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Business Profile

Health Insurance

Ambetter from MHS

Complaints

This profile includes complaints for Ambetter from MHS's headquarters and its corporate-owned locations. To view all corporate locations, see

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Ambetter from MHS has 2 locations, listed below.

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    Customer Complaints Summary

    • 26 total complaints in the last 3 years.
    • 5 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:03/07/2025

      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.
      Since January 2025, Ambetter has done nothing but create turmoil in pur lives. Wrong spelling on wife's insurance card. Card was invalid, so she had to decide on spending $300 for meds, that would have been free, or minimal copay. 2. Then they wanted to argue that i could not request a new card for my wife. She had to. They wanted to use HIPAA as an excuse. ***** regulations do not apply. 3. After several attempts to reach the "people who said they'd help", no return phone calls or texts. 4. I was mislead into changing my existing "silver plan" to a "bronze plan". Now I have higher copay & deductible. Representative from ambetter, ***** ********* from a company called *********************, agreed the prior agent committed fraud.

      Business Response

      Date: 03/20/2025

      Ambetter from *********************** (MHS) (Ambetter) received your grievance on March 10, 2025, concerning Mr. **** ********* 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 Mr. ******** on March 11, 2025, and advised they will be assisting her with her concerns.   We will be sending a detailed response directly to Mr. ******** addressing BBB Complaint Case # ********.If you have questions, please call us at **************.

      Respectfully,
      Member Relationship Liaison
      Ambetter
    • Initial Complaint

      Date:02/04/2025

      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.
      1/13 2025 I canceled this marketplace insurance back in September of 2024. I turned 65 and went on ********. I have just received a bill for ****** dollars. When I have tried to contact Ambetter they switch me to 3 different personal after waiting on hold for over an hour. They told me an agent on marketplace took it upon themselves and re-enrolled me in the insurance. I have ********. I believe they enrolled me again to get the money they receive from the government. However they are trying to bill me for this. They told me they were getting a Supervisor, put you on hold and hang up. This is going on my taxes and credit report. This is fraud. Last person I spoke with was ******. Please help they are trying to fraud me and the government.

      Business Response

      Date: 02/04/2025

      Hello,

      This BBB complaint involves an Indiana member, not an Illinois member. Please route to the appropriate team.

       

      Thank you,

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

      Senior Manager, Compliance

      Business Response

      Date: 02/20/2025

      Ambetter from MHS received your correspondence 02/04/2025 concerning Complaint ID ********. 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 with anyone other than our members or their authorized representatives. Ambetter will be sending a detailed response directly to Ms. ****** ******** addressing BBB Complaint Case# ********. If you have questions, please call us at **************  
    • Initial Complaint

      Date:01/21/2025

      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 would like to cancel my policy effective immediately. My Policy # is ******** and Member ID is ***********

      Business Response

      Date: 02/06/2025

      February 6, 2025

      BBB of ***************
      ******************************************************************
      ************, IN 46241

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

      To Whom It May Concern,
      Ambetter from MHS received your grievance on 02/05/2025 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 attempted outreach to Mr. *** to discuss his concerns; however, there was no answer, and a voicemail was left requesting a callback. We will be sending a detailed response directly to Mr. *** addressing BBB Complaint Case # ********. If you have questions, please call us at **************.

      Respectfully,

      Member Relationship Liaison
      Ambetter
    • Initial Complaint

      Date:10/24/2024

      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.
      Our Primary Care Physician, ***** *******, at **************************, was listed as a preferred provider on Ambetter's list during the open enrollment period in late 2023. We chose the Ambetter plan for our family. Claims were being reimbursed until late February. ********, claims started to be denied without notice. ***'s office stated they were never alerted to them being dropped from the preferred provider list by Ambetter. Ambetter tells us that ***** ********* contract with them ended on 4/30/24. We were told this information by a customer service representative, but have been unable to confirm. We are not sure if this information is true or not. This is unacceptable. We need to get to the bottom of what actually occurred, have our claims paid by Ambetter, and get ***** ******* back on Ambetter's approved provider list. Also to note, there are claims that have been denied that were filed prior to 4/30/24, so again, we are not sure what is happening. We have spent hours trying to contact Ambetter and resolve this issue. We have been hung up on, cut off, and not called back. We have spoken to two individuals in the escalations department at Ambetter, and this information should be on file at Ambetter.

