AmeriGroup Health Insurance Company
Considering the purchase of a health insurance policy from AmeriGroup Health Insurance Company? Read this AmeriGroup Health Insurance review and then compare quotes.
Learning some things about your potential insurer can often help make your choice easier. You may want to know a little bit about the company’s history and scope. The types of products they offer as well as who the plans are designed to serve will also be a factor in your decision.
In this tough economic climate, the economic stability and financial rating of the company from which you intend to purchase your insurance can also be helpful in the decision making process.
Lastly, with health care costs constantly on the rise the cost of your health care premiums will be important as you decide whether you wish to purchase a policy with AmeriGroup or another health insurance provider.
Be sure to read the entirety of this AmeriGroup Health Insurance Company Review article, peruse through the customer reviews of AmeriGroup at the bottom of the page (and maybe leave an AmeriGroup review yourself), and then use our free health insurance quote finder on the right side of the page to shop for quotes from many different health insurance companies.
History of AmeriGroup Insurance
AmeriGroup Health Insurance Company got its beginning in 1944 and had a vision of helping the disabled and persons of low income obtain quality health care. The company has been publicly traded on the stock exchange since 2001. They are licensed in eleven states which include Florida, Georgia, Maryland, New Jersey, New York, Ohio, South Carolina, Tennessee, Texas, Virginia, and the District of Columbia. The company insures 17 million Americans and employs hundreds of health care professionals.
Their vision for providing health care for low income and disabled persons has prompted AmeriGroup Health Insurance to work together with state governments to offer Medicaid and Medicare programs for those who qualify for public health care. The company has one of the most comprehensive prenatal plans available. They are in the process of developing both comprehensive and limited benefit plans for those who are uninsured.
AmeriGroup Health Insurance Plans
AmeriGroup Health Insurance plans are designed to facilitate building good doctor patient relationships. Benefits are distributed on the basis of eligibility, treatment appropriateness and medical need. The company has supplemental plans that will supply care that public programs won’t cover like health education, dental and nutrition. AmeriGroup’s programs provide preventative care as well as incentives designed to help participants make better lifestyle choices that will result in better health.
The company’s plans offer a large group of doctors from which participants can chose their primary care physician. The primary care physician is then responsible to write any needed referrals for specialists. Preauthorization is required prior to the performance of medical procedures. The programs also include a dental or prescription plan.
AmeriGroup Medicaid Programs
The Medicaid programs AmeriGroup covers include, Temporary Assistance to Needy Families (TANF), Supplemental Security Income (SSI), Long Term Care (LTC) and State Children’s Health Insurance Program (SCHIP). Supplemental Security Income is designed to assist the elderly and disabled.
Temporary Assistance to Needy Families is geared toward providing coverage for children under eighteen and women who have children or are pregnant. Those wishing to participate in TANF need to meet their state’s income requirements.
AmeriGroup Long Term Care Insurance
Long Term Care is for those whose health concerns require medical care over an extended period of time and also for their caregivers. This can take different forms in different states. For instance, in Florida this program grants waivers to elderly residents so that they can remain in a nursing home or an assisted living facility. In New York, it is used to enable chronically ill or disabled persons to obtain services whether they reside at a nursing home, assisted living facility or at home.
AmeriGroup Children’s Health Insurance Programs
State Children’s Health Insurance (SCHIP) is a program that was developed to provide health coverage for the children of families who do not qualify for Medicare or Medicaid but can’t afford a family plan from a private health insurance company. The benefits and income guidelines for this type of program vary from state to state. Sometimes small premiums may be required.
AmeriGroup’s Medicare Products
AmeriGroup offers three products for those who qualify for Medicare. These are called the Specialty + Rx Plan, the Classic + Rx Plan and the Balance + Rx Plan. Another term for the Specialty + Rx Plan is the Special Needs Plan (SNP). This plan is geared toward assisting those with medical conditions that require extra care. For instance, those who have diabetes, kidney disease, cancer, mental illnesses or other chronic illnesses might find this plan meets their needs fairly well.
In this plan, AmeriGroup provides full Medicare benefits plus Part D prescription coverage. The same member ID card is use for both the health and prescription portions of this plan. This dual eligibility plan is available in areas of Florida, New York, Maryland, New Jersey, Tennessee, New Mexico and Texas.
