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Business Profile

Health Care Referral

Ambetter from Sunshine Health

This business is NOT BBB Accredited.

Find BBB Accredited Businesses in Health Care Referral.

Complaints

Customer Complaints Summary

  • 128 total complaints in the last 3 years.
  • 31 complaints closed in the last 12 months.

If you've experienced an issue

Submit a Complaint

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.

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Complaint status

Complaint type

  • Initial Complaint

    Date:04/23/2025

    Type:Service or Repair Issues
    Status:
    Resolved
    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.
    Has had my personally paid for disability scooter for 30 days, no repairs done & deflected by customer ************ case mgr. These imbeciles need to be reprimanded & working in a fast food restaurant. My disability has been sitting in the repair shop with Integrated home care systems of *****. This is deplorable & causing my CPTSD Complex Post Traumatic Stress Disorder to extremely escalate. I will be reporting this to Florida State ********

    Business Response

    Date: 04/11/2025

    Please review the attached acknowledgement letter. 

    Customer Answer

    Date: 04/26/2025

    The issue with Sunshine has been resolved, no further action is needed.

    Kind regards

  • Initial Complaint

    Date:03/17/2025

    Type:Service or Repair Issues
    Status:
    Answered
    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.
    Someone used my identity for Ambetter health sunshine and i had humana insurance for awhile and when i try to report fraud they want to give me a hard time my wallet was stolen with all my info in it

    Business Response

    Date: 03/24/2025

    March 24, 2025

    Better Business Bureau
    Attn: Dispute Resolution Department
    *********************
    *************************

    To Whom It May Concern:
    Ambetter Health received your correspondence on 3/17/2025 concerning (******* *******, BBB Complaint Case # ********).Due to federal and state privacy and confidentiality regulations, we are unable to disclose any personally identifiable information or protected health information. We will be sending a response directly to (******* *******, BBB Complaint Case # ********).

    If you have questions, please call us at ************** (TDD/TTY **************).
    Thank you, 

    Customer Answer

    Date: 03/24/2025

     
    Complaint: 23075477

    I am rejecting this response because:

    Sincerely,

    ******* *******

    hi ******* ******* have reached out to let them know of the fraudulent that is occurring with my information and they are so rude and hang up and that's why I had to file a complaint against this business

    Business Response

    Date: 03/31/2025

    March 31, 2025

    Better Business Bureau
    Attn: Dispute Resolution Department
    *********************
    *************************

    To Whom It May Concern:
    Ambetter Health received your correspondence on 3/24/2025 concerning (******* *******, BBB Complaint Case # ********).Due to federal and state privacy and confidentiality regulations, we are unable to disclose any personally identifiable information or protected health information. We will be sending a response directly to (******* *******, BBB Complaint Case # ********).

    If you have questions, please call us at ************** (TDD/TTY **************).
    Thank you, 

  • Initial Complaint

    Date:03/12/2025

    Type:Product Issues
    Status:
    Answered
    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 is deceiving it's customers by offering redemption of points through a **** gift cards. They claim the gift card can be used to pay utilities, rent, telecommunications, related health products and services etc.. However, I saved up my point to use in case of an emergency. I now need to use my points to pay for medication. Which should be classified as health product or service. Ambetter's reward card is being denied for everything and anything I tried to pay with. Including rent, telecommunications and anything medical. Yet, the card worked fine when I attempted paying my monthly payment to ************************* my experience, this card is extremly deceitful and misleading. Representative says I can use it at ********* on certain items. Yet Ambetter fails to provide a list of stores and approved items the card maybe used for. Ambetter, is having it's memebers complete a series of taks to recive points to then either overcharge on eligible redeeming items through their gift shop or redeem a unessisarly overly restrictive gift ******* me it feels like I've been lied to. I feel like i worked for ambetter and did not get paid as I cannot use the money I worked for to cover my medical needs, nor necessary living needs. I would like to cancel my helath insurance plan but they will seize the money I've "worked" for and saved up. Even if it's been already redeemed in the provided debit prepaid ****.This is clearly false advertisement. I feel like I'm losing money and wasted my time and I'm now being forcefully put in a difficult position. Being forced to keep ambetter health plan in order to not lose the money I've worked for and yet not being able to use it on anything other than ambetter services.Please transfer the money I'm entitled to into an actual **** gift card that I may use to pay for my medication.