      Business Response

      Date: 10/28/2024

      Acknowledgement Letter attached. 

      Customer Answer

      Date: 10/28/2024

      Better Business Bureau:

      I have reviewed the response made by the business in reference to complaint ID ********, and have determined the response would not resolve my complaint.  For your reference, details of the offer I reviewed appear below. 

      Ambetter said they had assigned this to their SWAT team. As of today (10/28/24) we have not received a call to address our claim and we absolutely expect our doctors office to be back on the plan and these claims to be paid in network or alternatively through continuity of service because they were in network when the plan was chosen.

          Anything less than this resolution is unacceptable. 

      Thanks, 

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


      Customer Answer

      Date: 10/28/2024

      I wanted to follow up and state that the doctors office manager has told us in writing (which unfortunately is protected from taking a screenshot on my phone because it was via a . message in our health portal), and would be easily confirmed with a call to the office, that they have submitted (long ago) all known paperwork that is required to get back on the approved provider list. They have heard nothing from Ambetter and have not been given any kind of a timeline as to when they will. This is wholly unacceptable. I am happy to put the BBB in touch with the doctor's office if that would help resolve the issue. 

      Business Response

      Date: 10/31/2024

      The attached response to the complaint is only the Acknowledgement of the complaint. The final resolution letter will be sent directly to the complainant.  

      Customer Answer

      Date: 11/04/2024

      Better Business Bureau:

      I have reviewed the response made by the business in reference to complaint ID ********, and have determined the response would not resolve my complaint.  For your reference, details of the offer I reviewed appear below. 

      There was no update given in this response.  It was simply an exact copy of the initial acknowledgement of the original complaint.  We are still waiting on updates and resolution. 
      Regards,

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

      Business Response

      Date: 11/08/2024

      The Acknowledgement letter response to the complaint is only an Acknowledgement of the complaint. The final resolution letter will be mailed directly to the complainant, and not attached here, in order to protect the complainant's privacy.  

      Business Response

      Date: 11/18/2024

      A final response was mailed directly to the complainant on November 18, 2024. 
    • Initial Complaint

      Date:09/17/2024

      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.
      During the months of approximately April/May of 2024 ambetter has advertised to their members that they could earn 300 rewards points if they have a kidney screening test performed. That was the only requirement for the points. So, I had this test done on May 8th 2024 and ambetter still refuses to issue the 300 rewards points to my account and they claim that it was for diagnosis purposes and not for preventive purposes but I do not now have any kidney related medical issues nor have I ever had such problems so the only reason that I had this test done was because they promised to issue 300 rewards points to anybody who did and now they are refusing to honor their advertised plan. The claim number for this test is X141MPEG4211.

      Business Response

      Date: 10/17/2024

      ACK Letter Provided 9/20/24

      Customer Answer

      Date: 10/17/2024

      Better Business Bureau:

      I have reviewed the response made by the business in reference to complaint ID 22295844, and find that this response/resolution is satisfactory to me. 


      Regards,

      Chuck Lane

    • Initial Complaint

      Date:03/25/2024

      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.
      Was promised a $600 spending card with funds loaded onto the card for monthly use starting in April at the time of enrollment

      Business Response

      Date: 04/05/2024

      Complaint ID: ********

      To Whom It May Concern,

      Ambetter from MHS received your grievance on 03/28/2024 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 04/01/2024 and 04/03/2024 to discuss her concerns. Our representative was unable to reach ****************; however, our representatives direct contact information was left on **************** voicemail.  We will be sending a detailed response directly to *********************** addressing BBB complaint #********.  If you have questions, please call us at ************** (TTY/TDD **************).

