no one ever does. my original coverage was not activated because they never credited my first payment to my account my second payment activated it but now they are sending me emails saying my account is delinquent due to non payment. I don't want to keep having to call and keep paying more than i owe and continue to have the issue remain unresolved. I have had multiple ambetter reps say my December payment was for december coverage I didn't have insurance with ambetter in December.

  

  Business Response

  Date: 02/26/2024

  February 7, 2024
  
  Better Business Bureau
  P.O.Box 191279
  *****,** *****
  
  Re:*******************************
  Complaint **: ********
  
  To Whom It May Concern,
  
  Ambetter of Oklahoma received your grievance on February 7, 2024, concerning ******************************* BBB Complaint Case# ********.  Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including eligibility, claims, and billing information, with anyone other than our members or their authorized representatives.
  
  An Ambetter representative attempted to contact ****************** on February 7, 2024, to discuss the details and resolution of the complaint; however, was unsuccessful in reaching her. An Ambetter representative is actively working on continuing efforts to establish contact with ******************. We will be sending a detailed response directly to ****************** addressing the BBB complaint Case # ********. If you have questions, please call us at **************.
  
  
  Respectfully,
  
  *****************************
  Member Relationship Liaison
  Ambetter
  
  
  

• Initial Complaint

  Date:08/11/2023

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Ambetter of Oklahoma owes me a premium refund of $523.22. They have attempted to refund my money via ach to an invalid bank account. I have called in 4 times to request a paper check in the mail yet they refuse to do so.

  

  Business Response

  Date: 08/14/2023

  August 14, 2023
  
  Better Business Bureau
  17 ***********************
  Oklahoma City, ** 73102-2400
  
  
  Re: *********************
  Complaint ID: #********
  
  To Whom It May Concern,
  
  
  Ambetter of Oklahoma received your grievance on 08/11/2023 concerning *********************, BBB Complaint Case# ********. Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including eligibility, claims,and billing information, with anyone other than our members or their authorized representatives.
  
  An Ambetter representative spoke to *********************, on 08/14/2023 and advised they will be assisting him with his concerns.  We will be sending a detailed response directly to ********************* addressing BBB Complaint Case # ********.  If you have questions, please call us at **************.
  
  Respectfully,
  
  *************************
  Member Relationship Liaison
  Ambetter

• Initial Complaint

  Date:03/10/2023

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Made a payment of insurance premium on February 8th. I then received an update saying my policy was suspended due to non-payment. After being on the phone with their customer service for over 40 minutes I was told that the payment would not be updated for a number of days, and this was essentially just how things went. I contacted Ambetter again on March 8th. After demanding to speak with a supervisor, I was placed in contact with their escalation team. I was again on the phone for over 40 minutes. This time after filing a grievance, I was told I would be called by a representative within 72 hours. It is past 72 hours and I have not been contacted, but my notifications on my Ambetter account says I will be mailed an acknowledgement letter in 3-5 business days. this company appears to be a joke. If I was made aware of the fact that they have been in business for less than a year I would've never chosen them as my health insurance.

  

  Business Response

  Date: 03/14/2023

  To Whom It May Concern,
  Ambetter of Oklahoma received your grievance on 03/13/2023 concerning ***********************, BBB Complaint Case# ********. Due to federal and state privacy and confidentially regulations, we are unable to disclose any protected health information, including eligibility, claims,and billing information, with anyone other than our members or their authorized representatives.
  
  An Ambetter representative spoke to ***********************, on 03/14/2023 and advised they will be assisting him with his concerns. We will be sending a detailed response directly to *********************** addressing BBB Complaint Case # ********. If you have questions, please call us at ************ (TTY 711).
  
  Respectfully,
  
  *****************
  Member Relationship Liaison
  Ambetter

• Initial Complaint

  Date:01/20/2023

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I have been trying to make my premium payment for about a week now so first I went to my online profile and try to make my payment there only to see an error when I try to process the card, ok so I tried a different card same outcome so then I tried to do it with my routing and baking number same outcome. So I get on the phone spend 15 minutes waiting giving all the information and they tell me an error is coming up and to try and call back the next day. I call back the next day this time I spend 20 minutes just for the same result but I tell them I need to talk to someone that can tell me what is happening I get put on hold and then magically the call goes dead. I called again 5 more times just for the same result. At this point I have spend about 3 hours of my life trying to make a payment. Each time I explain my situation and frustration and no one seems to know what is going on but the operator wont let me speak to a supervisor or someone that can offer me an explanation as to why I CANNOT pay my premium. It should not be this difficult for customer to make a payment. The website offer no help on who to reach out to for help solving the issue.

  

  Business Response

  Date: 02/06/2023

  To Whom It May Concern,
  
  Ambetter of Oklahoma received your grievance on 01/30/2023 concerning ***********************, BBB Complaint Case# ********. Due to federal and state privacy and confidentially regulations, we are unable to disclose any protected health information, including eligibility, claims, and billing information, with anyone other than our members or their authorized representatives.
  
  An Ambetter representative reached out to **************** on 01/30/2023 and left a voicemail with their direct contact information.  This liaison will be assisting her with her concerns.   We will be sending a detailed response directly to **************** addressing BBB Complaint Case # ********. If you have questions, please call us at ************** (TTY 711).

• Initial Complaint

  Date:12/15/2022

  Type:Service or Repair Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I was considering changing from BCBS to an Ambetter of Oklahoma policy through the healthcare marketplace here in oklahoma. I started researching doctors I could switch to due to my current doctors not being in Network with Ambetter. I chose some that were listed in Ambetters in Network list on their website. When I called those doctors they had never heard of the company. I called 6 different doctors in my area and none of them had heard of Ambetter of Oklahoma. I then called Ambetter to ask what the issue was and how I could find a doctor if their list is that inaccurate and they said they didnt know what to tell me. Something should be done about our choices here in oklahoma and Ambetter should not be misrepresenting themselves in such a matter. How many people take them for their word and sign up with their plans just to find that they are being deceived! Immoral and unethical company in my opinion. t

  

  Business Response

  Date: 01/10/2023

  Response in attached file. 

  Customer Answer

  Date: 01/12/2023

  
  Complaint: ********
  
  I am rejecting this response because:

  It won't be resolved for me because I chose to go with another company but for everyone else who are being deceived by them it won't be resolved until they start being alot more accurate on their list of participating providers.  They did call me but like I said nothing can be resolved for me I just want to make sure no one else is scammed by them or taken advantage of. 
  
  Sincerely,
  
  *************************

  

  Business Response

  Date: 02/06/2023

  To Whom It May Concern,
  
  Ambetter of Oklahoma received your grievance on 01/03/2023 concerning *************************, BBB Complaint Case# ********. As stated previously, due to federal and state privacy and confidentially regulations, we are unable to disclose any protected health information, including eligibility, claims, and billing information,with anyone other than our members or their authorized representatives.
  
  We are also in receipt of ******************** rejection of our initial response, which she submitted to your agency on 01/12/2023.  An Ambetter representative spoke to ****************** on 01/04/2023.  Unfortunately, at that time ****************** informed our representative that she had selected another insurance carrier,and our representative was unable to assist her further.  ****************** was asked to forward the names of providers who had informed her they were not participating with Ambetter to our representative for follow-up; however, as of the date of this letter we have received no further communication from *******************
  
  We sent a detailed response directly to ************************* addressing BBB Complaint Case# ********. If you have questions, please call us at ************** (Relay 711.)
  
  Respectfully,
  *************************
  Member Relationship Liaison, AmbetterTell us why here...