Ambetter Health Insurance Class Action Lawsuit Investigation

Ambetter Insurance Policies: Who’s Affected?

health insurance form, paperwork and questionnaire for insurance concepts

Are you a Missouri resident who held an Ambetter health insurance policy and experienced a lack of available physicians, confusing billing, and / or denial of pre-authorized coverage?

You may have a legal claim.

Reviews of Ambetter health insurance online suggest many policyholders are not satisfied with their coverage. Online reviewers complain that they can not find a physician or specialist that accepts Ambetter insurance despite representations on the insurer’s website. Others say that they experienced confusing billing scenarios. Some Ambetter policyholders allege they were denied coverage for a service or specialist visit that had been pre-authorized.

Ambetter health insurance policies are offered in 15 states, including Missouri by a Centene subsidiary. Centene has already faced at least one health insurance class action lawsuit alleging Ambetter health insurance misleads Missouri residents due to the lack of available physicians advertised on the Ambetter website, provides confusing coverage resulting in policyholders experiencing “Balanced billing” chargesand denies coverage for services the insurer had pre-authorized.

Do You Qualify?

You may be able to join this class action lawsuit investigation if you held an Ambetter insurance policy since 2018 while residing in Missouri and you experienced one or more of the following situations:

  • A lack of available physicians and / or specialists available to you
  • Balanced billing due to Ambetter’s confusing insurance coverage
  • Ambetter denied coverage that had been pre-authorized

Fill out the form on this page for more information.

Ambetter Health Insurance Coverage Is Misrepresented, Policyholders Say

In 2018, a group of Ambetter policyholders filed a class action lawsuit against Centene for allegedly misrepresenting its provider networks. The policyholders alleged Ambetter healthcare plans mislead consumers about the availability of providers who take out the insurance.

Some Ambetter insurance reviews claim that Ambetter’s website listed primary care providers as accepting the insurance plan when they did not. As a result, policyholders either had to pay out-of-pocket fees to see the physician or delayed their appointments in order to find a new physician who accepted Ambetter insurance.

In some cases, Ambetter health insurance policyholders claimed they had to call many providers to find one that actually accepted the insurance plan or had to travel long distances to see a covered provider.

Some policyholders have complained about Ambetter’s confusing insurance coverage. In some cases, Ambetter policyholders have allegedly gone to a hospital, specialist, or physician group “covered” by Ambetter but were billed for “out of network” services or hit with “balanced billing” charges.

Others claim that they obtained Ambetter healthcare pre-authorization for a service or specialist visit only to have the service denied. As a result, they were either forced to pay for the coverage or spend months disputing the charge.

Another Ambetter class action lawsuit claims the health insurer’s plans fail to comply with federal rules under the Affordable Care Act, including rules regulating network adequacy, plan disclosure standards, coverage of essential health benefits, and providing adequate protections under the patient’s bill of rights.

Join an Ambetter Health Insurance Class Action Lawsuit Investigation

Policyholders may have been misled about Ambetter health insurance coverage, including the lack of advertised physicians who accept the plan, confusing Ambetter healthcare coverage, and / or denials of pre-authorized coverage.

If you had an Ambetter health insurance policy while residing in Missouri, you may qualify to participate in an Ambetter healthcare class action lawsuit investigation.

Leave a Comment

%d bloggers like this: