AmeriHealth Reviews

I started their behavior health service after being told that my therapist would be covered as in network, 100% coverage. This was a big deal for me and I was really happy to find someone I liked who was in network. After 2 months I received a check in the mail for the entire amount I had paid until that point and I was thrilled. Then 2 more months passed and I received nothing. I called many times and was told I was covered and not to worry. Another month passed, no check. I called again, then I was told that none of the claims would be covered because she was out of network. So now, I owed my provider MONTHS of back payments.

Worst company ever. Their system is designed to be impossible to navigate and to actually talk to a human. They don't pay doctors - they deny claims that they previously authorized. Preventative procedures that are preauthorized as 100% covered are never fully paid for. They hang up on you when you call customer service. I hate this company. They are in bed with the state, who requires you to buy their horrible product.

I am having a terrible time dealing with this company and I am now stuck with it for the rest of the year. I have been calling the providers listed as Tier 1 in AmeriHealth network, only to learn from their offices that they are in fact Tier 2. I called more than 5 different providers and then called AmeriHealth. The agents tell me that see the same information on the portal as I do. Hence they cannot confirm who is actually a Tier 1 provider. Such a nightmare to find care in times of need!

I am currently on a Amerihealth Medicare Advantage plan it's called amerihealth core and says it covers Comprehensive Dental. I found the dentist that takes this insurance I went there checked to see if they would cover my procedure which was a dental crown. The dentist gave me a piece of paper which showed my 20% of the payment and what the insurance company would pay. I was able to have the crown procedure started the same day after waiting for my permanent crown. During that time I received the letter from the insurance company denying the claim saying that the procedure wasn't necessary and that the dentist had options to use less expensive Crown material and I may be responsible for all or part of the procedure with an outstanding balance.

I have to pay for my own health insurance because I do not have any though my work. I chose Amerihealth because it was cheap. I fully understand you get what you pay for, but you should get better than this.

Just enrolled in Amerihealth through healthcare.gov, huge mistake. Everything - from simple registration on their site to picking a doctor, to contacting them - is downright terrible. I tried to change my PCP several times and I keep getting an error. Registering for their member portal sucks, it keeps timing out and giving errors. It was a miracle I finally completed it but using it is even worse. There are CONSTANT error messages. Once you finally get into the site you will find it is NOT user friendly and actually finding doctors is very difficult. I hate to see what happens when I make it to the doctor. What a nightmare this has been. The other low cost option was Oscar, do yourself a favor and pick them over this Amerihealth disaster.

I was assigned a pcp with a health grade of 1.7. This company Amerihealth has a 1.9 rating. We get the bottom of the barrel Dr group to pick from. Have called them twice and Amerihealth has stated more than once that I am not in their system. I was later told that was incorrect info. Well my psychiatrist had to send over preauth for a treatment I’ve been undergoing for well over a year. My Dr was told there was no such member number. (wrong again) Today I called because out of their directory- all providers say new patients yes. Medicaid no. This is a Medicaid health plan. Why send me a book that means nothing? I’m to sit and call 24 pages of providers so they can tell me Amerihealth book is wrong? I emailed the CEO, Mark Grippi (email found online) and I recommend you all do as well. In summary- I’d rather go to a veterinarian. This place ABSOLUTELY SUCKS.

AmeriHealth has been the worst company to deal with to get medications filled. I have been waiting 3 almost 4 months to get a tier 1 generic medication refilled. My medication helps me perform my job more efficiently and live my life more productively and happily on the day-to-day. Not WORTH the lower premium.

I’m in the long term care program. They don’t care for you and make you do everything on your own. What’s the point of having a care coordinator? Since I came to the diamond plus side it’s been. Nightmare denials after denial.

I chose this plan specifically because they have my specialty drugs listed in their formulary. But they deny every drug - repeatedly. I've been on one drug for almost a year with my other insurance, but had to switch to get this plan and now they deny everything. They leave you a voicemail with a callback number that does not work. Their insurance card arrived with a sticker on the back to validate it - with a number that is out of service. And now, after fighting almost 2 months to get coverage, my medicine is again denied. My shot is due tomorrow and yet there's no end in sight. My condition is going to revert quickly and they don't care, not at all. What a terrible company that they do this to people. In addition, one of my doctors was listed as a participating doctor, but he's not. And to think I chose a higher costing plan because I needed to be sure I could continue my care. Horrible company.