      *************************
      Member Relationship Liaison
      Ambetter

      Customer Answer

      Date: 04/06/2024

      Better Business Bureau:

      I have reviewed the response made by the business in reference to complaint ID ********, and have determined the response would not resolve my complaint.  For your reference, details of the offer I reviewed appear below. 

      [Provide details of why you are not satisfied with this resolution.]

      Regards,

      ***********************
    • Initial Complaint

      Date:02/21/2024

      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.

      On November 28, 2021, my son **** was born. There have been problems with the insurance company (Ambetter) and the hospital (************************** in ********, **) sending matching bills and explanation of benefits (EOBs) ever since.In August of 2022, I filed a BBB complaint (#********) against Ambetter because I had spent hours on the phone over the spring and summer of **************************** EOBs (because they were no longer available online on my son and wife's linked accounts) but 3 times I was promised EOBs would be mailed but they never showed up. I was told they couldn't email the EOBs to me, they could only be mailed. Then, thankfully, after filing a BBB complaint, I guess the BBB pressure made it possible to email me all the EOBs within a few days of filing the complaint.The new EOBs all claimed that I didn't owe the hospital for the associated charges because of a mistake in billing or prior authorization by the hospital.The situation remained the same for the next year.On 10-22-2023, I received a new statement from the ************************** that claimed the issue with Ambetter had been resolved and Ambetter had paid their part and now I owed my part.After talking on the phone with the hospital's billing department, I agreed to pay after I received a matching EOB from Ambetter. I waited a couple months, but no new EOB.On 2024-01-03, I emailed Ambetter requesting an updated EOB giving them all the available information from the hospital's claim. After 2 weeks of emailing, I finally understood that my wife had to request the **** I could not request an EOB on her behalf. She does not have an "Ambetter Account", everything was handled through my account in the past. So my wife called customer service on 2024-01-17 and was promised the EOBs would be mailed and arrive in 2 weeks. 1 month later, they still haven't arrived.I would like Ambetter to email me the EOBs relating to the hospital bill on the attached email from 2024-01-03.

      This is not the same complaint as August of 2022, just the same parties (me and Ambetter) and the regarding the same bill.


      In Oct 2023, Ambetter finally paid their portion of the cost of service from ****'s birth in Nov 2021. The hospital then sent me a revised bill for the amount still owed by me. But my old EOBs that were sent to me in August 2022 after the BBB complaint was processed are now invalid. I need new EOBs to show that Ambetter has processed the claim and paid their portion. This new EOB will also show the portion of the bill that is still owed by me. Without the new **** I have no way to confirm that the hospital is accurately charging me for my portion of the hospital services according to my insurance coverage at the time.
      I am needing Ambetter to send me a new **** but when I emailed in Jan 2024 requesting the new **** I was told my wife needed to call. So she called on Jan 17, was promised an EOB in 2 weeks, but now 5 weeks later we've never received an EOB. I tried emailing the Ambetter customer service again but the person I'm dealing with now acts like they can't read the previous emails (I've attached to the BBB complaint) and has no idea what I'm talking about.
      Can you please help me get Ambetter to send me the new EOB so I can pay the hospital? I just want this to be over, but I can't without the EOB.

      Customer Answer

      Date: 02/22/2024

      This is not the same complaint as August of 2022, just the same parties (me and Ambetter) and the regarding the same bill.

      In Oct 2023, Ambetter finally paid their portion of the cost of service from ****'s birth in Nov 2021. The hospital then sent me a revised bill for the amount still owed by me. But my old EOBs that were sent to me in August 2022 after the BBB complaint was processed are now invalid. I need new EOBs to show that Ambetter has processed the claim and paid their portion. This new EOB will also show the portion of the bill that is still owed by me. Without the new EOB, I have no way to confirm that the hospital is accurately charging me for my portion of the hospital services according to my insurance coverage at the time.

