Complaints

This profile includes complaints for Ambetter from Fidelis Care's headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

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  Ambetter from Fidelis Care

  2501 Jackson Ave Long Island City, NY 11101-5095

  
• 

  Fidelis

  21630 Hanover Ave Lakeville, MN 55044

• 

  Fidelis

  PO Box 241036 Apple Valley, MN 55124

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:04/09/2025

  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 called Fidelis to get insurance coverage. I was told my policy would start immediately if I paid $195.87 I did that on March 14th 2025. I received a letter in the mail on 3-20-25 that states i need to pay another $145.61 i paid that on 3-31-25. I went to use my insurance it's not valid. I never has insurance during this whole time. I call on 4-2-25. I was told I had a back balance I needed to pay but they won't tell me what it was or how much. They just keep telling me to pay the $195.87 witch is my premium. I asked for a supervisor she than tells me to contact New York state of health to change the active date from 3-1-25 to 4-1-25 so I do this. Newyork state of health says that they can't do that and I need to call Fidelis. So I have been back and forth with both Newyork state of health and Fidelis. I am out $341.48 the supervisor at Fidelis doesn't call back and I dont have insurance still. I don't know what to do other than dispute charges with my bank because I paid for something I don't have.

  Business Response

  Date: 04/23/2025

  ***** *** **** ****** ******** ****** ****************************** ****************** ****** *** ********
  To Whom It May Concern:
  Fidelis is in receipt of your letter dated April 9, 2025 regarding a complaint filed by consumer ******* ***********. 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. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will address the concerns directly with the complainant.
  

• Initial Complaint

  Date:03/10/2025

  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.

  My full amount has been paid there is no reason my insurance shouldnt be active I have health issues and cant have the proper testing done I need with out it its been 5 days battling with this company and they have no answers for me I had coverage for all of February they inactivated me with no contact of telling me so I have been under the impression I had coverage this whole time

  Business Response

  Date: 03/24/2025

  
  Fidelis is in receipt of your letter dated March 12, 2025 regarding a complaint filed by consumer ****** *********.  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. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will address the concerns directly with the complainant.

• Initial Complaint

  Date:02/21/2025

  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.

  I am writing to express my frustration and concern regarding the ongoing difficulties Ive encountered while trying to pay my familys insurance premiums for my children's health plans. Despite multiple attempts, I have been unable to successfully make a payment. The automated phone payment system is not in service, and I have been unable to use it.I have contacted Fidelis IT department several times in an attempt to set up an online account, but each time, their system rejects my account for no clear reason. With the payment deadline fast approaching, I am deeply concerned that my eight children will lose their *********** is beyond frustrating to face these issues with a health insurance company, especially when technology offers so many viable payment options. This situation feels like a failure of the system, and Im left questioning how a company like Fidelis can operate without providing a reliable means for customers to make payments.I urge you to resolve this issue immediately, as my familys health coverage is at risk.

  Business Response

  Date: 03/07/2025

  Fidelis is in receipt of your letter dated February 21, 2025 regarding a complaint filed by consumer
  ****** ********. 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. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention
  of the Plan however, the Plan has addressed the concerns directly with the complainant.

• Initial Complaint

  Date:02/12/2025

  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.

  The company overcharged me on December 27 2024 for my February 2025 premium. I should have been charged ****** but was instead billed *******. I have called multiples times to resolve this and obtain a refund. I have spent hours explaining this issue every time to a new *** that claims to have no information on my previous calls. They have admitted it was an overcharge and keep claiming its being sent to finance for a resolution but nobody ever follow up and to date I have not been refunded.

  Business Response

  Date: 02/26/2025

  Fidelis is in receipt of your letter dated February 12, 2025 regarding a complaint filed by consumer ****** ********.  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. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will address the concerns directly with the complainant.
  

  Customer Answer

  Date: 03/05/2025

  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 and the matter has been resolved.
  
