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:02/22/2023

  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.

  I HAVE NOT HAD INSURANCE WITH THIS COMPANY SINCE 2019. ON 1/17/2023 THEY TOOK 546.03 OUT OF MY CHECKING ACOUNT..I CALLED MY BANK AND WAS SENT A FORM TO FILL OUT THEN IT WAS PUT BACK IN ON 1/25/2023. NOW ON 02/21/2023 THEY HAVE TOOK 1108.63 OUT OF MY CHECKING ACCOUNT. I HAVE CALLED MY BANK AGAIN AND THEY ARE SENDING ME ANOTHER FORM TO FILL OUT AND SUGGEST I GET A NEW ACCOUNT. I CALLED AMBETTER THE FIRST TIME THEY TOOK MONEY OUT AND THEY TOLD ME THEY HAD NO RECORDS OF THIS TRANSACTION. NOW TODAY I HAVE CALLED THEM AGAIN ABOUT THE 1108.63 BEING TOOK OUT AND WAS ON THE PHONE OVER A HOUR AND GOT NO RESOLUTION.. THEY SAY THEY HAVE NO RECORD OF THIS AND TO EMAIL THEM A PRINTOUT OF THE TRANSACTION. AGAIN I HAVE NOT HAD INSURANCE WITH THEM SINCE 2019 AND THIS IS VERY UPSETTING TO ME. I AM OLDER AND DO NOT KNOW HOW TO UPLOAD DOCUMENTS, IF YOU CALL ME AT ************ I CAN GIVE YOU MY BANK INFORMATION OR WHATEVER YOU MIGHT NEED. THANK YOU, ***** ** ******

  

  Business Response

  Date: 03/20/2023

  We appreciate communicating the concern to Ambetter.  The individual was contacted on 03/08/2023 and communicated the resolution related to their concern.  The individual understood the resolution and Ambetter also communicated that they can reach out to the member services line on the back of their insurance card for any additional questions.

• Initial Complaint

  Date:02/22/2023

  Type:Billing 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.

  Last year from September to December of 2022,I received health insurance from Ambetter home state health at no charge due to a tax credit provided. At the end of 2022, after updating information they said I didn't qualify for tax credit for 2023, so i asked them to cancel and they said they would. but later that day they text me saying I qualified and only had to pay $48 each month and followed with a letter. After I sent $48 for ******** they sent a letter requesting the balance of the full amount of $1425, so I called again and requested them to cancel and they said they would, but didn't so I called again in January in which they assured me they would cancel again, but didn't and continued to add $1425 each month, for **** Feb, and Mar, so that's why I'm contacting the BBB now. I need this resolved ASAP please. I would appreciate it. Invoice #***********, plan #*****MO0090011-01, member ID: ***********, policy #********. I appreciate your help. Thanks.

  

  Business Response

  Date: 03/07/2023

  Ambetter from Home State Health (Ambetter) appreciates the notification related to ******************************************** concerns. Ambetter can confirm that Ambetter staff have outreached the member and resolved Members cancellation issues. The member is encouraged to outreach Ambetter staff for any further assistance.

  Customer Answer

  Date: 03/13/2023

  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

  Date:02/16/2023

  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 enrolled with Ambetter Insurance that is supposed to include insurance for dental and vision in the state of MO. I have attempted unsuccessfully to get an appointment with a dentist. Ambetter does not have a list of authorized dentists, the numbers they provided me did not accept Ambetter, in fact one company asked me to tell them to remove them from their list. I called and got conflicting information repeatedly from Ambetter, in fact one time I was given a number for what appears to be a prisoner dental center. This is unacceptable and fraudulent. If there are no dental providers then do not lie to people who purchase insurance, just make it medical and vision. I would like an accurate and current list of dental providers in *** ***** or *** ***** county provided to me and to the BBB that can be verified. I have attempted numerous times to no avail.

  

  Business Response

  Date: 03/06/2023

  Ambetter from Home State Health (Ambetter) appreciates the
  notification related to ***** ******** concerns. Ambetter can confirm that
  Ambetter staff has outreached the member and provided the requested
  information. ***** ****** is encouraged to reach back out to this staff member
  if they require any further assistance.  

