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:12/28/2022

  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 July 28, 2022 *** went to the doctor and they informed
  him our insurance was inactive. On 7/29/22 (Ref# I-********) **** contacted
  Ambetter regarding this issue. Ambetter claims that they have no information on
  us since 12/31/21 so on a conference call they included **** and a
  representative from the market place. The marketplace found us right away and
  said our insurance is active and payments are up to date. Ambetter and the
  marketplace had two different application numbers on file Ambetter's last application
  they had on file was from 12/21 and marketplace was current. Ambetter requested
  the file/application to be sent over. Everything sounded like it was ironed out
  between the two and we just had to wait up to 14 business days for everything
  to go through. I was advised to call back then. Looking at our bank account all
  of our payments made since January had been refunded to us ($2,093.16). We also
  received a check in the mail for $79.13.
  On 8/5/22 (Ref. # **********) **** calls Ambetter back to
  verify everything went through. Since 8/5/22 was exactly 2 weeks since the file
  was sent over they hadn't received it and I needed to call back the next
  business day to check.
  On 8/11/22 (Ref. # **********) **** calls Ambetter back to
  verify everything went through. The exact same thing happens beginning to end
  as 7/29/22 but Ambetter did say they saw that the file was sent/received but
  was rejected. After the 3 way conference call with, Ambetter, marketplace and
  ****, the marketplace once again sent over the needed file/application to
  Ambetter.
  8/16/22 We received a check in the mail for $489.91.
  8/19/22 We received a check in the mail for $25.00.
  On 8/22/22 **** called in and spoke with *******, a
  supervisor from Ambetter. She saw all the conversations in the notes and
  decided to try and help **** as much as she could. Once again a 3 way
  conference call was made with *******, **** and **** (marketplace rep.
  (Activity # ***********) The conversation seemed to go very smoothly and it was
  very thorough and seemed like finally there was a light at the end of the
  tunnel.
  8/25/22 We received an invoice showing the amount of
  $2790.09 due by 8/31/22.
  8/29/22 We received a check in the mail for $336.32.
  9/6/22 **** called Ambetter to verify what we owed towards
  our account. Ann said we owed $369.01 and that was all she saw due. **** made a
  payment in full (confirmation #********)
  On 9/8/22 We received a letter from Ambetter saying we no
  longer have health care benefits effective 2/1/22 with no explanation why.
  On 9/9/22 **** calls Ambetter back to verify everything went
  through from the conversation on 8/22. **** speaks with ******* and once again
  has to go through all this again since the file/application was rejected. 3 way
  conference call with Ambetter, **** and the marketplace (Activity id:
  *********) The marketplace verified we were active but at some point ******* hung up/got disconnected.
  On 9/9/22 We received a letter from Ambetter saying we no
  longer have health care benefits effective immediately saying the reason for
  cancelation is non payment.
  On 9/19/22 **** calls Ambetter and speaks with ********* the
  supervisor (Interaction # **********) He said he would file a request for us to
  be reinstated. **** requested a conference call with Ambetter and the
  marketplace to confirm everything is good on both ends. The marketplace rep
  confirmed we were active and gave ********* our application number and he said
  he would add it to the reinstatement request and it may take up to 7 business
  days for any updates.

  

  Business Response

  Date: 02/03/2023

  Ambetter from Home State Health (Ambetter) appreciates the
  notification related to **** *****’s concerns. Ambetter believes we
  have resolved the individual’s concerns.  Ambetter staff have
  outreached the members on January 19, 2023, to communicate the resolution and a
  letter was mailed January 23rd with the same information. If the
  individual has questions, they may contact Ambetter directly. 

• Initial Complaint

  Date:12/19/2022

  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.

  I started medicare on November 1 2022. I had to cancel the coverage with Ambetter, which was through the affordable care act. Called Ambetter on Nov 1st to cancel. Received a cancelation letter on Nov 5th from Ambetter and ************** had me canceled on the web site. I have requested a refund for the $487 premium withdrawn from my checking account on Oct 20. Since then I have called Ambetter 6 times and they keep giving me inconsistent information regarding the refund. After spending over an hour on the phone with Ambetter on Dec. 19th, and getting nowhere, is why I’m filing this complaint.

