Silver Summit Healthplan

"They use "prior authorization" as a means to deny coverage for certain necessary treatments. Even when my doctor recommended specific tests and procedures, they required prior authorization, which took weeks to process. In the meantime, my health deteriorated, and the delayed treatment resulted in further complications. It's maddening that they put bureaucratic hurdles ahead of my health and well-being, all for corporate profit. It should be illegal and investigated. No wonder their parent company has a spot on the Fortune 500… it's a simple formula – take high premiums in and pay as little as possible out. Unfortunately, it comes at the price of people's health. Navigating their customer service was a nightmare. I spent hours on hold, only to be met with unhelpful and often rude representatives who seemed more interested in deflecting responsibility than assisting me. The lack of transparency is another major issue. It was almost impossible to understand what was covered and what was not, even after reading my policy documents. It's as if they intentionally obscure the fine print to avoid paying out claims. I expected clear communication and honesty from my insurance provider, but it was anything but that. The denial of coverage despite clear policy statements and the use of prior authorization to delay necessary treatments should be investigated. Their lack of transparency only exacerbated the issue. Run, don't walk from this insurance provider. They're dangerous and a #HealthInsuranceNightmare"

"I chose the Ambetter Silver Summit Health Plan (Silver Value) through the Nevada Health Exchange. The premiums were over $800 per month (subsidized in part by my APTC). I tried to use the telehealth feature covered under my plan when I had a health issue and wasn't able to use it. I was told by Membership Services that I didn't have telehealth services (not true, it's on my policy) and when I tried to connect with Teladoc (through the link on Ambetter Silver Summit's website under my personal coverage) I was told that my health plan wouldn't authorize it. I'm done with this insurance company, the customer service was terrible."

"Tried to find a PCP using their system, all the links they provided were either out of network or not taking new patients. Called customer service 3 times - 1rst they gave me a new “updated list,” and same issues - either they weren’t taking the insurance or not taking new clients. 2nd and 3rd times they stated they found a provider for me - both times the providers they sent me were not taking new clients or not taking the insurance. This company is a joke…."

"Absolutely no excuse for the poor lack of help to your patients. My daughter is 16 and suffers from chronic migraines and has taken every oral medication out there to help. She has not had a break in a YEAR. I don't know about anyone else but watching her go through excruciating pain and having to be homeschooled due to them and watching her suffer would hurt ANYONES mental health. My daughter and our entire family have been hurt mentally by this company as they denied the 1st medication that may ACTUALLY HELP HER! The first denial was simply "Need a reason" for taking the medication, welp, the doctor gave you what you wanted and you STILL denied it. The pharmacy COWARDS ONLY speak with physicians not with patients. It is no surprise as to why, it's because you would have to explain to the patient why you denied it and don't feel like dealing with the reality you are putting others through. I am now having to wait for the doctor to tell me why it was denied because they also don't tell you why over the phone they make the doctor do it to not take responsibility of making CHILDREN SUFFER! I was an RT and I know how healthcare should be done and it's with compassion and care, not however y'all are doing it. DO NOT USE THIS COMPANY! WORST EVER!"

"This place is just a joke. Their network is small and it's impossible to find providers on their website. I have better luck on Google maps and calling. They're highly restrictive of what they'll cover and what justifies being covered. I can't even search a walk-in clinic near me. They say there's none. Case managers call and even if you call them back literally seconds later they don't pick up and once they call you they don't try again until the next month and basically drop the responsibility and you have to keep trying to call them, on top of being little to no help with anything. They're constantly losing clinicians so suddenly therapists or doctors are no longer in network. It's pathetic and it's clear they don't care at all. If you get this company assigned through medicaid absolutely switch to HPN. Don't wait and don't hesitate. Get away from these people."