    Business Response

    Date: 03/13/2025

    March 13, 2025

    Better Business Bureau
    Attn: Dispute Resolution Department
    *********************
    *************************

    To Whom It May Concern:
    Ambetter Health received your correspondence on 3/13/2025 concerning (***** *******, BBB Complaint Case # ********).Due to federal and state privacy and confidentiality regulations, we are unable to disclose any personally identifiable information or protected health information. We will be sending a response directly to (***** *******, BBB Complaint Case # ********).

    If you have questions, please call us at ************** (TDD/TTY **************).
    Thank you, 

  • Initial Complaint

    Date:03/10/2025

    Type:Customer Service Issues
    Status:
    Answered
    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 Ambetter and searched their website for a primary care provider.Found one, and VERIFIED that they accepted Ambetter. Yes, VERIFIED.Had two appointments with them. Regular doctor visits, lab work, vital signs, got a referral for mri, etc. Nothing out of the ************, I'm getting a bill for over $900 from seeing my PRIMARY CARE doctor/nurse practitioner. Not from going to ER or getting some expensive tests run. Ambetter claims that my doctor wasn't in their network, all of a sudden, after the fact, even though TO THIS DAY, she is listed on their website. I appealed and they still denied it. Now, it's went to a debt collector.The doctor sent a letter out saying they wouldn't be accepting Ambetter after August of 2024. Mind you, I saw this doctor in January and May of 2024, when they were accepting Ambetter and were IN their network.Ambetter *****. I paid them every month for health insurance, but for what? Now I've changed companies, but I have a new fear unlocked, because now I don't even know if I can trust any insurance company or doctor's office. Can I even go to my primary doctor, without worrying about getting an exorbitant bill months later? Why did I even pay premiums to choose a doctor that wasn't covered? How does that even make sense? Why would I do that??And, also, they still send me bills talking about I owe them for monthly premium. I don't know if they are severely understaffed or entirely mismanaged, but they got a lot of problems, clearly. I want my money back, since my visits weren't even covered. They didn't cover their end of the agreement. Healthcare companies like this are infuriating. They should be removed from the marketplace and held accountable for fraud and taking member's money.

    Business Response

    Date: 03/11/2025

    March 11, 2025

    Better Business Bureau
    Attn: Dispute Resolution Department
    *********************
    *************************

    To Whom It May Concern:
    Ambetter Health received your correspondence on 3/10/2025 concerning (******* ******, BBB Complaint Case # ********).Due to federal and state privacy and confidentiality regulations, we are unable to disclose any personally identifiable information or protected health information. We will be sending a response directly to (******* ******, BBB Complaint Case # ********).

    If you have questions, please call us at ************** (TDD/TTY **************).
    Thank you, 

    Customer Answer

    Date: 03/11/2025

     
    Complaint: 23043830

    I am rejecting this response because:

    It doesn't address anything about the complaint. This info isn't protected by *****.

    I think they're just trying to get out of responding. And I haven't recieved anything from them privately. 

    Sincerely,

    ******* ******

    Business Response

    Date: 03/13/2025

    March 13, 2025

    Better Business Bureau
    Attn: Dispute Resolution Department
    *********************
    *************************

    To Whom It May Concern:
    Ambetter Health received your correspondence on 3/10/2025 concerning (******* ******, BBB Complaint Case # ********).Due to federal and state privacy and confidentiality regulations, we are unable to disclose any personally identifiable information or protected health information. We will be sending a response directly to (******* ******, BBB Complaint Case # ********).

    If you have questions, please call us at ************** (TDD/TTY **************).
    Thank you, 

  • Initial Complaint

    Date:03/03/2025

    Type:Service or Repair Issues
    Status:
    Answered
    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 2 daily prescriptions *************************** that have generally been filled by Publix and accepted by Ambetter in the past, but now they are rejecting their portion of the payment for said meds due to a timing issue (?) on filling them. After many frustrating calls with their cust service ***** it is still unlclear why this was rejected. It is my position that these meds (have been taking them for a decade or more) have been rejected for insurance co-payment. They are very std meds, and relatively cheap when compared to the potential for a heart attack and related insurance coverage payments as a result of not taking them daily. Seems like they are cutting their nose off to spite their face on this.