  

  Business Response

  Date: 01/20/2023

  Ambetter from Home State Health (Ambetter) appreciates the
  notification related to ****** ****’s concerns. Ambetter believes we
  have resolved the individual concern.  Ambetter staff have made
  multiple outreach attempts and left voicemail messages to communicate the
  resolution and answer any outstanding questions without success. If the
  individual has questions, they may contact Ambetter. 
  

• Initial Complaint

  Date:12/02/2022

  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 September 30th i had to cancel my wife and I joint insurance because I was going on Medicare. I called ambetter and asked what I needed to do. They told me that I could switch my wife over to a new policy and keep deductible met to date. They transferred me to the market place and created a new policy. I was told when I asked if the deductibles would be reset and I was told they would not. I was lied to by both ambetter and the market place because the deductibles did not carry over. I want my wife’s drugs covered as we met the 8600 deductible for 2022.

  

  Business Response

  Date: 12/14/2022

  Ambetter from Home State Health (Ambetter) appreciates the
  notification related to ***** *******’  concerns. Ambetter has
  reviewed the complaint and is working to transfer the deductible and out of
  pocket maximum to the new plan. Ambetter staff have attempted outreach to the
  Roberts and left a voicemail with no contact at this time.  Ambetter requests the Roberts to return the phone call if they would like more information on how their concern is being addressed. 

• Initial Complaint

  Date:12/02/2022

  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.

  I signed up for services in May 2022, the number I was given to speak about services led to an unmarked voicemail box which I never received a call back from.When I looked up the number online I was looped in a automated system and I couldnt speak to anyone.I never received insurance cards, despite the fact that I was charged for the services every month.Today 12/1/22 I received an automated text indicating my account had been declined due to insufficient funds with a phone number attached.I called the number and actually spoke to someone who attempted to collect payment.When I indicated that *** been trying to contact them for months, and that I never received anything from them at all, they claimed that I must be mistaken and that it was sent out June 22nd.Due to the fact that I know that is not true as I never received anything I suspected it may be some sort of scam and I requested to cancel the service and I wanted a refund for the amount I already paid.After being transferred I was informed that they dont give any refunds (even when I never received services) canceled my service and rushed me off the phone.

  

  Business Response

  Date: 12/09/2022

  Ambetter from Home State Health (Ambetter) appreciates the notification related to **************** concerns.Ambetter records show that **************** has not contacted Ambetters **************** line in the past. ********************** staff have attempted outreach to **************** twice since receiving the notification with no success in making contact. Voicemails were left for **************** to call back in order to address their concerns. **************** may call Ambetter **************** at **************.    

• Initial Complaint

  Date:11/29/2022

  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.

  Cancelled my health insurance in October as I obtained insurance through my work effective November 1. Was not told or could not understand the call center person(people) who speak marginal English at best that I need to speak w ************** to end the insurance. Got a nasty past due letter last night in mail and called. Finally had someone transfer me to ************** to cancel. Issue is ************** said they could only cancel today or tomorrow dates. I am not paying for two health insurance plans period. I told am better and was reassured that cancellation was good for November 1 and now it’s not. I want this resolved and will not pay AM better a dime for coverage I did not want and cancelled in plenty of time.

  

  Business Response

  Date: 12/07/2022

  Ambetter from Home State Health (Ambetter) appreciates the
  notification related to ******* *********** concerns. We can confirm that ******* ********* has been contacted by Ambetter staff who assisted in contacting
  the Health insurance Marketplace to request retroactive cancellation and the member would work with the Health Insurance Marketplace on changes to the cancellation dates. Ambetter
  would like to clarify that all cancellations must be done through the Health
  Insurance Marketplace. Ambetter will implement a change in the cancellation date as communicated by the Health Insurance Marketplace. 

  Thank you for informing us about the individuals concern.