The Classic + Rx Plans are for those who get Medicare Part A and have enrolled in Part B. They must live in the service area and can’t be in the end stages of renal disease. This plan provides the normal Medicare coverage with Part D prescription benefits. There are no extra premiums or deductibles; however, nominal co-pays may apply in many cases. This plan is available in portions of Maryland, Florida, New Jersey, New Mexico, Texas, Tennessee, and New York.
AmeriGroup’s Balance + Rx Plan is similar to their Classic + Rx plan in that it is available to those who qualify for Medicare Part A, are enrolled in Part B, live in the service area and do not have late stage renal disease. The major difference is that with the Balance + Rx plan the participants first $500 in medical expenses is covered then deductibles of between $1,100 and $1,900 per year apply. Once the deductibles are met, any remaining medical expenses are again covered in full. This plans availability includes parts of Texas, Tennessee, New York, New Jersey, Maryland and Florida.
AmeriGroup has an additional product called Amerivantage. Amerivantage is designed to provide coverage for people who qualify for both Medicare and Medicaid. Amerivantage offers not only the Classic + Rx Plan, Specialty + RX Plan, and the Balance + Rx Plan but also a Choice + RX Plan. Choice + Rx Plans make it possible for participants to choose out of network medical care for services that are covered.
AmeriGroup Prenatal Care
One of the areas in which AmeriGroup excels is in the area of prenatal care. They provide many services to low income mothers that are not normally covered by traditional health plans. These include assessment screening, nurses for high risk pregnancies, and phone and e-mail reminders for appointments. Additional benefits they offer these mother’s are travel assistance and a 24 hour nurse line.
AmeriGroup Health Insurance may not be as highly rated by independent auditors compared to some private organizations since AmeriGroup’s primary focus is on providing care for needy patients rather than gaining profit. The company has received good ratings in the past for chronic disease care. Some of the conditions that might be classified as chronic disease would be mental illnesses, diabetes, cardiopulmonary disease and asthma.
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35 Comments to “AmeriGroup Health Insurance Company”
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Christine simmons says:
“My 90-year-old aunt is on this plan. Has been nothing but a hassle & run around to get any of the care she needs. Took over a year to get her a hearing aid. And the current incident is she fractured her pelvis right before Easter. She has been waiting on her case worker for 4 days to come by & evaluate her & when she finally showed up was supposed to call a family member so we would know what her treatment would be & case worker would not let our aunt call.
So, the outcome is my aunt signed a lot of paperwork & still knows absolutely nothing as to what care she is to receive. So much for treating the elderly with a little dignity & respect.”
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Angela Hoeltzel says:
“I have Amerigroup Plan D. I live in Hudson county, NJ.
I would like to have a list of dentists so I can go for check up and cleaning.” -
Gisella says:
“Do not use this insurance. I honestly believe they are scamming the poor and the system. Medicaid should find another company.
My mom has pre-cancerous colon mass that needs to be removed as well as gall bladder stones. Her current doctor under plan is strange, it is almost impossible to see him or make an appointment because voicemail always full or his number changes if we show up they turn us away.
She needs a referral for pre-op and can’t get one. I tried calling other doctors under plan and was told they no longer accept because they are not able to refer patients to anyone causing liability issues for them. Yet amerigroup website still lists these doctors under their plan.”
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Matt Myers says:
“I wish I never worked for Amerigroup. I never had health insurance the whole time I worked there. Now after being let go, I can’t get Cobra because Amerigroup was too cheap to pay for health insurance. I was a full-time employee with no benefits.
Amerigroup acts like they care about people, but it seems like they only care about the almighty dollar. I would steer clear of this company..”
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KAREN says:
“I have only been an Amerigroup Advantage subscriber since September 1, 2011, and I already want out! However, I am stuck with them until the next enrollment period.
I was told that they have doctors in my town but every doctor I called will not take Amerigroup any longer even though they are still listed as Amerigroup doctors. RED FLAG! I have asked repeatedly, for a packet that they were supposed to send me and I have yet to receive one.
