5.4

Overall Score

Oscar

verified
Trying to Fix Health Care
  • Free Services with Plans
  • Free Misfit Tracker
  • Oscar is a new name to the health insurance industry, but they have grown significantly as a company since their founding in 2012. The company values simplicity and communication, so they seek to simplify policy in order to better cover the needs of their clients. Claiming that they grew tired of complicated health plans, Oscar Health Insurance was created to give customers a new, simple way to get health insuranceand affordable care that involves several free perks that many other health insurance companies do not offer. They claim to put a strong emphasis on technology to cater to customers’ needs and add convenience to health care. 

    The Good

    • Types of Plans Offered
    • Member Resources
    • Unique Features
    • Customer Service

    Types of Plans Offered

     

    Oscar, as a health insurance company devoted to simplicity and functionality, tries to ensure that all clients find an easy health plan to suit their individual needs. Oscar takes both on and off exchange individual plans in all states in which it operates, plus small business plans in New York, New Jersey, and Tennessee. They offer several different plan types: EPOs, HSA-compatible plans, and self-funded options. Oscar does not currently serve Medicaid or Medicare customers.

    The perks of EPO plans are that individuals do not need referrals to see a specialist, and they can use any doctor or hospital within the EPO network. However, EPOs (similar to HMOs) have no benefits for out-of-network facilities, except in emergencies.

    There are four kinds of Oscar Plans: Classic plans, Simple plans, Saver plans, and Backup plans. All Oscar Plans have free Doctor on Call telemedicine services, rewards for steps tracking, an Oscar Concierge team, and pre-deductible preventive care benefits to keep out-of-pocket costs to a minimum for both specialty and brand-name drugs.

    Oscar Classic plans generally match the policy and structures of most of the plans in the individual insurance market.

    However, Oscar Simple plans are easier to understand, because clients only have one dollar amount to remember: all covered services are free after clients hit their deductible. This is because the deductible is set at the same level as the maximum out-of-pocket amount. (Note: Care that happens pre-deductible requires a copay, coinsurance, or full payment by consumers.)

    Oscar Saver plans are HSA-compatible plans with low monthly premiums and a higher deductible. Members use funds out of their HSA to pay for health care throughout the year.

    Oscar Backup plans are a low premium, high deductible option designed for healthier people who was to save on upfront medical expenses.

     

    Member Resources

     

    Before becoming a member, potential clients have access to a free premium quote on Oscar's website or by phone. With this tool, individuals answer a few general questions about themselves (zip code, age, how many people you want to cover) as well as about their expected medical needs in the next year. Through this brief process, Oscar which helps direct clients to the most cost-efficient plan. Individuals are then able to see all of Oscar's plans, costs (including government subsidies if you qualify), benefits, and recommended options to help decrease out-of-pocket costs.

    After clients pay the first bill, Oscar sends a welcome kit, which includes the client's ID card(s), an in-depth look at the free perks and benefits, as well as the individual's Schedule of Benefits and Coverage. This welcome kit also has a "Health Care Cheat Sheet" to help break down all the details of the chosen insurance coverage within the individuals' plan. 

    Lastly, Oscar offers a web account and mobile app to its customers. These allow members to search for health professionals covered by Oscar's plans, book appointments with select providers, and view detailed doctor credential information and reviews to find the one(s) best suited to handle their specific needs. Members can call or message their Concierge team by simply clicking a button within the app. This app also provides members with a "Health Timeline", which contains their personal medical information and history such as appointments, prescriptions, lab results, and billing information.

    Unique Features

     

    Oscar has unique features that many other competing health insurance companies do not. One of these is the fast registration process. Because they pride themselves on simplicity, Oscar has taken many steps to remove the complication of choosing a health insurance plan and registering. They also seek for simplicity by providing efficient customer service, clarifying information on health insurance policy and potential medical expenses, and more.

    Each member is also assigned to a Concierge team and a registered nurse, which allows customers to receive specialized service. This team can assist with finding doctors, booking appointments, coordinating care for complex or chronic medical issues, providing clinical guidance, and resolving billing or reimbursement issues. 

    Furthermore, instead of casting a wide net and contracting with every health care provider, Oscar has developed a curated network of medical groups and doctors in each of its service areas to ensure tighter integration and higher quality health insurance policy for members. Additionally, they use data science and complex modeling to assess network coverage, provider quality, and service volume to improve their offerings. 

    Oscar also provides rewards to customers who reach their step goals. Customers track their steps using the health apps that come with iPhones and Androids. When they reach their daily step goals, they can receive up to $100 in Amazon gift cards per year. 

    Customer Service

     

     Oscar provides excellent customer support. They provide phone support from 8 a.m.-8 p.m. Monday-Friday local time in each of its markets, and 9 a.m.-5 p.m. on weekends. When clients call or secure message Oscar, you are connected to a Concierge team. This unique model provides customers with additional support. Each Concierge team consists of a care guide and a registered nurse.

    In addition, due to the nurse's experience on the team, they can also handle clinical questions, including assessing a member's needs and connecting them with the proper type of doctor to address their needs. Concierge teams proactively reach out to members if they visit the ER or hospital unexpectedly to make sure they are okay and that they have done all the follow-ups the doctors requested. Because they're familiar with you and use Oscar's powerful backend systems to see your history instantaneously, there is never a need to be passed off to another department.

    Oscar also provides what they call Doctor on Call, a telemedicine service that lets members talk to a doctor 24/7 for free over the phone. This service is especially convenient for getting medical advice when you don't want to take a trip to the doctor's office. According to Oscar, 91% of all Doctor on Call visits end in a resolution without the caller needing an in-person doctor visit. In this sense, Oscar delivers on its emphasis on technology to make customers' experience more convenient.

     

    The Bad

    • Location
    • No Dental or Vision Insurance
    • Limited Plan Types

    Location

    Oscar health insurance plans are only available to customers in New York, New Jersey, California, Texas, Ohio, and Tennessee. Small businesses may also be eligible for Oscar coverage in Tennessee, New Jersey, and New York.

    No Dental or Vision Insurance

    Oscar health plans don't include dental or vision coverage, except for children under the age of 18. Many competing insurance providers do include dental and vision options.