  Sincerely,
  
  ****** *********
  
  
  
   
  
  

• Initial Complaint

  Date:02/06/2025

  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 have a fidelis care dual access plan. In the hand book my dibeties supplies are supposed to be covered completely with 0.0 copay. On Jan 9, 2025 i was charged ***** and again on fed 6, 2025. I have called them a million times & being told different stuff. I also have new york state ********. Fidelis claims ******** is supposed to pay the copay that isn't covered for my medicine & supplies medicade says no... but in the hand book from fidelis itself states all my meters & strips are covered ??. I feel this is unfair on me & false info. I should need to fight this out at all. Im ********** & not fair. Fidelis should be calling medicade if they are supposed to pay also for being contracted in with them. Everyone giving different stories so no clue how or where to turn. All I know if says ?? covered in fidelis hand book

  Business Response

  Date: 02/17/2025

  Fidelis is in receipt of your letter dated February 7, 2025 regarding a complaint filed by consumer ****** ****. 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. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will address the concerns directly with the complainant.

• Initial Complaint

  Date:11/26/2024

  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.

  On April 1st, 2024, I had a severe diarrhea and I went to ****************** in ********, where I got Doctor's check up and treatment, at front desk I was told that they accept my insurance - Fidelis, but some time later I received bill from City MD in amount of $624.00, I called this office, they told me that Fidelis did not pay them. At the time of appointment I was collecting unemployment benefits since December 15, 2023, and I did not have any insurances besides Fidelis which I get from Marketplace, I was surprised that Fidelis Denied claim from City MD using excuse that I have second insurance, they even **** out my"second Insurance" name CareSource and added year (2022) for this not existing insurance, all of it was not true, because I did not work on April 1st. I tried to call customer service, and it was another torment: I could not reach anybody who could help me or give reasonable advice or explanation what should I do. I was given many different numbers: for *********** for Coordination of ******************** I even called Marketplace, etc. Maybe these customer service representatives just unprofessional or, maybe they have direction to use any excuses and not pay claims to save money...

  Business Response

  Date: 12/10/2024

  Fidelis is in receipt of your letter dated November 26, 2024 regarding a complaint filed by consumer ****** ********.  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. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will address the concerns directly with the complainant.

  Customer Answer

  Date: 01/09/2025

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:

  Good morning,

  Please see attached copy of the bill from CITY MD dated December 21, 2024, which means that Fidelis did not do anything to resolve this payment problem, and one more thing: when I was trying to login  to my Fedelis account, it turned out that Fidelis blocked my account, and I don't have access to it.

  Could you please re-open my case to get my medical bill processed correctly and competently.

  Thank you .

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

   

  In order for the BBB to appropriately process your response, you MUST answer the question above.

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

  Customer Answer

  Date: 02/07/2025

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because: I started to dealing with Fidelis regarding processing of the claim from Urgent Care since November 2024 by filing Appeal Request Form for Denial of Services, and after their response i realized that this "Member Services" department belongs to Fidelis and they are never going to help me because they belong to Fidelis and never will do anything against this company, that is why I appealed to Better Business Bureau, and all replays from Fidelis since then were excuses on privacy matter and promises to figure out with my bill processing, but why it takes soooooo long?  Maybe it means that Fidelis just stalling for time, or employees not capable to do simple work...

  [Your Answer Here]

   

   

   

   

  In order for the BBB to appropriately process your response, you MUST answer the question above.

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

  Business Response

  Date: 02/27/2025

  Fidelis is in receipt of your letter dated February 17, 2025 regarding a complaint filed by consumer ****** ********.  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. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan has addressed the concerns directly with the complainant.

• Initial Complaint

  Date:11/14/2024

  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 submitted my application for health insurance with the state of health for the business in question I get told it was alert and may take a week to get a response and I had to contact them to see after a week about the application and I got one vary rude representative hearssing and unhelpful I have been texted and had to get the supervisors number was told they would get me a case where someone would be able to assist me that would not cause me any issues and I got a second representative who had started more problems after I had bad service and they blew throw my hole lunch and they continued harassing me after my lunch at my day job so much that they forced me to leave work early to destress and it's ended up losing me 3 hours of work which was a blow to my paycheck

  Business Response

  Date: 11/27/2024

  Fidelis is in receipt of your letter dated November 14, 2024 regarding a complaint filed by consumer ********* ****-******.  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. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will address the concerns directly with the complainant.