Now, because of Amerigroup, I cannot see the specialist that I need to see because I don’t have a Primary Care Provider to give me a referral even though my card says that I don’t need a referral, this is another Amerigroup lie! I will have to travel to another town to see some doctor who’s name I can’t even pronounce. It has been a nightmare!”
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J. Patrick Curley says:
“I don’t understand all the bad talk about Amerivantage from Amerigroup. Maybe it’s because I live in Nashville and my doctor options are so vast due to both Vanderbilt University Medical School and Meharry Medical College being here. Dentists are plentiful as well due to Meharry.
I have had 0 problems finding providers. I have had 0 problems seeing specialists. They have done everything they promised me when they sent someone out to show me their plan. I am well pleased with Amerigroup!”
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Diane Spohn says:
“AmeriGroup is so crooked suppose to help people with health care they are doing nothing but ripping off the people paying them because they are not getting patients what Dr’s order.
Jime Rios in the Houston office you are number 1 crook call make promises never intend on honoring ask for more and more documents, never planned on getting the items for the person!”
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Amerigroup Ripoff says:
Annoying phone calls and reminders. Poor selection of dr.s. Nosey personal questions that have nothing to do with health care. They waste money wanting to chat me up several times a month. Not looking for telemarketers just want a health insurance co.
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PK says:
“Have used this plan twice so far. I saw a great doctor, but I wouldn’t be surprised if he refused to accept my plan again. I had a great visit, but when the bill came AmeriGroup had refused to pay portions of it under the auspices of (obviously needed and very basic services (a blood draw – they covered what the physician did with the blood sample; the other was a cheap test for a highly infectious disease)) the services not being authorized.
What a hassle and a scam. I feel embarrassed for having such a chintzy plan, and I desperately hope AmeriCorp’s refusal to pay for my services doesn’t result in 1) my losing access to a great physician or 2) any appeals on my physicians part don’t end up costing me money.”
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Allen Wolford says:
Sad that I can only give them a 1. They don’t deserve that. This company really needs an investigation. They commit fraud every time they claim they are an insurance company.
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ss says:
They deny everything. I have to jump through nine million hoops to get needed medical attention, but they will readily pay for me to have 8 kids. Now it makes sense.
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Al Truglio says:
“DO NOT GET THIS INSURANCE! The only doctors who accept this insurance are those who belong in a rubber room!
Since my dad’s hospital discharge (3 MONTHS AGO), he has YET to hear from his PCP! It’s impossible to schedule an appointment with her as she’s either on vacation or sick. When he finally walked into the office, her first question was “”Are you here to change me as your PCP?””. What??? What kind of a question is that?!!! He had a stroke, and she was supposed to schedule a speech therapist for him. He is STILL waiting for one! This is AFTER changing from the first PCP, who was even worse.
I’m in process of desperately changing this reject of an insurance company!!”
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Keekee says:
They are refusing to pay for a drug that is not on the drug formulary, and they won’t grant me an exemption. Do not use this insurance.
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lee says:
“Horrible experience with the company. I can only use HORRIBLE to describe the company.
Liar, cheater, the ultimate goal of the company is profit. Stay AWAY !!!!!”
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CronoT & Akorrita says:
“These people are the most crooked mother ****ers on the planet. We got a free membership to a gym & a health club, but that’s where things went completely wrong. My g/f, Akorrita, got an upper respiratory infection from the nasty, uncleaned exercise equipment they had there. (I won’t say the name, but it’s a women’s gym that rhymes with Murves.)
Our PCP was so busy when we needed to go to the Dr. that they didn’t even answer the phone, so we went to the hospital ER, which was covered, thank God. At the hospital is where they diagnosed the respiratory infection, & prescribed Advil 600 mg, Z-PAC, & a cough medicine. Amerigroup REFUSED the cough meds, saying they were too close to over the counter. So we bought a buttload of Theraflu instead.
Next, we got a letter saying they were refusing to fill Akorrita’s primary bi-bolar med. We went to her psychiatrist, who said he’s going to try & fight it. So, after not getting the cough meds the hospital prescribed, Akorrita’s cough got worse. She finally got another Dr. we’re going to try to use as her PCP.