    Limited Plan Types

    All of Oscar's plans are EPO-based (Exclusive Provider Organizations), although they have different plan types available to small businesses offering out-of-area benefits. They don't work with customers on Medicare or Medicaid, and as a member, you must get health care, prescriptions, and medical supplies from providers who take Oscar plans. This might mean you don't need a referral for a specialist, but it also means you have no out-of-network benefits, except for emergency situations or if you sign up for out-of-area coverage as a small group customer. 

    The Bottom Line

    Oscar provides a wide array of member tools and support options. Their mobile app and Concierge Teams offer customers abundant and easily accessible customer service.

    Oscar has its advantages, but overall it's not a recommended health insurance company. Oscar has been in business for a short amount of time in, especially compared to other insurance providers, and only offers limited types of health plans. They are not an option for customers on Medicare or Medicaid. What's more, this company is only available in a handful of states; customers should check availability in their state before considering Oscar. 

    For customers in the available states who are looking for these types of plans, however, this company is a fantastic option. They boast reasonable rates, they provide several customer service contacts, they claim a fast registration process, and they give free services with every health insurance plan.

     

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    User Reviews

    1.4

    108 Reviews

    Your trust is our top priority, so we check all reviews for accuracy and relevance. Additionally, we do not allow companies to alter or remove reviews. Learn more

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    Maria Garza
    July 16th, 2018 DETAILS
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    Well let's see where should I start? I need an MRI that has been requested by two different doctors and Evicore denied it three times and so did oscar. I feel that if a request or several have been made by a doctor and I am paying my premium that I should be able to get my MRI. I am not happy with this insurance and wasnt happy with the last one which was Ambetter by Superior.

    Helpful?
    Jim Schoen
    July 16th, 2018 DETAILS
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    They refuse to honor their commitment - they have very thin network, had no Doctors available, told me to go to Emergency Room, said they would pay, refuse to pay

    Helpful?
    Sean P Pabbruwee
    July 12th, 2018 Huntington Beach, CA DETAILS
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    It is aweful. Don't use this insurance, they will cover nothing and fight you on everything. They will tell you your covered if you ask then refuse to pay once you submit a claim. I went for a flu shot and the doctor that Oscar recommend and said was in network had never heard of Oscar, would not take my insurance and told me I had been scammed. Instead of reimbursement, Oscar told me I had to go back to the doc and tell them Oscar was a real insurance. What kind of rip off are they running?

    Helpful?
    jENN
    July 11th, 2018 Westbury, NY DETAILS
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    Horrible customer service, every representative tells you different information. Worst experience with a health insurance company in my life. Premium for me and my husband because he lost his job is $1132.06 a month. Paid my premium temporary ins card said coverage effective date is 7-1-2018, got to pharmacy was told no coverage three hours after I made my payment on phone with rep. Was told I could get reimbursement for paying $58 for a med that usually costs me $5.00. Now told they don't cover med. If you need health insurance RUN FOR THE HILLS.

    Oscar Logo

    Reply from Oscar

    Oscar HealthJul 13, 2018

    Hi Jenn – we’re sorry to hear you’re not happy with the experience. Because of privacy concerns we’re not able to comment on any specifics regarding prescriptions or your coverage here. However we understand you’ve connected with a supervisor on our team to further address the issue. Our team is always here to help for any questions you might have. You can reach us any time by calling 855-OSCAR-55 or by sending us a secure message from your account or the app.

    Helpful?
    Alan H Brown
    July 10th, 2018 DETAILS
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    Online portal is good. Customer service is good. Selection of Doctors OK. Need better contracted rates...office visit too high.

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    Reply from Oscar

    Oscar HealthApr 19, 2018

    Hi Alan, we apologize for the frustration. While we do have negotiated rates with all of our in-network providers, these rates vary by service and provider. We're unable to speak on rates that providers have with other insurers, but rest assured that all of our providers work off of a pre-negotiated fee schedule. Please don't hesitate to give us a call with any questions or concerns: 855-OSCAR-55.

    Helpful?
    Karen Shenker
    July 6th, 2018 New York, NY DETAILS
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    With all the issues we gave to deal with after Obama Care andcthe Affirdabke Care Act was introduced, Oscar medical insurance is a pleasure to deal with. Unfortunately they’ve also become very expensive but they’re not to blame My main negative is that they stopped their affiliations with Weill Cornell and NY Presbyterian so I was forced to change all my doctors and hospitals. I love their website and the fact that they’re current with the times. Technically driven, organized and their staff aim to please. Billing is excellent too.

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    Reply from Oscar

    Oscar HealthJul 13, 2018

    Hi Karen – thanks for taking the time to share your experience. We're so glad to hear that you're happy with Oscar. We built our network in New York around three great hospital systems that ensure complete and high-quality care, collaborate with us for a seamless care experience, and provide great value without sacrificing quality. If you’re looking for a provider, our team is happy to help - they can narrow down a list based on the criteria that are most important to you. As always, if you have questions or would like help from your team, call us at 855-OSCAR-55 or send us a message via your account or the Oscar app.

    Helpful?
    Shawn Ordoyne
    June 25th, 2018 Austin, TX DETAILS
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    This is a scam. Stay away. Oscar SUCKS. First, they only have O.D., Nurse practitioners and P.A.s that you can see. Forget about seeing an M.D. Second, if you see an M.D. by some miracle, you will pay $120 for a "free" primary care physician because of some B.S. medical coding scheme and it will be charged under your deductible. These people are crooks.

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    Reply from Oscar

    Oscar HealthJul 13, 2018

    Hi Shawn, we’re sorry to hear you’re frustrated and have had difficulty finding a doctor. Due to privacy laws we can’t discuss anything regarding your claims or private health info here. However we’ve sent this feedback to our team and understand they have been in touch with you to further address the issue. Our full network of providers is searchable on our site at hioscar.com/search, but we're also always happy to help you find providers that meet your needs. You can always reach your Concierge team by giving us a call at 855-OSCAR-55.