It’s very difficult to speak a human. Their records are never up to date. They feed false information about benefits such as who’s in their networks. They delay and they deny reimbursements, hoping the clients will just give up. To me that’s just really well organized thieving: the customers don’t get what they pay for.

Worst decision I've made was switching to Amerihealth Caritas NEXT and now I'm stuck until open enrollment next year. The list of doctors they provide that accept them is falsified. It's true that some do accept amerihealth caritas, but no one accepts amerihealth caritas NEXT. I checked over 36 gastroenterologist from their provided list, the entire state of Delaware and not one of them actually accept my insurance. So they told me they would "look into it" and get back to me. That was a week ago.

They make filing a reimbursement as hard and confusing as possible. One member services person said they don't do reimbursements. After filing one online (difficult to find how to do that) and then talking to someone on the phone, they said they didn't have enough information. And that *if* my reimbursement was approved, it would take 7 months for me to receive a check.

It's the worst health insurance ever. The customer service agents generally don't know what they are doing and are often rude and cold. If your employer offers this health insurance, you should seriously consider declining this job. I spend hours every week just to get general claims sorted out by calling them again and again with the same kind of questions. Because each customer service agent gives different answers, it makes the whole process extremely difficult. I want to give 0 stars if I could.

My first near deadly encounter with AmeriHealth was when paying for it and being denied life-saving medication that would cure me. One person said it was too expensive. Of course, people around the world buy the drug for pennies on the dollar. The written denial said it was because I didn't have Stage 4 cancer or need an organ transplant. My second denial is for ongoing services after a TBI (traumatic brain injury) in 2012. They've decided that I no longer need a health aid as I approach 70 under the state Brain Waiver Program that I'm in. The caller -- nothing in writing -- would not give her name and did not have a reason. After dozens of calls to file an appeal, no one knew anything about it. Eventually, the reason given on the phone was that I could drive (.02 miles or approximately 1,000 feet to PT) and had a microwave (which I do not).

I have had AmeriHealth for the last year and we have been extremely happy with the plan. I just had to get assistance for the second time from a broker for your company. Her name is Venta **. This is the second time I have had the pleasure of working with her. She was very thorough, professional and answered all of my questions. I have worked in 5 star hospitality my whole life and Venta is "5 Star". She has such a pleasant attitude and excellent communication skills. I would hire her in a minute if I was looking for someone.

AmeriHealth knows how dangerous these vendors are and they don't care. Get a different name, not Caritas. They are the worst.

This company has been a thorn in my side from the start. Constant issues with billing, customer service is awful, and constant rejection for necessary meds. They refuse to speak with me even though I'm the one who signed up for the insurance through NJ marketplace even after my husband submitted paperwork confirming approval. Looking into placing a complaint through the state if it will even matter.

Very poor cost negotiations - barely pays for anything - and lousy customer service. My premium was set up on auto pay and when my bank card changed I got no letters in the mail, no emails and no phone calls about my past due premium. NOTHING. Now I'm without insurance!!!! After I learned of the insurance problem after visiting pharmacy, so I immediately called and was told I was already on inactive status and that I had to wait until next open enrollment - no appeals process, no chance to pay the missed premiums. NOTHING. This carrier is the absolute WORST.

Despite what your policy overview says, it may not cover BASIC lab tests for yearly routine checkups. The small letter trap. Almost $500 (2024) for routine bloodwork that wasn't paid by the insurer. Their website is horrible. Not user friendly at all, asks for logging in repeatedly, there is not much you can manage there. Useless. Their phone automated system is worse! The machine repeats over and over again the same options. You pick one, it repeats everything again. It doesn't catch the numbers you type.

