Ambetter of Illinicare Health

Unbelievable. USAF veteran, injured during service. On same medicine for 8+ years, same price, needed a PA, but aside from that - otherwise ok. Until January 2020.
Without any notification or really, anything - *** decided to raise the price of my medicine from $50... to $1,400. With a Prior-Authorization. My doctor, pharmacist & I were all stunned - thought it MUST be an error. Even their own representatives couldn’t figure out what happened. Made 15+ calls & got 15+ different answers.
I’ve now missed two weeks of work, am in agonizing pain, but instead of doing what I pay them to do, ambetter would rather just take your money & watch you wither away. I thought just maybeee, somebody would sympathize, for having been involved in a helicopter training accident. Boy, I was wrong! Aside from that usual “thank you for your service” - the rest amounted quite literally to “Sorry, you’ll just have to deal with it”. I even asked the representative, “is there ANYTHING OR ANYONE WHO CAN HELP?” To which, she replied “nah, looks like you have to pay the $1,400 or figure out something else”
The kicker: when I setup my plan, on the phone with these animals, I told them every medicine I was on & how coverage of those meds was my top priority. I was assured, that not only would I be covered, but if there was a change that would impact me - I would receive mail, informing me. Instead, I had to wait, until I was OUT OF MEDICINE, to say “hey, we’re not going to cover that anymore - we realize it’s the only effective medicine, but just pull $1500 out of your as every month”
So, after exhausting all possible, logical solutions, I’m here now, to warn you - if you have any pain at all, stay away from this company. You get treated like a criminal-lab-rat. I know I won’t get an apology for throwing a wrench into my life from ***, but JUST MAYBE, they’ll see all of these comments & make some changes.
You just can’t treat people like this. Especially, those of us, who put our lives on the line, while you stuff your wallets and bank accounts, in complete ignorance & safety. If you cared at all, I would have received a call, that I was promised, from a supervisor - now, I’m looking for the soonest & best company to switch over to. These greedy, greedy people, would rather you be crippled in pain, not working & unable to do day to day activities - than actually have to provide, for the services they claim to have.
One can’t help but wonder, if YOU were injured & only one medicine worked for you - then your insurance company switched the price of your monthly meds, from $50/month to $1500/month. And to say “tough it out..” to me?? I just hope you never have to feel the pain, I’m enduring, so your next fiscal quarter looks a litttttle better.

Am better is the WORST. I spent 2 hours yesterday trying to resolve a problem with no success. On 9-11-18 I was seen at Mountain Medical. I paid my co-pay, all's well. On 11-21-18 I see a physical therapist at High Desert Therapy. I'm told I owe $140.00 to pay off my deductible for 2018, which I pay at that time. The next day I receive a bill from Mountain Medical for, you guessed it, $140.00. I assume, foolish, foolish me, that Am better would see my payment to the physical therapist the day before and rectify the billing/payment snafu. Eight bills later and multiple messages to Mountain Medical the problem is still not resolved and they are going to send me to collections. According to the billing person, they don't call the insurance company, they only do what the insurance company tells them to. So I call the insurance company to deal with their ridiculous automated gauntlet. Finally get a person and thus ensues the 2 hour circular argument. Turns out the insurance company doesn't talk to the doctors they just receive the bills and assume you've paid the deductible and you get billed for the rest. The deductible is between the provider and me "whether you've paid it or not." Kid you not. But I paid it, that's between you and the provider. Over and over and over........ Finally give up and call the provider. Turns out they sent in the bills and haven't been paid either. Am better says they aren't a provider. However, when I was seeing the provider they were on the provider list. Turns out providers are leaving in droves because Am better isn't paying claims and they are not updating the provider lists either. This means you could find a provider on their list, see that provider, and wind up eating the bill. NICE. Also found out that Am better has a "secret" list of providers that are opting out of the system, but you don't know that to ask if a provider is opting out. Feel the love yet? And this isn't the only problem. During 2018 they merged my husband's account with mine so they were denying claims due to "fraud" read clerical error. I've filed a complaint with the Nevada Insurance Commission but I'm not holding my breath. In spite of all the evidence Am better is still in business defrauding customers and providers. I would really like to give them a -10 rating. They are every thing a person needing health insurance doesn't need.

Not sure who the biggest crook is Ambetter or the Healthcare market place. I Corrected their documentation error for the 3rd time this year. Each time they reinstate it, then immediately suspend it w/o notice for the same clerical error of theirs. This time they say I owe nearly $800. to reinstate.... I'm only supposed to pay $4.95 per month. WTH??? Because of this I lost health coverage for 2019

Jan 2018 I call customer services in order to set my PCP due to my continued failure to set a PCP online. The cs rep helps me select my PCP. I go to the doctor. April 2018 I start getting a bill for new patient services from the doctor I saw. I was confused because I paid my copay and thought I had everything set up. According to Ambetter, my PCP was not in-network. I tell them that they are the ones that approved this PCP. After fighting for over a year (now May 2019) with four appeals and grievances and after that bill was sent to collections and docked my credit score 28 points, I have no recourse. No justice. The last I spoke with customer service they were clear that I am on my own and unwilling to help me any more. I am stuck with a bill. Ambetter claims it is the doctor's responsibility to stay current, the doctor mentioned nothing about being out of network. I am not even sure she knew that she was out of network at the time. Ambetter is the WORST insurance I have ever worked with. As of Dec 2018 I still didn't have a PCP listed on the website. The whole operation is a joke. You won't save any money unless you don't use it!

This is the worst company I have ever dealt with. My husband is a diabetic and his policy started January 1, 2018. Took until February to get his Omni pods that hold his insulin. Now, time to re-order another supply been working on the re-order since July 9th today is July 24th and still sitting in their pre-auth department. Just called them again said can see it still sitting there but don't know why and imagine this that department isn't taking calls right now. Really?? So, taking manual injections with a type 1 diabetic, dealing with extreme low blood sugars and we can't get his medicine. This place and plan is a joke! How can they allow this, my payment is taken out AFT each month. So, my plan is paid never late but I still can't get my medicine.

Texas gave me very little choice when I used the affordable care act so I went with Ambetter. Big mistake. The few doctors who try to use them can't get through, they don't respond to requests for service, and when I got private insurance and tried to cancel Ambetter, they told me I owed for an additional three weeks after that point. I've been robbed in third world countries by people with more integrity than these shysters.