      I am needing Ambetter to send me a new EOB, but when I emailed in Jan 2024 requesting the new EOB, I was told my wife needed to call. So she called on Jan 17, was promised an EOB in 2 weeks, but now 5 weeks later we've never received an EOB. I tried emailing the Ambetter customer service again but the person I'm dealing with now acts like they can't read the previous emails (I've attached to the BBB complaint) and has no idea what I'm talking about.

      Can you please help me get Ambetter to send me the new EOB so I can pay the hospital? I just want this to be over, but I can't without the EOB.

      Business Response

      Date: 03/05/2024

      March 4, 2024

      Better Business Bureau
      2601 **************** #***A
      ************, ** 46241

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

      To Whom It May Concern,

      Ambetter from MHS received your grievance on 02/29/2024 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 spoke to ************** ***** on 03/01/2024 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 **************.

      Customer Answer

      Date: 03/05/2024

      Better Business Bureau:

      I have reviewed the response made by the business in reference to complaint ID ********, and find that this response/resolution is satisfactory to me.

       

      I appreciate ******'s help on getting me the **** she did a fantastic job. But I definitely will never buy insurance through Ambetter again. It shouldn't require a BBB complaint to get an ***.

       

      The problems I had getting the original *** for ****'s birth were ridiculous, which took 9 months after his birth and over 3 hours worth of phone calls with customer service and a ******************** complaint to get the *** for his birth. Then to have the same thing happen again after Ambetter processed the claim and paid their portion of the hospital bill 23 months after his birth, it took 4.5 months to get an *** with multiple emails and phone calls to customer service and finally another ******************** complaint. Ambetter's customer service help line is worthless. Depending on who I got on the phone to try to answer my questions, I got a different answer on why I hadn't or couldn't receive the ***. The people who promised to send an *** in 2 weeks or less never came through (3 separate times was promised this on the original *** issue and 2 times on the 2nd *** issue).


      Regards,

      ***** *****

    • Initial Complaint

      Date:02/03/2024

      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.
      I switched my healthcare insurance 12/23 due to wanting to obtain healthcare coverage for the pcp doctor that I trusted with my healthcare issues from Anthem (he is not a part of their network and the doctor I saw office personnel wasn't good and most of the doctors listed in Anthem healthcare network don't accept the insurance) back to Am Better ( I used their services 3/22 -5/22 it was cancelled due to nonpayment and the reason for nonpayment is I was dealing with my mom dying from cancer and ended up moving to ******* ********* to take care of her. I did ask about whether I owed anything from my 2022 account and was told no by the agent I made my payment to). I have been making my payments on my **** coverage but is unable to use it because there is a billing issue from my 2022 coverage policy (it doesn't show that I owe any money but for some reason my account is remaining suspended despite it showing no money due for either 2022 or ****). Community Health Network (where my doctor work) is unable to verify my healthcare coverage because my account is suspended. I spoke with AmBetter agents 12/23/23,1/28/24, and 2/2/24 in regard to this issue and have been redirected to Healthcare Market 1/28/24 and 2/2/24 who stated that my insurance is shown as active in their system. I managed to get transferred to ********************* 2/2/24 but was mysteriously disconnected when I was about to be given the incident number so that I can follow up on my complaint and I was not given at ANY TIME a direct number to the ********************* when I asked. None of the agent would give me their agent number for me to be able to identify them if I had any issues with their services. The only conversation reference I was able to receive 2/2/24 from agent ***** (doubt that is actually her name) is the incident number I124749724 before she transferred me to ******** in ********************* around ****pm central time 2/2/24. I do have health issues that warrants coverage needs.

      Business Response

      Date: 02/09/2024

      February 7, 2024

      BBB of Central *******
      ***************************************************** A
      ************, ** 46241

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

      To Whom It May Concern,

      Ambetter from MHS received your grievance on 02/05/2024 concerning Billing, 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.

      Ambetter representative has attempted to contact ****************** to discuss her concerns; however, there was no answer. A voicemail was left with our representatives direct contact information. We will be sending a detailed response directly to *************************** addressing BBB Complaint Case #********. If you have questions, please call us at ************** (TTY/TDD **************).