They list “in-network” doctors, who do not actually accept Amerihealth. The doctors even wonder why they have not updated the list to remove their names. If you are here it's either because A) Your employer got a great deal and saved a bunch of money at the expense of your health, or, or B) You could only afford the legal minimum, bare-bones government insurance. If you are here because you use government aid, I'm sorry for your loss. If you are here because this is the insurance your employer offers, you need to quit, yesterday. If you are here because you can only afford the government insurance options, well.. I'm pretty sure the fine for not having insurance is cheaper than having Amerihealth, and your coverage will still be equivalent to that of an Amerihealth member.

Their customer service is very bad. They lied to you what was 100% covered due to family history and later they denied they said that unless you recorded their conversation over the phone (never knew you need to do that). Also, you talked to different person every time you called, they said they are working on your case. Actually no one is working on it. This way your 6 months appeal is delayed or expired. I won't recommend AmeriHealth to any one since their customer service is terrible and you are wasting your time to talk to them. Please use other health insurance but AmeriHealth.

There's no way I didn't think to look here first before I signed up with this company. It hasn't even been a month and I've been on the phone every day for multiple authentication issues, transportation miscommunication, wrong information for MULTIPLE nurses, and a litany of other things that just don't even make sense to even be happening. It's incredible that there's a review with 5 stars and I just wanna know what kinda drugs they're on cause this is an absolute joke if it's not a scam. STAY AWAY!!!

I called Amerihealth 16 times since Jan 2nd, 7 of the calls they filed an appeal on my behalf, only 1 is required, then it goes to the 2d level, which I am not educated in the insurance process (until now). I explained that I have not received any notice from the appeals, nothing, they sent me a stack of denials overnight FedEx on Feb 29th, I then spoke to Patty on the sixth of March, she called my Doctors office while I was on hold she said they did not answer, she asked me to call my physician, I did immediately, they answered right away (as usual) she did not call, I called her back a few days later, she said I should receive a notice from the appeal and it was expedited, I received a recorded call from Optimum on Mar 12 saying they approved my medication, that was all that was said, I'm thinking okay great.

Just a few weeks into coverage I have encountered numerous problems with Amerihealth:

My daughter was on Medicaid and we were trying to get a breast pump for her before she had the baby and we were on the phone for numerous hours. They sent one. It didn’t work. We sent it back and long story short after she even had the baby we never got a breast pump, she actually got one from our niece who sent it from Maryland.

My name is Carly and I have Amerihealth Caritas Medicaid and I'm a part of the community health choices waiver program. I highly recommend you stay away from this company. In November of 2022 I was dangerously ill and on a feeding tube. I qualified for services such as in home care and an emergency button (examples) at this time. I was in great need of help as I have no family who are able to support me. Despite multiple phone calls, I did not start receiving ANY of the services I needed until MAY of 2023. From November to May, I had been hospitalized with life threatening sepsis twice, had to relearn how to balance/walk and was walker dependent, and was having frequent episodes of passing out. I was also fully gj feeding tube dependent 24/7. These issues were exacerbated because I did not have the help or care that I needed and was supposed to be guaranteed.

Expensive and hardly pays for anything. Hard to find doctors who take it. Pays only part of very basic items, like primary care doctors, until very high deductible. Very expensive. Created an account just to say how unhappy I am with this company so hopefully buyers beware this coming insurance rotation.

Ameri"Health" refuses to credential PA's, even though PA's are highly qualified medical providers with extensive training. By doing so, they are depriving consumers of the stellar healthcare services that they deserve. Meanwhile, Ameri"Health" credentials NP's, in spite of NP's vastly inferior training.

AmeriHealth New Jersey is by far the WORST health plan company I have ever had. Given that I live in CA, I have access to the MultiPlan and PCHS network of doctors and almost 90% of the time, they deny payment saying the doctors I've found on the MultiPlan site are out of network. Each time, I (or the billing departments) have to spend HOURS with mostly rude people in their customer service department to get their error corrected. They have even denied an emergency hospital visit saying that the emergency hospital I went to was "out of network" and that in advance I should verify if the emergency doctor that would be treating me is in the network. WHO DOES OR KNOWS THIS IN AN EMERGENCY? They eventually relented -- seeing their error -- but only after almost a year of fussing with them.