We go to that Dr., who now says that because of the improperly treated & medicated cough, she now has bronchitis with acute reactive asthma. So, the Dr. prescribes her with predniSONE, antibiotics, a bronchodilator, & more cough meds. We warned the Dr. ahead of time, & sure enough, Amerigroup denied the cough meds.
So, we got in touch with her old insurance, United Healthcare. They were not only up there the same day to see her with an agent, he went onto their formulary & found out what the cough meds were because we kept a voided copy of the cough meds script. It turned out it was Mucinex, so we bought three small bottles of the generic max strength cough meds. That finally started to help. Unfortunately, United Healthcare doesn’t kick in until July ’13.
Now today, we received in the mail a note from Amerigroup, saying they don’t cover the bronchodilator…..
FFFFFFFFFFFFFFFFFFFUUUUUUUUUUUUUUUUU……………..”
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Kathleen Cutrone says:
“This company is AWFUL!
My previous insurance company transferred all accounts to Amerigroup and no one is taking ownership of my son’s Continuity of Care. He has a chronic condition and I have been trying to confirm his ongoing care. Been on the phone for weeks now trying to confirm coverage and all I have gotten is told that I have to call someone else.
AND to add insult to injury – the doctors they keep sending us to aren’t in the plan!!! Amazing.”
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Tony says:
“My dad has amerigroup Medicare advantage over 5 years. He lives in Houston Texas. He does not have any problem so far with providers and dentists.
If you don’t want any problem with HMO plan, you need to know how it works before you join so you don’t have any issues. I love amerigroup.”
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Mrs. Lavern Nelson says:
“I recently (a few months ago) joined AmeriGroup Ins. because of the way they presented the plan’s benefit pkg to me when the rep came to my home. They talked about the advantages I’d receive, the free gym membership, they said they pay for over the counter meds as well as my prescribed meds, that I’d have access to 24 hr nurse hotline and all the good things they’d do.
However, before I joined AmeriGroup I was doing fine with medicare and Medicaid… I was going to the County Hospital and seeing the Doctors there, my meds were paid for as well as the doctor’s care. I was told that the county hospital wasn’t on their network but that I’d be able to choose from their array of doctors, specialist without a referral… I was sold by the convincing was the plan was presented!
I’m an elderly woman and I’m not understanding much about all of the health plans and different parts to these plans so I guess I was easily swayed. Now I’m receiving med bills in the mail that I can’t pay! Bills for prescriptions AmeriGroup didn’t pay for! My only income is a small SS check, I’m barely able to survive, I’m too old to work and have no other income… I will contact AmeriGroup and drop them asap.
wouldn’t refer them to any elder person. If you’re doing ok without this ins. I’d suggest you leave “”well enough”” alone or check with another company.”
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Mary says:
“$25 in over the counter meds and supplies. Surprise! Nothing is covered! I spent an hour going through the list at my pharmacy and the pharmacist finally told me that “”so far, nothing has been covered for anyone”” – this is not good and Florida Managed Medicaid is pushing this on people.
Amerigroup needs to publish the list of approved (name brands, store brands and sizes) that are approved so people can plan ahead and so pharmacies don’t waste time doing Amerigroup’s job.”
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Komal says:
“This is the most AWFUL, worst insurance company.
You will never find the doctors who take this insurance.. It’s very hard to deal with this insurance company ..even the operators are no help, even has a different answer that will never help you.. It will take days and months to find the doc or the treatment you needed.
It’s like having insurance same as not having an insurance..
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yesenia Ortega says:
I just saw a rep today and we were convinced. My mother was caution and said let’s ask around first. Thank God after reading all these reviews, we are not going to get Amerigroup!
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Lindsey says:
“I work in a doctor’s office and this is by far the worst insurance company I have ever head to deal with. They deny almost every single procedure, they take forever to give you an answer.
I’ve been dealing with trying to get a patient her CHEMOTHERAPY that she was already in the middle of, I had to get a new auth because it expired and they denied it even though the patient was already approved before and already int he middle of treatment!
The WORST insurance company ever. I’d rather have no insurance than have insurance through Amerigroup. The only reason I gave them one star was because you had to rate them.”
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scott says:
“just the worst.
Wasted so much time just on basic things, invoices always wrong, they now have one month extra of my money and will take 8 weeks to get back. I’ll be lucky to actually see a check.