    Helpful?
    Rich
    June 18th, 2018 Olmsted Falls, OH DETAILS
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    Recently went to The Cleveland Clinic (Oscar was only Insurance available for CC through Healthcare.gov). My doctor requested a Hep C test. I received the bill. $2,153.00 !!! My girlfriend had the same lab work and test done at University Hospital and was charged $548.00 for the same lab work and analysis. To add further insult, Cleveland Clinic had to run this laboratory test three separate times to get results that they could trust. They are "partners with Oscar". My out of pocket cost was $889.51 !!! Additionally I have had issues with medications that were covered by my former healthcare insurance provider (and prescribed by my family doctor at Cleveland Clinic), that are not covered! If I could give less stars I would. I will now have to switch healthcare providers in order to get insurance that is reasonable relative to total costs. BTW I pay $953.67 monthly!!!!!!!!!!!! I cannot believe the Cleveland Clinic would make such a poor choice in Insurance providers. I wonder what other poor choices they making?

    Oscar Logo

    Reply from Oscar

    Oscar HealthJul 11, 2018

    Hi Rich, we’re sorry to hear you’re not satisfied with your experience. Depending on the plan you’ve chosen, you may need to reach a deductible for non-preventive services, including lab work, before cost sharing applies (preventive services are always covered). This means that you'll be responsible for the full negotiated rate of those services up until the amount of your deductible is met. We’re unable to comment on rates that other providers and insurers have, however if you have questions about costs of specific medications, tests, or services your Concierge team would be glad to help. Anytime you call or send a message through the app, you’ll speak to the same people every time. Please don't hesitate to give us a call to discuss this or any other concerns: 855-OSCAR-55.

    Helpful?
    K
    June 13th, 2018 Brooklyn, NY DETAILS
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    Un-effing-believably bad. Get ready for no help, no information, nothing covered, and nobody at the company who knows jack about anything. Not sure if it's helpful if you're hit by a bus, but everything short of that is pretty much not covered.

    Oscar Logo

    Reply from Oscar

    Oscar HealthJul 09, 2018

    Hi K, we’re sorry to hear you’re frustrated and would like to help resolve any issues you’re having. Know that if you’ve signed up for a high-deductible plan, preventive services are covered in full, but any non-preventive services will be subject to the deductible. This means that you'll be responsible for the full negotiated rate of those services up until the amount of your deductible is met. For questions on your plan or billing, if you need to find a doctor, or want information about costs prior to scheduling an appointment, our Concierge team is here to help. When you call or send a message through the Oscar app you’ll be connected to the same people every time. If you’d like, we’d also be glad to reach out to you directly. In that case, please email your member number to [email protected] or call us at 855-OSCAR-55 to connect with our team.

    Helpful?
    Lee
    June 5th, 2018 Pasadena, CA DETAILS
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    I don’t want to give any star to this insurance company. First of all the clinic told me they have network. I have received claim declined letters from Oscar since they are not network. But they are network... I have visited the clinic manager to make sure if they really are network with them. The manager called the insurance and they admitted they are network with this insurance provider. Again I have received another declined letter from the insurance. I contacted with insurance to ask what’s going on. They said they will need to confirm so need time. I am wondering why they don’t know if they have network with the clinic... I have no idea ... this is ridiculous. I don’t know what I am paying for. This is huge mistake to pick this insurance. Please don’t ever get this insurance. It’s not worth it at all

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    Reply from Oscar

    Oscar HealthJul 13, 2018

    Hi Lee, we’re sorry to hear you’re frustrated. Due to privacy laws we’re unable to comment on anything related to specific claims here. We’d like to connect you with our team to further address your concerns. Please send us a private message here with your member number and someone will be in touch. Or you can call us any time at 855-OSCAR-55.

    Helpful?
    kristen yee
    June 5th, 2018 San Francisco, CA DETAILS
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    THIS COMPANY GETS YOUR BUSINESS BY LYING TO YOU If you have need medicine or have a pre existing condition run as fast as you can away from this company. First if all their "negotiated costs" for some medicines is no different than paying at a retailer with a Good RX card. I spent multiple phone calls with them to make sure all my drugs and durable med equipment was covered. Even gave them id's so they could check. When I went to order they only covered one, and not with the suppliers I gave id's for but with a third party. One of the items I need they charge MORE than if I buy direct from supplier out of pocket. Their idea of a negotiated cost is 175 bucks for a 20 day supply of insulin. I can get that with a good rx card without insurance. They don't tell you this before you sign up. Not to mention this is a pharmacy order BUT they won't apply it to the $500 pharmacy deductible. They apply it to the $6000 deductible which means they never help with the cost. The website is a joke. You call a doctor on the site they have never heard of Oscar. Even when you call them they give you names of doctors that have not heard of them nor take their insurance. 6 months I have been trying to get appointments. We are self employed and we pay ALOT for really nothing...and don't even get me going on the pediatric dental. This company is a scam to rob you of your money. Can't wait for 2019 so I can be done with them.

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    Reply from Oscar

    Oscar HealthJul 09, 2018

    Hi Kristen, we’re sorry to hear you’re frustrated with your plan. Due to privacy laws we're unable to discuss the specifics of your private health info here. Depending on the plan you’ve chosen, you may be subject to the full negotiated rate for prescriptions and services until the deductible is met. Please be aware that Oscar works with a third-party partner for all durable medical equipment requests and if filled with an in-network provider, any costs would be applied to a plan’s deductible or durable medical equipment cost-sharing. Our Concierge team is standing by to help find providers that meet our members’ needs – they can supply a list of potential providers according to a member’s plan. If you’re open to it, we’d like to have your Concierge team get in touch to help further. In that case, please DM us your member number, or call us at 855-OSCAR-55 and we’ll connect you with them directly.