    Business Response

    Date: 03/06/2025

    March 6, 2025

    Better Business Bureau
    Attn: Dispute Resolution Department
    *********************
    *************************

    To Whom It May Concern:
    Ambetter Health received your correspondence on 3/3/2025 concerning (******* ********, BBB Complaint Case # ********).Due to federal and state privacy and confidentiality regulations, we are unable to disclose any personally identifiable information or protected health information. We will be sending a response directly to (******* ********, BBB Complaint Case # ********).

    If you have questions, please call us at ************** (TDD/TTY **************).
    Thank you, 

  • Initial Complaint

    Date:02/09/2025

    Type:Billing Issues
    Status:
    Answered
    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 never signed up for Ambetter Health. I have employer provided health care insurance. I keep getting statements from them as if I'm getting health insurance from them and I am not. Now I have received a 1095A from them showing a monthly advance payment of premium tax credit. This is not true. I have called them three separate times to remove me from their service. Each time they say they will fix it and now I can't file my tax return due to their erroneous records.

    Business Response

    Date: 02/10/2025

    February 10, 2025

    Better Business Bureau
    Attn: Dispute Resolution Department
    *********************
    *************************

    To Whom It May Concern:
    Ambetter Health received your correspondence on 2/9/2025 concerning (****** ******, BBB Complaint Case # ********). Due to federal and state privacy and confidentiality regulations, we are unable to disclose any personally identifiable information or protected health information. We will be sending a response directly to (****** ******, BBB Complaint Case # ********).

    If you have questions, please call us at ************** (TDD/TTY **************).
    Thank you, 

  • Initial Complaint

    Date:02/03/2025

    Type:Product Issues
    Status:
    Answered
    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 signed up for services with them in February 2024. I never used the insurance, have no claims filed with them, and canceled the services in October 2024. I went through their cancellation process and the marketplace cancellation process. In January 2025 I received a welcome packet stating I had insurance with them again. Every representative I speak with says its in process of being canceled. They have illegally placed an auto renewal on my information that I did not agree to hold. I want all services with them canceled and all marketplace services canceled. This company continues to state they cannot send a confirmation email or letter of cancellation. So, I go about my business assuming I have no services with them to get bills in the mail on a monthly basis. I just want it all to stop!

    Business Response

    Date: 02/05/2025

    February 5, 2025

    Better Business Bureau
    Attn: Dispute Resolution Department
    *********************
    *************************

    To Whom It May Concern:
    Ambetter Health received your correspondence on 2/4/2025 concerning (****** Card, BBB Complaint Case # ********). Due to federal and state privacy and confidentiality regulations, we are unable to disclose any personally identifiable information or protected health information. We will be sending a response directly to (****** Card, BBB Complaint Case # ********).

    If you have questions, please call us at ************** (TDD/TTY **************).
    Thank you, 

  • Initial Complaint

    Date:01/30/2025

    Type:Service or Repair Issues
    Status:
    Answered
    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 has suspended my account and wants me to pay 389 dollars. The amount is from an insurance premium that I terminated and never used. I have a premium that was paid for February that was *****. I do not make enough to pay almost 400 a month in healthcare. Im worried that because they suspended my account that I wont have access to healthcare

    Business Response

    Date: 02/03/2025

    February 3, 2025

    Better Business Bureau
    Attn: Dispute Resolution Department
    *********************
    *************************

    To Whom It May Concern:
    Ambetter Health received your correspondence on 1/30/2025 concerning (*********** ******, BBB Complaint Case # ********).Due to federal and state privacy and confidentiality regulations, we are unable to disclose any personally identifiable information or protected health information. We will be sending a response directly to (*********** ******, BBB Complaint Case # ********).