• Initial Complaint

  Date:02/14/2023

  Type:Billing 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.

  This dental company keeps billing me for services, and I gave them my son's dental card number multiple times. ******, the secretary, had gotten my oldest son mixed up numerous times with my other son's account. She put my son's name on his bill, and then I got another bill for my other son with different amounts. When I called to get this straightened out, ****** told me nothing was done on the insurance side and that it was the patient's responsibility to contact the insurance company. Upon calling the insurance company of Ambetter at ************, I spoke with the agent. Then we called the office at 4:51 pm on Feb 14, 2023, as ******, the office manager, answered as rude to the agent on the phone and threatened to report this account to collections knowing that my son was covered and there were not NO Claims reporting on that date of June 17th, 2022. I spoke with the office manager, ******, and our insurance company at Ambetter for Envolve. The service was for $184.44, and the insurance number is U9314373603 for *******************************. Maybe ****** put in the wrong patient ID Member number, too. He asked them if they wanted to scan his card again to make sure, and they refused that as well. Therefore, it is their mistake, and the insurance company is not doing their jobs. Yes, my oldest, *********************************, did not have insurance for dental last year, but in 2021 his id number was ***********. Mine is U93143736-01. I want this to be paid and resolved immediately! This has been going on for a long time, so please make sure all the claims are paid for and get ahold of ************************* office for the claim process to start immediately and have them stop harassing me with bills since the insurance is responsible for paying for this bill. I want this to be corrected and need this to be taken care of immediately, and tired of this office trying to say or threaten me into collections. I never cared when I lost my job in October; the dental place never cared and just wanted money.

  

  Business Response

  Date: 03/21/2023

  Ambetter from Home State Health (Ambetter) appreciates the notification related to ************************************* concerns. Ambetter can confirm that Envolve Dental, Ambetters dental benefits manager, has attempted to outreach *********************************** with a resolution in their favor, but was unable to speak directly. Envolve Dental left a voicemail, and we encourage *********************************** to reach out with the information provided in that voicemail if they have any further questions. 

  Customer Answer

  Date: 03/22/2023

  Complaint: 19407454
  
  I am rejecting this response because Complaint: 19407454
  
  I am rejecting this response because I have called multiple times and they are still failing to contact *********** to pay this claim from June 16 to June 17th 2022. I am tired of fighting with this company and if they paid my claims as my son had same insurance with me from Market place, than there is no reason his claims should not get paid. I hate Ambetter and *********** nor taking care of this and now we are in collections because of them. Not okay business to me! Pay these claims!
  
  
  
  Sincerely,
  
  ***********************************
  
  
  
  Sincerely,
  
  ***********************************

  Customer Answer

  Date: 07/27/2023

  7/27/23 JA - Called consumer and she said the complaint has been resolved with the company.

  

  Business Response

  Date: 07/27/2023

  JA

• Initial Complaint

  Date:02/09/2023

  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.

  They are false advertising that you will get $500 on a health card and it's supposed to be from the government. They are advertising on the internet, on ********. I think they are scamming the government off and ripping people off. They wanted me to give them $90 for another insurance. Why do I have to pay $90 for $200 insurance when they are getting $1100 for my insurance from the government?

  

  Business Response

  Date: 02/22/2023

  Ambetter from Home State Health (Ambetter) appreciates the
  notification related to **** ********s concerns. Ambetter can confirm that
  Ambetter offers a My Health Pays Rewards program through which Member’s can log
  qualifying health events to earn reward points, exchangeable for reward dollars
  on a prepaid Visa card. Members must sign up on Ambetter's website in order to
  earn points and exchange those points for a prepaid Visa Card. Members can
  complete this signup process at *********************************************************************.
  Ambetter is unable to provide reward benefits until Member’s sign-up for the
  program and agree to the terms and conditions. If any additional questions, they may contact Ambetter at ************** **** *****  

• Initial Complaint

  Date:02/09/2023

  Type:Delivery 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 had to constantly beg them to send me a hard copy of my member id card they kept telling me to copy one off their website. I have called about this matter 6 times, I escalated my complaint to a supervisor, after repeated "promises" it was mailed and when I received on it had the wrong Member ID #. They keep stating its corrected one is on the way in 10 business days, right it will be March before I obtain what I am entitled too obtain. This is unacceptable they should of provided me and all insured a mailed copy of cards. My ask is simple provide me a card via mail with the correct user member id.