    Helpful?
    Joanne
    May 25th, 2018 El Segundo, CA DETAILS
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    DO NOT PROVIDE PHYSICAL THERAPY anywhere acceptable close to me (Los Angeles) I switched to Oscar from Blue Shield at the beginning of the year because Blue Shield premiums skyrocketed all of a sudden (we all know why). It was the only other insurance UCLA accepted from the self-insured ones. I thought it was good that they covered UCLA and USC doctors, which are research facilities and more trustworthy. However, I did not check their physical therapy network. It is horribly slim. UCLA has offices in many parts of LA, but their physical therapists are only around Santa Monica and central LA. I have a back injury, and cannot travel far for physical therapy: I don't drive and cannot sit long in a car. The closest physical therapist they gave me was 14 miles away in Santa Monica. Driving 14 miles into Santa Monica means sitting in a car for 45-60 min because of horrible traffic. By the time I would get there I would be in too much pain to do any exercises, and it would add up quite a lot with Uber ($45 for round trip), plus 1.5 hours gone a day that I could be working. You see a physical therapist more often than a doctor who could be farther for that one time check-up. This is not acceptable. I wrote to request I see the physical therapist I've used in the past who is 1.5 miles away and who knows my issues, but was denied because they are not in their network. This is a normal price physical therapy facility which accepts every insurance out there (but Oscar who they said wouldn't even return their phone calls and forced another patient of theirs to go 70 miles away for physical therapy). Yes, I understand what "in-network" means, and I agreed to it when I signed up, but I didn't imagine their network would be so poor. I am going to follow with the state and submit and IMR report, and may end up paying out of pocket to see my local physical therapist (which is the same as not having insurance and worse than having stayed with the more expensive Blue Shield). _____________________________________ Separately, I read the comment on the blood panel. Yes, Oscar did not cover my Vitamin D and calcium panels because those were not considered preventive. This at a time when Americans are largely suffering from a Vitamin D deficiency. __________________________________ Other than this I have been happy with their bill paying and letters regarding bills sent. That part of the insurance company works well. But if they don't cover physical therapy in a way that is manageable or acceptable, it is useless to have.

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    Reply from Oscar

    Oscar HealthJul 09, 2018

    Hi Joanne, we’re sorry to hear you’re frustrated with your experience. Due to privacy laws we’re unable to discuss any specifics related to your health information or claims here. We partner with a curated network of providers built around systems whose goal, like ours, is to keep costs down and provide a better experience for our members with excellent quality of care. Our full network of providers is searchable on our site at hioscar.com/search, but our Concierge team is also always happy to help you find in-network options. If you’d like to be connected with your team, please DM us your member ID number and we’ll have them reach out. Oscar follows the US Preventive Services Task Force guidelines. Services that are not deemed preventive by these standards – such as Vitamin D and calcium tests – are covered by your plan but subject to lab cost sharing. If you have any questions about these topics or anything else, please feel free to call us anytime at 855-OSCAR-55 or send a message via the app.

    Helpful?
    Pete L
    May 10th, 2018 Brooklyn, NY DETAILS
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    I've been going back and forth with Oscar and Mt Sinai hospital over an unpaid claim, which Oscar of course assured me was taken care of. It's been 4 months. I found out today they denied the claim because "it was supposed to go to Optum - who handles our mental health claims". This was for a consultation for basal cell carcinoma, NOT a mental health issue. Not only did they deny the claim without telling me, they actually told me it was paid and now I'm past due! I'm on hold right now with Oscar and the agent told me I had to call Mt Sinai and deal with this myself. This is absurd! NEVER EVER insure with Oscar. I'm going to find a new insurance company for my business as soon as I get this fixed.

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    Reply from Oscar

    Oscar HealthMay 15, 2018

    Hi Pete, we're very sorry to hear this. Due to privacy laws we're unable to discuss with anything regarding your private health info, such as claims, here. Give us a call at 855-OSCAR-55 and we'll be happy to look into this further and escalate your concerns as needed.

    Helpful?
    Paul G
    May 9th, 2018 Van Nuys, CA DETAILS
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    3 free primary care visits, except, they aren't free! Oscar claims you get up to 3 free visits with a primary care doctor per year. except once you make the first visit, you will get the pleasant surprise of a nice sized bill from your primary doctor's office. so now you're paying $220/month for nothing, thanks Oscar. Can't wait until Obama care gets overturned by our new President. This is such a scam. I'm paying well over $2k year for nothing.

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    Reply from Oscar

    Oscar HealthMay 15, 2018

    Hi Paul, we're sorry to hear you feel this way. Due to privacy laws we're unable to discuss the specifics of your private health info here, but please be aware that if your plan includes 3 primary care visits, those office visits will be covered in full with an in-network primary care doctor. If the doctor runs any additional tests or lab work, those services will be subject to the cost-sharing of your plan. Give us a call at 855-OSCAR-55 and we'll be happy to look into this further for you.

    Helpful?
    Emily
    May 1st, 2018 Los Angeles, CA

    Great app! Easy to navigate and find a doctor within my network.

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    Reply from Oscar

    Oscar HealthMay 01, 2018

    Thanks for taking the time to share your feedback, Emily! We're so glad to hear that you're experience has been so seamless. Please don't hesitate to reach out to your concierge team if there's ever anything we can do to help: 855-OSCAR-55.

    Helpful?
    Geraldine Merola
    April 30th, 2018 Sag Harbor, NY DETAILS
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    Not worth the price! You have to pay the full price of EVERYTHING at the docs office till you meet the deductible. So much for budgeting a feely paycheck! My last 15 minute appointment cost me $215 out of pocket!!! The network hospital is over 1.5 hours from my home. I have a local hospital and a full network of docs 20 minutes away and must now drive past all of them to get to Oscar's network! This plan should not be sold in an area if the local hospital doesn't take it!! If you haven't checked on their website yet- the search function to find a doc is useless- or I'd have discovered the paltry network when I shopped for a health plan.

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    Reply from Oscar

    Oscar HealthMay 01, 2018

    Hi Geraldine, we're sorry to hear you're frustrated with your plan. If you have a high-deductible plan, preventive services are covered in full, but any non-preventive services will be subject to the deductible. This means that you'll be responsible for the full negotiated rate of those services up until the amount of your deductible is met. We do have a curated network of providers, which means that our network is made up of select providers and hospital systems who, like us, are interested in keeping costs down for our members without sacrificing any quality of care. Our full network of providers is searchable on our site at hioscar.com/search, but we're also always happy to help you find in-network options. Additionally, if there's ever an emergency, your plan covers emergency care at out of network emergency rooms as well as urgent care at out of network urgent care facilities. Please don't hesitate to give us a call at 855-OSCAR-55, we're always here to help.