  Customer Answer

  Date: 12/10/2024

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:

  [Your Answer Here]

   

   Because they have yet to contact or reply to anything still waiting for a confirmation of my insurance plan new cards or anything I have reached out via there contact info but nothing has come from it called there service to get the run around harassed at my job and still nothing 

   

   

  In order for the BBB to appropriately process your response, you MUST answer the question above.

  
  Sincerely,
  
  ********* ****-******
  
  
  
  
   
  

  Business Response

  Date: 12/19/2024

  Fidelis is in receipt of your letter dated December 12, 2024 regarding a complaint filed by consumer
  ********* ****-******. 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. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention
  of the Plan however, the Plan will address the concerns directly with the complainant.

  Customer Answer

  Date: 12/30/2024

  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 and the matter has been resolved.
  For I have received the letter weeks later than expected but still got it
  Sincerely,
  
  ********* ****-******
  
  
  
   
  
  

• Initial Complaint

  Date:09/27/2024

  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 am being trolled/harassed by Fidelis. Fidelis sent me an email titled "You have a document available for viewing." They sent it Sep 24, 2024, 7:54AM. They told me to click on a link in order to view the document. However, the link instead told me to create an account. After going through several steps to create the account, I was told the account is "no longer active" instead of being shown the document. Fidelis is wasting my time. Fidelis must authorize all coverage temporomandibular joint treatment immediately.

  Business Response

  Date: 10/11/2024

  ******* ******* ****** ******** ****** ****************************** ***************** ****** ***********
  
  To Whom It May Concern:
  
  Fidelis is in receipt of your letter dated September 27, 2024 regarding a complaint filed by consumer ***** ******.  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. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will address the concerns directly with the complainant.
  
  
  

  Customer Answer

  Date: 10/14/2024

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:

  [Company (Fidelis) is insulting me in the response by calling me a "*****" when that is not my real name. Also, Fidelis hasn't answered a question I asked about them TMJ coverage on a phone call. Fidelis said I would have to talk to my doctor to request the coverage, which doesn't make sense as my doctor acknowledges that dealing with insurance companies is a hellish experience. Therefore Fidelis is scheming to deny people TMJ/TMD coverage ]

    

  In order for the BBB to appropriately process your response, you MUST answer the question above.

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

  Business Response

  Date: 10/25/2024

  Fidelis is in receipt of your letter dated October 15, 2024 regarding a complaint filed by consumer *****
  ******. 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.
  Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan
  however, the Plan addressed the concerns directly with the complainant.

• Initial Complaint

  Date:05/24/2024

  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.

  I underpaid Fidelis for my coverage on February 28 therefore my Plan was terminated. I have been requesting to be refunded since March. I have yet to be refunded $500. I have made multiple requests.

  Business Response

  Date: 06/05/2024

  **** ** **** ****** ******** ****** ****************************** ******************
  Review ID: ********
  To Whom It May Concern:
  Fidelis is in receipt of your letter dated May 24, 2024 regarding a complaint filed by consumer ***************************. 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. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan has addressed the concerns directly with the complainant.

• Initial Complaint

  Date:03/18/2024

  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.

  Invoice is overcharging me. Please fix the invoice to reflect the $1,274.48 that I should be charged. ** State of Health backdate canceled my wifes plan effective 12/1/23 since I never recieved an invoice or health care for my wife in December and she couldn't see a Doctor. I recieved an email if this extra ammount wasn't paid we would loose health coverage. That is not operating in good faith. Please work it out with ** State of Health since I have already been on a 3 way call with Fidelis Care and ** State of Health and ** State of Health said everything is done on their end and Fidelis Care needs to update the invoice now.

  Business Response

  Date: 04/01/2024

  ***** ** **** ****** ******** ****** ******************************************************************************
  Review ID: ********
  To Whom It May Concern:
  Fidelis is in receipt of your letter dated March 18, 2024 regarding a complaint filed by consumer *******************************. 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. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will address the concerns directly with the complainant.