  

  Business Response

  Date: 02/15/2023

  Ambetter from Home State Health (Ambetter) appreciates the notification related to ******** *******i’s  concerns. Ambetter can confirm that the member’s ID card is being mailed and it should be received withn two weeks. If you have any questions, please call member services at ***************

  Customer Answer

  Date: 02/17/2023

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

  What they keep sending is INCORRECT!  They sent me two cards,  MY MEMBER ID ends in ** my husbands ends in **.  Check out the attachment.   I have called on this 7 times now, waited never received anything then i received two and still they cant get it right!    10 days is also NOT acceptable, this is an escalation I expect a urgency in the delivery not the "norm".  We are into month 3 and I pay $$$ for this insurance and should not be treated the way I have been treated and denied what right to obtain a simple request for a hard copy insurance card. 

  
  
  
  Sincerely,
  
  
  
  ******** ********

• Initial Complaint

  Date:02/07/2023

  Type:Customer Service 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 had two policies with Ambetter,and have since cancelled both of them. I called them several times to try and resolve this issue, but I was unsuccessful. Yesterday when I called, I asked to be transferred to a supervisor,and I was hung up on.

  

  Business Response

  Date: 02/15/2023

  Ambetter from Home State Health (Ambetter) appreciates the notification related to ******************** concerns. Ambetter has confirmed that this member was is in contact with customer service on 2/7/2023 and that their concerns are being addressed appropriately. In addition, we wanted to provide information on healthcare.gov (****************************************************************************) on how to cancel a policy through the Health Insurance Marketplace at ************** or through healthcare.gov.

  Customer Answer

  Date: 02/15/2023

  Complaint: 19349757
  
  I am rejecting this response because: I have been in contact with customer service,and have cancelled all of my policies. I was also told that I would receive a refund by 2/14/2023, and I have yet to receive it.
  
  
  
  Sincerely,
  
  ***************************

  Customer Answer

  Date: 06/23/2023

  6/23/23: AI- Called consumer yesterday and left VM for call back. Will follow up with email regarding mediation introduction and desired resolution.

  7/7/23 AI - 2nd attempt to consumer requesting resolution status. Email has been sent.

  7/7/23 AI Consumer responded in email 

  **************************************;<**************************>

  ?

  ?

  ?

  ?

  ?

  To:

  • Ashleigha ******

  Fri 7/7/2023 9:59 AM

  

  Thank You for your email. I just wanted to let you know that Am better has issued me a refund,and cancelled my policy. I now have health insurance through another company. Thank You for reaching out to me.

  
  

• Initial Complaint

  Date:02/03/2023

  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.

  On December 3rd we chose Ambetter of Mo for ACA plan on ***********. We made the first payment with no issues and received our ID cards. Then we got a notice that our premium would come out for next month autopay and it was for $22,593.24 instead of the $109.88. We contacted them on January 2nd or 3rd and told them of the situation and they said that has happened to some others and they are working on fixing. They said they cancelled the autopay and won't pull the amount. On 1/15 ambetter pulled the $22,593.24 from my bank account on the autopay and I had to get with my bank to dispute charges. I was able to dispute and get the money back, but still had to pay sweep transfer charge of $10 and an insufficient funds of $36 that I want covered due to Ambetters error. I am unable to speak to a person in the US that can assist to remedy the situation and am also going to file a complaint with the Dept of Insurance.

  

  Business Response

  Date: 02/17/2023

  Ambetter from Home State Health (Ambetter) appreciates the notification related to **** ******’s concerns. Ambetter has reviewed the concern and contacted the member with our response and working through resolving the complaint. This member may contact Ambetter with any additional concerns.