    If you have questions, please call us at ************** (TDD/TTY **************).
    Thank you, 

    Customer Answer

    Date: 02/03/2025

     
    Complaint: 22875146

    I am rejecting this response because:

    My account is now suspended because of this issue. I have already paid my ***** premium for the month of February. Im not able to access my account now due to the lack of urgency. I still have a balance of ****** for a policy that was terminated and confirmed by a representative at ****************************** while I also had a representative with Ambetter on the phone. I never used benefits from the January and Im still being punished by Ambetter. Please update my account so that the balance is cleared and that I am able to get the proper healthcare I need. 

    Sincerely,

    *********** ******

    Business Response

    Date: 02/03/2025

    February 3, 2025

    Better Business Bureau
    Attn: Dispute Resolution Department
    *********************
    *************************

    To Whom It May Concern:
    Ambetter Health received your correspondence on 2/3/2025 concerning (*********** ******, BBB Complaint Case # ********).Due to federal and state privacy and confidentiality regulations, we are unable to disclose any personally identifiable information or protected health information. We will be sending a response directly to (*********** ******, BBB Complaint Case # ********).

    If you have questions, please call us at ************** (TDD/TTY **************).
    Thank you, 

  • Initial Complaint

    Date:01/27/2025

    Type:Product Issues
    Status:
    Answered
    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.
    5th phone call today. Letter sent in September. Refused to give me a password so I could disenroll. This company has you for life I can't believe this. It's like a utopian nightmare. Once again I was promised paperwork to get the heck away from this company. They want me to pay them to disenroll They refuse to give me the necessary items to do that. This cannot be legal! It is set up so the customer can NEVER stop using them. Information is doled out in driblets so one can never escape. This is a nightmare!l Please please I am begging you, someone, anyone help me get away from this company!***** ******

    Business Response

    Date: 01/07/2025

    This is assigned to the incorrect account - should go to the Centene account for ********************** rather than the Meridian account.  Thank you. 

    Business Response

    Date: 01/24/2025

    Hello,

    This BBB complaint involves a Florida member, not an Illinois member. Please redirect to the appropriate team in ********

     

    Thank you,

    ******** ********

    Senior Manager, Compliance

    Business Response

    Date: 02/03/2025

    Better Business Bureau
    Attn: Dispute Resolution Department
    ****************************************
    *************************

    To Whom It May Concern:
    Ambetter Health received your correspondence on 1/28/2025 concerning (***** ******, BBB Complaint Case # ********).Due to federal and state privacy and confidentiality regulations, we are unable to disclose any personally identifiable information or protected health information.

    Based on the information provided, we are unable to locate complainant in our system.

    If you have questions, please call us at ************** (TDD/TTY **************).
    Thank you, 

  • Initial Complaint

    Date:12/23/2024

    Type:Customer Service Issues
    Status:
    Answered
    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 health insurance company denied my insurance I have scheduled this week Friday and have been procrastinating and approval on it. The doctors office has been working tirelessly to get an authorization from them but all they are getting our delays and procrastination on Ambetters end. With just a few days away scheduled for surgery this company is not treating my health as a priority. I am scheduled for carpal tunnel surgery and they are not taking my health seriously with issues with performing at work and daily functions. I just recently signed a new policy for 2025 and they are glad to take my $169 monthly payment out of my pocket but they are not taking my health as a priority. I have never had an insurance company beat around the **** to approve a procedure needing to be done to improve my health. At this time I am requesting an expedited approval with Christmas coming up my surgery is scheduled for Friday following Christmas.

    Business Response

    Date: 12/26/2024

    Better Business Bureau
    Attn: Dispute Resolution Department
    *********************
    *************************

    Re:  ****** *******
    Complaint ID: ********


    To Whom It May Concern:

    Ambetter from Sunshine Health received your correspondence on 12/23/2024 concerning (****** *******, BBB Complaint Case ********). Due to federal and state privacy and confidentiality regulations, we are unable to disclose any personally identifiable information or protected health information. We will respond directly to the consumer.

    If you have questions, please call us at ************** (TDD/TTY **************).
    Thank you, 

Ambetter from Sunshine Health is NOT a BBB Accredited Business.

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