      Respectfully,
      Member Relationship Liaison
      Ambetter
    • Initial Complaint

      Date:01/30/2024

      Type:Product 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.
      My doctor ordered blood tests for me last year. My previous health insurance would have cost me $2400 for them. Since healthcare.gov indicates that some tests would be free, I signed up through the .gov website and signed up with Ambetter starting Jan 1st ****. The first week of January, I called Ambetter and was told I would have to meet my deductible first before Ambetter would pay. I again consulted the .gov website and saw again that basic tests should be free under ALL plans. Through the Ambetter web portal I submitted an email asking the most cost effective way to get blood tests. I got an auto-response indicating a response within 24 hours. Two weeks later - no response. I looked for another email address and found one that responded that I should use the web portal for email. I called Ambetter again and talked to ****. After 15 minutes of questions and asking **** to slow down in talking because I couldn't understand him, he gave me a place to go for blood tests. I called that place and they DON'T do blood tests. I am frustrated beyond belief!!!!

      Business Response

      Date: 02/05/2024

      February 2, 2024

      Better Business Bureau of Central *******
      ***************************************************** A
      ************,** 46241

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

      To Whom It May Concern,

      Ambetter from MHS received your grievance on 01/31/2024 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 spoke to ***************************************, on 02/02/2024 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

      Customer Answer

      Date: 02/05/2024

      Better Business Bureau:

      I have reviewed the response made by the business in reference to complaint ID ********, and find that this response/resolution is satisfactory to me. 


      Regards,

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

    • Initial Complaint

      Date:01/03/2024

      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 had a plan with ambetter for 2 years that was about $38 a month for the first and went down to about $32 for the second. By the end of the second year, I got a letter saying that my plan was going to go up to over $80 a month so I decided to re-enroll in a different plan. The one I chose said it was about $45 a month so I picked that one because it was better and would be less than the plan I had would be going up to. When I enrolled, my portal then said I was gong to be paying $6.35 a month and I was pleasantly surprised. Since then, however, the last three pay cycles have all been different prices per month, in heavily increasing amounts. I think this is completely ridiculous and feels very fraudulent. I will be cancelling my plan asap. Tired of these awful insurance companies!

      Business Response

      Date: 01/12/2024

      January 11, ****


      *************************
      6557 S *****
      ************ 47874


      RE: Better Business Bureau complaint #********

      Dear **************,

      We are in receipt of the above-referenced complaint as of 01/03/****. Ambetter from MHS Health Plan ************************ insures you with an Ambetter Focused Silver, Silver Level, on-exchange plan effective 01/01/****.  The base rate of this policy is $390.35, with an advance premium tax credit (APTC) of $317.00, leaving a monthly member responsibility of $73.35. This policy is currently paid through 1/31/****.  Your member ID is ***********.  This policy provides coverage for you individually.

      In the complaint received, you stated your plan premium changed drastically from the estimated amount you saw when completing the estimator online. The amount you saw online was approximately $40.00 and the **************** Marketplace (Marketplace) determined your premium to be $73.35.

      Monthly premiums are determined by the Marketplace based on the personal and financial information provided on your application, and not by Ambetter. If there is any discrepancy with your premium, please contact the Marketplace directly at **************. Per our phone conversation on 01/10/****, I advised the estimator is only an estimate,and that the Marketplace ultimately determines your costs; however, I have made note of your concern.  I am also including a copy of the **** renewal letter sent to you by Ambetter on October 23, 2023, for your reference.

      You have been provided with my direct contact information, should you have further questions regarding this matter.

      Sincerely,
      *****************************
      Member Relationship Liaison, Ambetter

      Customer Answer

      Date: 01/12/2024

      Better Business Bureau:

      I have reviewed the response made by the business in reference to complaint ID ********, and find that this response/resolution is satisfactory to me. 


      Regards,

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

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