Stay away if you don’t want a hassle.”
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Blake says:
“I hate this Insurance Company so much! NONE of my specialists are covered. I am on the Autism Spectrum and don’t deal well with changing Drs. These are Drs. that I have had for years, that know my history, like my load of allergies to medicines, etc.
My Gastroenterologist is one of the only ones in the Tri-State area that deals with the condition I have, Gastroparesis. I am forced to pay out of pocket, which I can not really afford, but have to do to get the medical care I need, as these people suck.”
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Shelia says:
“Hands down… The “”WORST INSURANCE COMPANY “” in history.
Insurance regulators and government entities should investigate them for bait n switch services. the agents represent the company very well, but the truth of the matter is they are doing whatever it takes to get paid.
Please, please..investigate and shut them DOWN!
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Wendy Denney says:
My husband tore his Achilles tendon and Amerigroup fought his treatment every step of the way. I also found that their list of providers was totally inaccurate. They had assigned us to a primary care physician who had moved and was not even affiliated with them!
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Chris Hickman says:
“I have this insurance. I am a diabetic and I need insulin very badly. I was told my insulin needed pre-authorization.. My doctor put in an urgent request and I called several times, they told me that they contacted my pharmacy to put it through as urgent.
After finally speaking to a manager they said it was never sent to my pharmacy but instead to their medical director for review… 3 days now without insulin.
When I called customer service I was mocked and told if it was so urgent to go to the ER.. So I guess they would rather pay $5,000 dollars for 1 shot of insulin than pay a few hundred dollars for a few month supply.
Worst decision of my life choosing this insurance!”
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Laura says:
“Since 1/2015 I have had 5 primary care docs drop AG. Then, I get a letter from AG saying Health Care Partners of NV (largest care provider in NV) has dropped AG altogether.
AG sends me a letter with 5 clinics from which I can choose a new DR. 2 of them are clinics with no doctors at all. The clinic says I have to get my scripts filled there, but it can take up to a week to get filled. AG doesn’t allow me to even request refill until 4 days before pills run out.
1 of the clinics has a bus that goes around poor neighborhoods to do god knows what. I speak English and am an American citizen.
I HATE, HATE AG, and am considering not taking any of my meds just so I don’t have to deal with this nightmare. When I have a heart attack and end up in the hospital then they can pay! Obamacare my a@*!!”
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Robert McAlister says:
“These clowns signed my brother up for their version of “”Insurance”” in an Arby’s fast food joint. Sadly, the joke is on him.
He had a stroke(s) was admitted to the hospital spent three weeks there waiting for approval to get physical therapy and finally the verdict came in … they denied the entire hospital stay.
The hospital patient advocate said that was a first, they told us not to worry about it that they would take care of it at the corporate level. Now we’re having trouble finding a doctor that’s willing to accept their “”Insurance””.
Hurry up open enrollment. Please add negative ratings!”
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K Webb says:
“My daughter has this horrible insurance. She is adopted and is a special needs child. I went to get her medication today and was told she is not insured. She has been on Medicaid since we adopted her.
She is on this insurance. This is not the first time I have had problems with this incompetent company. I am speaking with my state representative tomorrow.
My child is going without her medicine until this is straightened out. Last time, it took a week. I am so frustrated with this company.”
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Denise says:
“This insurance company is a joke. They won’t cover a lot of the medications my son needs and they won’t even tell you in advance.
This is a disgrace.” -
Eric says:
“We as a unique provider haven’t accepted Amerigroup insurance for quite some time now. The administration cost to argue with them got way too high with long call waits, unhelpful phone reps and excessive transfers to other CS representatives.
It’s very clear that Amerigroup puts profits over anything and everything else and denying Medically Necessary Care is a great way for them to grow their profits. In 2016, we had to write-off over 245k in bad debt that we couldn’t collect from Amerigroup.
As a consumer, I would stay far away from any of their policies since they look at every way possible to not pay your Medical Insurance claims, including prescriptions etc.”
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Nikko says:
This company should lose their license to sell insurance they are a total fraud. They do not provide health care. This company is stealing taxpayers money.
I belong to amerigroup advantage plan. I would like to have dentist list in Houston Harris county so I can go for check up and cleaning