    Helpful?
    Queen kay
    April 11th, 2018 Los Angeles, CA DETAILS
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    Not happy nor satisfied with Oscar Insurance. I have hospital bills in my name and they won’t pay these billing companies. Nothing is really covered so just keep In mind , everything has a copay . That’s basically like false advertising. In California there’s no cooperate office or any available supervisors to help address issues. Been waiting for my problems to be resolved but nothing yet . Please fix these problems or else you will lose all your customers because this is my last year with you guys!

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    Reply from Oscar

    Oscar HealthApr 11, 2018

    Hi Queen, we're sorry to hear this. Due to privacy laws we're unable to discuss your private health info/claims here, but give us a call at 855-OSCAR-55 and we'll be happy to look into this further. Please also keep in mind that if you're on a high-deductible plan, with the exception of preventive care that is covered in full, any services will be subject to your deductible. This means that you'll be responsible for the full rate of non-preventive services up until the amount of your deductible. We're always here to help you understand the benefits of your plan and the way the cost-share structure works, please don't hesitate to get in touch with any questions or concerns.

    Helpful?
    Max
    April 9th, 2018 Costa Mesa, CA DETAILS
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    Called their “24/7 helpline” because I need to see a specialist on a Saturday. They Told me that they can’t tell me who’s is in network on a weekend , the “network navigators” are out until Monday. Pathetic.

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    Reply from Oscar

    Oscar HealthApr 09, 2018

    Hi Max, we apologize for the frustration. Our Member Services hours are Monday-Friday 8am-8pm local time and Saturday-Sunday 9am-5pm local time. It is only our Doctor on Call service that is 24/7. That being said, while our weekend team is able to help with many network searches on weekends, any specialized searches are completed by a dedicated network navigation team. This allows us to find specific providers that meet specific member needs. The network navigation team works Monday-Friday because this is generally when most provider offices are available to take calls, which is a part of the specialized network navigation process and ensures providers' ability to treat a specific condition or request as well as open availability. We apologize for any inconvenience you encountered this weekend. Please don't hesitate to reach out to us with any additional questions or concerns: 855-OSCAR-55.

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    Kerry
    April 6th, 2018 Los Angeles, CA DETAILS
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    Not happy with Oscar. The doctors list is NOT updated and slim. In California. I had to call my old Doctor and ask ? Oscar then added him to their “find a Doctor list” They dont cover a full blood panel when getting a physical like most. They hardly cover any general issues! Everything is extra. Terrible customer service.

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    Reply from Oscar

    Oscar HealthApr 06, 2018

    Hi Kerry, we’re sorry to hear you’re frustrated. We do our best to keep provider data up to date, but there are sometimes changes made on the provider side that we aren’t made aware of which can cause discrepancies in the data. In cases like this, just let us know like you did and we’ll be happy to update the information accordingly. As for coverage of a blood panel when getting a physical, these services should be covered under the benefits of your plan as long as they’re sent to an in-network lab. It’s possible that your provider is referring to preventive services being covered-in-full in which we follow the U.S. Preventive Services Task Force (USPSTF) recommendations for preventive services. Any preventive lab work done in conjunction with an annual physical will be covered in full with all Oscar plans. Any non-preventive lab work will be generally be covered, but subject to the cost-sharing of your plan (copay, co-insurance, or deductible). For more information on preventive services, you can check out the USPSTF guidelines here: https://www.uspreventiveservicestaskforce.org/Page/Name/uspstf-a-and-b-recommendations/ or as always, please don’t hesitate to give us a call at 855-OSCAR-55. We’re always happy to help in any way we can.

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    Teresa Hanan
    April 5th, 2018 Austin, TX DETAILS
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    I am SO frustrated by my dealings with OSCAR and the company who provides their Physical Therapy services, eviCore. I and my physical therapist office have talked to them on MULTIPLE occasions to try to get the services that my Therapist, my doctor and myself, feel I need. EVERY time I call their representative to try to get some clarity, I am given information that does not match what I have been previously been told or that my therapist have been told. so, one complaint is that they do not keep good notes and are unclear about what they are doing. My second complaint is that they are disregarding my best interest. I have been in pain for over a year and am finally feeling better and seeing a light at the end of the tunnel. My therapist has said to them on multiple occasions that she feels like if she were able to work with me for 4 more weeks then I should be good to go but they are not allowing that. She has now requested 2 more visits to set up a home plan because they told her they would not give anymore and she was able to get them to consider the 2--even thought this is not what she thinks I need. (btw, I am already doing LOTS of exercises she has given me at home, I am still having trouble sleeping due to hip pain and am not able to walk or sit for any amount of time with out discomfort, not to mention get any kind of exercise) I am so frustrated as is my provider. Additionally, I drive 30 minutes to go to a therapist because you guys had only ONE of the many physical therapy groups that my Doctor (who is in your plan) recommended. I think this is unacceptable.

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    Reply from Oscar

    Oscar HealthApr 05, 2018

    Hi Teresa, we're sorry to hear this. Due to privacy laws this isn't something we can help with here directly but Chelsey, one of the representatives on your concierge team, will be keeping an eye on the next steps in the authorization process. We understand that this has been a frustrating process and will share your feedback with our team so we can work to improve this. Please don't hesitate to reach out to Chelsey or any member of your concierge team with any additional questions or concerns: 855-OSCAR-55.

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    Nate Adams
    April 3rd, 2018 Beverly Hills, CA DETAILS
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    Oscar was the least expensive plan in my area, had a nice website, and promised to basically be "techy" and "new." I signed up. I have my first claim. It's under $70, and I'm not even seeking reimbursement - only want the payment reflected in my deductible since I paid out of pocket. It has been nearly two months and they have denied my claim without even speaking to my doctor. I call them to figure out why they haven't spoken to my doctor and they lie and tell me they tried calling them several times and faxing and they won't respond. This is a major nationally-known hospital, not some family practice with a 68 year old receptionist who can't use a computer. In my experience, they are just in the business of denying claims. Luckily for me it's less than $70 and was only for a follow-up appointment, but what of all the people they are doing this to who have life-threatening conditions? Who don't have the money to cover these mistakes by Oscar while it gets "figured out?" My experience so far: seems to be a scam company. And wouldn't you know it, Jared K.'s brother is the founder. I'd pay double next year for any other insurer. It's not worth it.