• Initial Complaint

  Date:01/25/2023

  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 participate in Ambetter's Myhealthpays Rewards. This program rewards Ambetter insurance customers with debit cards or merchandise for positive health behavior. A few months back with my points I accumulated, I transferred the points to a $225 debit card, which was sent to me in the mail. When I received the debit card in the mail, I activated it by calling their activation number from a sticker on the card. I even checked the balance using their ***** number, which stated that the card had $225 on it. I tried using the debit card at multiple locations and was denied access to my $225 every time. I called Ambetter's ************** to try and resolve the issue of my card not working. Every time I was connected to service representatives who spoke broken English, hung up on me, wouldn't connect me to their supervisors, etc. *********** representatives always would say their supervisors were unavailable or on a lunch break. I finally connected with a service representative who agreed to send me another debit card to replace the one that didn't work. About a month later, I received another debit card in the mail and activated it by their ***** number. I tried using it at ********** and ******* and was unable to make my purchase. These items were not prohibited according to the **** card agreement. I called Ambetter's ************** number. I had several calls dropped or the service representative hung up on me. Eventually, I talked to one service representative who told me that I needed to convert my debit card numbers to dollars. I told her the debit card was already in dollars. I asked to talk to her supervisor and she was very reluctant to do that after my repeated attempts to have her transfer me to her supervisor. She then put me on hold and after several minutes she comes back and says her supervisor is unavailable. She tells me that I have to wait a month before trying to use it again. I don't have a high opinion of Ambetter Service Reps.

  

  Business Response

  Date: 01/30/2023

  Ambetter from Home State Health appreciates the notification related to ******************** concerns. Ambetter would like to clarify that funds earned through the My Health Pays program may only be used at certain merchants and must be redeemed for one of the choices listed on the website. *********** Wal-Mart or supermarkets would not be an approved merchant.  Outreach was attempted on January 27, 2023 to provide additional information without success.  A listing of choices and additional information related to the My Health Pays program can be located at the following website: **************************************************************************************************************************************************.

   

   

  Customer Answer

  Date: 01/31/2023

  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.  The link provided by Ambetter in their BBB response leads to a error page on their website.  Also, the person I talked to also provided an email with links to file complaints against their service representatives who provided poor information or no information concerning their health rewards program.  
  
  Sincerely,
  
  *************************

• Initial Complaint

  Date:01/04/2023

  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.

  Hello,
  My name is ***** ********, member ID is *********.
  
  On 11/18/2021, I had an infusion (see enclosed EOB). I have been getting these infusions every 4 weeks since 2010 (12 years!). The beginning of every year SSM gets a approve for my 12 infusions (see enclosed approval letter for 2021). In Dec. of 2022 I received a bill from SSM for $8,216.64 (see enclosed statement from SSM) for the infusion I had on 11/18/2021. I called them to see why I received this bill & they told me that My insurance (Ambetter) took back the payment in Dec. of 2022 for the infusion I had on 11/18/2021 (13 months latter!). I have tried four times calling the phone # on my card (which is a call center in the Philippines) and have been disconnected three times & on the forth time, I was told a supervisor would call me that day, but no call that day or any day! This is the second time they have just taken money back & had to file a grievance.. The first time was in 2019. They did finally pay it back after a lot of calls. I am hoping this time it doesn't take as much time & effort. I want this bill for my infusion to be paid. Thank you,

  

  Business Response

  Date: 02/10/2023

  Ambetter from Home State Health (Ambetter) appreciates
  the notification related to ***** ********'s concerns. Ambetter has reviewed the concern and contacted the member with our response. Ambetter also contacted the related provider related to the concern. Mr. ******** can contact Ambetter with any additional concerns. 

  Customer Answer

  Date: 02/10/2023

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

  SSM is still billing me the $8,216.64 that I have paid & have sent Ambetter receipts showing that I paid. The lady from Ambetter who called me & talked to me asked for the paid receipts. She also said that she would call SSM & call me back. I have never received a call back. I don't even understand the response from Ambetter to my complaint.

  Please call me & explain what is going on, thank you.
  
  
  
  
  
  
  
  Sincerely,
  
  
  
  ***** ********

  

  Business Response

  Date: 05/16/2023

  Ambetter from Home State Health appreciates the notification
  . Ambetter has outreached the member
  and left a voicemail to provide additional information. Ambetter believes the related concerns to be resolved. If there are any
  further concerns, the member can return the call from Ambetter
  staff to discuss.