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    Reply from Oscar

    Oscar HealthApr 04, 2018

    Hi Nate, we're sorry to hear this. Due to privacy laws we're unable to help with anything regarding your claims here, but if you message us with your Oscar ID number, we'll be happy to have someone from our team look into this for you. Apologies for any frustration.

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    Amanda
    April 2nd, 2018 DETAILS
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    My daughter was seeing a speech therapist prior to joining Oscar. We live in the big city of Austin and there is not one speech therapist with Oscar. When I contacted customer service about getting approved the the therapist she was already seeing and knew given there were no therapists in Austin, they told me I had to drive to TEMPLE (over an hour away) twice a week. I work so this is not a possibility. I would have to take off half a day everytime. So in the crucial point in development my only option is wait until Oscar can find a speech therapist in Austin to contract with or pay out of pocket to get less time with a therapist.

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    Reply from Oscar

    Oscar HealthApr 03, 2018

    Hi Amanda, we're sorry to hear this. We're always working on growing our provider networks to best serve our members. Due to privacy laws this isn't something we can help with directly here, but your concierge team will continue to work with you to find the best option for you and your daughter. If you'd like, feel free to message us your Oscar ID number here and we'll be happy to have someone from our team look into this further.

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    rose
    April 2nd, 2018 Helotes, TX DETAILS
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    So far I've had a good experience with Oscar. I don't go to the doctor that often and I just needed a plan to cover in case of an emergency. Had Humana and the rates were ridiculous. I used their app because my son had a bug bite, I took a picture of it, minuets later a doctor called me to advise me of what I should do next. As far as the billing goes, I have it automatically drafted out of my checking account, so far so good. My co-pay is $10 so I'm happy about that too.

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    Reply from Oscar

    Oscar HealthApr 03, 2018

    Hi Rose, thanks for taking the time to share your experience! We're so glad to hear that your happy with Oscar. Please don't hesitate to reach out to us if there's ever anything we can do to help! 855-OSCAR-55.

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    Stephen Smart
    March 26th, 2018 Austin, TX DETAILS
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    I cancelled my coverage on Feb 28th, and Oscar verified that the coverage was cancelled. However, I found out it was not cancelled, and two months later am still receiving bills. Now they have no record of the cancellation, and are just saying it was a cancellation of the auto-pay. It is really an awful company to do business with. I'm still trying to get the situation resolved, but each time I call, no one seems to be able to help.

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    Reply from Oscar

    Oscar HealthMar 26, 2018

    Hi Stephen, we're sorry for the confusion. When you called and spoke to us on 2/28, we turned off your automatic payments and Lynn, the representative you spoke with, advised that the cancellation would need to be made through the Federally Facilitated Marketplace (FFM) because you enrolled through healthcare.gov. Unfortunately we're not able to cancel enrollments from the state marketplace which is why the cancellation has to be done directly through them. That being said, because your automatic payments were turned off when you called, your policy is currently in a grace period and will be automatically cancelled after 3/31 due to nonpayment. This means that the end date of the policy will be backdated to 2/28 and you will not be responsible for the March premium payment. Rest assured that the only consequence to the plan being cancelled for nonpayment is the cancellation–we never report to creditors or anything of that nature. Please don't hesitate to reach out to us with any questions or concerns: 855-OSCAR-55.

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    Karen
    March 13th, 2018 Avon, OH DETAILS
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    This is a horrible company...their customer service is the worse! I have been trying to get a refund for the last 3 months. I have been told 3 times my check is in the mail...well, I still have not received any money!! After 10 calls, still no refund! Horrible customer service!!!

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    Reply from Oscar

    Oscar HealthMar 13, 2018

    Hi Karen, we're sorry to hear this. If you're comfortable doing so, please message us your Oscar ID number and we'll be happy to have our team look into this further. Apologies for the frustration.

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    Heather
    March 5th, 2018 Montclair, NJ DETAILS
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    I chose Oscar simply because it was the cheapest option in my area with my doctor in network. I'm regretting it. They don't accept credit cards. Given how "secure" we know systems are not these days, I NEVER give my debit card out. And, yet -- now I have to to these people. Plus -- EVERY time I've gone to the site to either pay or look something up, I have had nothing but trouble. And, you can't call after hours to pay a bill over the phone. They're terrible at user functionality. I haven't had to use the actual coverage yet. I'm worried given some of the reviews and the fact that it's hard enough just to pay them.

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    Reply from Oscar

    Oscar HealthMar 05, 2018

    Hi Heather, we do not accept credit cards due to the high fees that they charge. We do our best to keep costs down for our members whenever we can. A minimum of $0.85 of every $1 we receive in premiums is spent directly on health care claims for our members. Unfortunately accepting credit cards would mean potentially raising premiums to accommodate this and we're not interested in raising rates for our members whenever we can avoid it. We apologize for any inconvenience. As for our site, we did have a brief outage with our payment vendor for about an hour on Friday 3/2. During this time, the payment are of the site was indeed down. This has since been fixed and you should be good to go, apologies for any frustration this outage caused!

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    Louisa
    March 5th, 2018 San Antonio, TX DETAILS
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    I chose the wrong insurance policy. Horrible is the word. Read the small print when seatching for plans. It gives you the persuading benefits of AFTER deductible is met. Everything is 100% to MY cost. Might as well not have insurance. Cant change my plan since it's not open enrollment.

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    Reply from Oscar

    Oscar HealthMar 05, 2018

    Hi Louisa, we're sorry to hear your unhappy with your plan choice. All of our plan structures can be found on our site here: https://www.hioscar.com/individuals/plans/sa . For more in depth information, you can click "Compare plan features" for detailed information on how coverage on each plans work. You also should have received information on the cost-sharing/deductible of your plan both upon enrollment and in your member welcome kit that included your ID card. We're also always here to help you understand your benefits, so please don't hesitate to reach out to us: 855-OSCAR-55.

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    Curtis Clogston
    February 27th, 2018 Boerne, TX DETAILS
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    Does not accept credit cards in the year 2018. Expects me to have auto-pay set up to overdraft me $200 on my checking account every month and cover literally nothing unless I die.

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    Reply from Oscar

    Oscar HealthFeb 28, 2018

    Hi Curtis, we do not accept credit cards due to the high fees that they charge. We do our best to keep costs down for our members whenever we can. A minimum of $0.85 of every $1 we receive in premiums is spent directly on health care claims for our members. Unfortunately accepting credit cards would mean potentially raising premiums to accommodate this and we're not interested in raising rates for our members whenever we can avoid it. We apologize for any inconvenience. Please be advises that you are not required to setup autopay and are able to pay via debit card each month when the bill is available should you choose to do so.

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    Jamie
    February 27th, 2018 Los Angeles, CA DETAILS
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    Believe all the other reviews - Oscar is awful. RUN in the other direction. My health insurance broker mistakenly signed me up for a February start date instead of March (even though I already had coverage from another company for February). No problem, I was told by my concierge, if I could provide proof of overlapping coverage for February, Oscar would refund me the payment and my policy could officially start in March. Great - I provide the proof, I get my refund and everything is all set...or so I thought! By total chance, I happened to sign into the Oscar web site a few days later - only to discover they had cancelled m entire membership (without alerting or warning me). I asked my concierge about it, and DESPITE HIS ORIGINAL ASSURANCE THAT MY POLICY COULD START IN MARCH, now told me that receiving a refund meant I had to give up my entire policy. Again, he did not originally tell me this! I was offered NO apology for the mistake. When I explained this would potentially leave me without health insurance for all of 2018, he insisted my health insurance broker had to call Oscar and verify that he made a mistake before they would even consider reinstating my policy - first, he had to call a certain number; then, it changed to an e-mail he had to write; constantly changing. What's more, they simply do not care. And, again, keep in mind that I discovered my terminated policy by accident! They never even told me about it. By the grace of God, I had not yet cancelled my coverage with my previous health insurance provider - I am now so grateful and happy to be giving them my money. If I had not randomly decided to check my Oscar profile online, I would have been in for a MAJOR rude awakening come March. Unethical, deceitful, mismanaged company.

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    Reply from Oscar

    Oscar HealthFeb 28, 2018

    Hi Jamie, we're very sorry to hear this. This certainly isn't the experience we aim to offer our members and would love to look into this further. If you're comfortable doing so, please private message us your last name and/or former Oscar ID number and we'll be happy to investigate this and the representative you spoke with. We apologize again for the confusion and negative experience.

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    Marie Standing
    February 27th, 2018 Santa Monica, CA DETAILS
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    I have the unfortunate experience of trying to use my Oscar "insurance." Don't buy into the "cool" company hype...it is a total scam. I am on the phone right now trying to find out the cost of an in network procedure. But guess what? They don't do "price checking." According the the uninformed agent I am speaking with, there is no way to know the negotiated rate until the claim is processed! So you just go in network and wait for a bill to find out the cost. Oh, you want to speak to a supervisor? Nope, none available. This is really outrageous. Update: I received a response from Oscar. It consisted primarily of a list of irrelevant excuses for refusing to disclose the negotiated rate for a specific procedure with an in-network provider. Completely unacceptable.

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    Reply from Oscar

    Oscar HealthFeb 26, 2018

    Hi Marie, unfortunately cost estimates are difficult to provide for two reasons. While we typically know why we're seeking care (maybe for a general check-up or a specific concern) we don't always know the kind of care we're going to need. Even when we do know the care we're seeking, the treatment is provided as a part of a care episode and may include other supporting services we're not anticipating. For example, if you go to see your provider for a cough, you will expect to pay for the office visit; however, diagnostic tests administered within the visit - such as breathing tests, labs ordered, or prescriptions sent may result in additional charges. Moreover, the charge you incur will vary depending on the setting in which you see a provider as well as that provider's specific credentialing and qualifications. While we are committed to providing cost transparency when and where we can, these factors make cost estimates hard to pin down. Above all, we want to make sure we're providing you an estimate that we can stand by so that you can make a decision with confidence and would never want to provide an estimate that could be inaccurate. We are aware that this is a pain point for members at this time and are working hard to improve this experience for the future. Your request to speak to a supervisor was escalated by the representative you spoke to and someone will be reaching out within 48 business hours.

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    Rand Shrader
    February 26th, 2018 San Marcos, TX DETAILS
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    A complete disgrace. Most web pages and buttons do not work. I simply wanted to find a listing of local primary care physicians, but such info doesn't seem to be available. I send the "Concierge" a message and got the auto response that they usually respond within a business day. This horrid company receives ~ $600/month for my insurance. What an outrageous joke on the American people!

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    Reply from Oscar

    Oscar HealthFeb 26, 2018

    Hi Rand, we're sorry to hear you're frustrated. Everything on our site appears to be functioning, if you're having any trouble, give us a call at 855-OSCAR-55 and we'll be happy to troubleshoot and get to the bottom of what could be happening. For reference, you can search our full network of providers on our site here: https://www.hioscar.com/search/. We do our best to reply to secure messages ASAP, but please be advised that the general turnaround time is indeed one business day. If you need to reach us sooner, just give us a call and we'll be happy to help.

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    KB
    February 23rd, 2018 Los Angeles, CA DETAILS
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    Oscar: You will be expected to cover 100% of the negotiated rate. Me: Understood. What is the negotiated rate for this mammogram. Oscar: Oh, we don't have that information, can no tell you and no one will. (Verbatim) I have one question. How is this legal? They refuse to say what the costs are, even when provided with CPT codes and the Tax ID# of the facility. Absurd. One thing they do expect is for their members to pay the bill when it does come. Oscar. Your system is broken. I have shared with our entire work network, friends, family and regional points of contact that your company is not a good option for anyone.

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    Reply from Oscar

    Oscar HealthFeb 23, 2018

    Hi KB, we apologize for the frustration. Unfortunately cost estimates are difficult to provide for two reasons. While we typically know why we're seeking care (maybe for a general check-up or a specific concern) we don't always know the kind of care we're going to need. Even when we do know the care we're seeking, the treatment is provided as a part of a care episode and may include other supporting services we're not anticipating. For example, if you go to see your provider for a cough, you will expect to pay for the office visit; however, diagnostic tests administered within the visit - such as breathing tests, labs ordered, or prescriptions sent may result in additional charges. Moreover, the charge you incur will vary depending on the setting in which you see a provider as well as that provider's specific credentialing and qualifications. While we are committed to providing cost transparency when and where we can, these factors make cost estimates hard to pin down. Above all, we want to make sure we're providing you an estimate that we can stand by so that you can make a decision with confidence and would never want to provide an estimate that could be inaccurate. We are aware that this is a pain point for members at this time and are working hard to improve this experience for the future.

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    Mark Turberfield
    February 22nd, 2018 Brentwood, TN DETAILS
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    Don't be fooled by all the fancy apps and simplistic design. Oscar is super expensive, has high deductibles you will never meet in the year and when you do need a doctor who is in network prepare to go to the worst doctors in the city. Also Liberty Dental what a joke.

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    Reply from Oscar

    Oscar HealthFeb 23, 2018

    Hi Mark, we're sorry to hear you feel this way. Jillian, one of your concierge specialists, has sent you a secure message to see how we can help. Please don't hesitate to let her know if there's anything we can do to assist.

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    brendan
    February 21st, 2018 Pelham, NY DETAILS
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    Premium rises every month to cover careless spending on Oscars behalf. I began paying 100, now I pay up to 200 a month. In addition, Oscar refuses to cover any of the costs of my medication or OON doctor. My monthly health insurance bill without (physically sickness) doctor visits, dental, etc = 2900 a month. Oscar is an expansion of Obamacare. Without tax paper funding Oscar doesn't exist. Let me ask you? Did Obama envision a bill - that is going to drive sick people in credit card debt as they cant afford "affordable" health insurance ? He did not care, he pushed it through when it was not ready. Now we are all suffering the consequences. Companies like Oscar can now take advantage of loopholes and ensue with predatory practices. I think it is disgraceful.

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    Reply from Oscar

    Oscar HealthFeb 22, 2018

    Hi Brendan, we’re sorry to hear you’re frustrated. It sounds like there may be a bit of confusion happening. Please be aware that premiums never change mid-year unless you have a subsidy from the State that is adjusted by them. While we did increase the premium price of some plans for the 2018 plan year as a result of the rising cost of health care services like doctors, hospital care, and drugs, the premium will not be subject to change again until the 2019 plan year. Rest assured that a minimum of $0.85 of every $1 we receive in premiums is spent directly towards health care claims for our members, the other 15% is used for our operating costs. Oscar is an EPO (exclusive provider organization) which means that, with the exception of emergency care, we only cover services with in-network providers. This information is included in all of the plan documents you received upon enrollment. We also do not offer any adult or vision services on our health plans. We’re always here to help you understand your plan and benefits, please don’t hesitate to reach out at 855-OSCAR-55 and we’ll be happy to answer any questions you have.

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    Francisco
    February 21st, 2018 Bell, CA DETAILS
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    This insurance is of no value to me. The plan that I had cost over 220 dollars and the deductible was over 4,000 dollars. It included no coverage what so ever unless you had already paid over 4k in medical expenses. At least with previous insurance they gave me 2 urgent care visits and a checkup. This insurance offers nothing. What a rip off. I don't recommend it for anyone. Even if you have obama care, it is junk. In fact, I think it is because of obama care that insurance companies get away with this because obama care subsidizes it. Customer service was quick on the phone when I called but guess what? the doctors listed on their site don't want to take the insurance because of high deductible even when they are listed on their web app as providers. Also online support cannot answer cost of blood work or services, they say they don't know because it is a negotiated rate. It is a total scam. Obama care is like free money to the industry and why would a negotiator negotiate in your favor if they have no stake in anything (because free money). Oscar was not able to deliver any value to me. Money down the drain. I am upset.

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    Reply from Oscar

    Oscar HealthFeb 22, 2018

    Hi Francisco, We’re sorry to hear you feel this way. A deductible is the amount you pay for non-preventive covered services prior to your insurance provider contributing. If you’re on a plan with a deductible, you will be responsible for the full negotiated rate of non-preventive services. All of this information is provided on our website upon enrollment as well as included in your welcome kit that was sent after you enrolled. Please be advised that all Oscar plans cover preventive care in full prior to the deductible being met (such as an annual physical with an in-network primary care doctor). For more information on your fully covered preventive benefits, give us a call at 855-OSCAR-55 and we’ll be happy to review this with you. As for providers not accepting Oscar because of the deductible, please give us a call and let us know which providers told you this and we’ll be happy to reach out and educate them. Our network is non-discriminatory and providers are in-network with us for all of our plans, not just some. Let us know the specifics and we’ll certainly get in touch with them to rectify this. Unfortunately cost estimates are difficult to provide for two reasons. While we typically know why we're seeking care (maybe for a general check-up or a specific concern) we don't always know the kind of care we're going to need. Even when we do know the care we're seeking, the treatment is provided as a part of a care episode and may include other supporting services we're not anticipating. For example, if you go to see your provider for a cough, you will expect to pay for the office visit; however, diagnostic tests administered within the visit - such as breathing tests, labs ordered, or prescriptions sent may result in additional charges. Moreover, the charge you incur will vary depending on the setting in which you see a provider as well as that provider's specific credentialing and qualifications. While we are committed to providing cost transparency when and where we can, these factors make cost estimates hard to pin down. Above all, we want to make sure we're providing you an estimate that we can stand by so that you can make a decision with confidence and would never want to provide an estimate that could be inaccurate.

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    Jessica
    February 15th, 2018 Pompton Lakes, NJ DETAILS
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    I enrolled my parents into Oscar and I feel terrible about it. At the time of enrollment, the market place website did NOT say thy were responsible for FULL PRICE visits/tests/etc until they met their deductible. What is that? My parents pay for full contracted rates for visits and now my father needs to see his doctor frequently. Once he meets his deductible, they'll cover 50%. Seriously? This was not on the website. I wish I could replace their place but unfortunately I will have to live with this regret for the entire year. Free incentives? None of them make up for what they have to pay. Also, everytime I search for a doctor on the website, 90% of the time, the doctor is not really the type I searched for or their office info is outdated. It gave me a MD that was 1 mile from my house but in reality, that MD hasn't been in that office for over 10 years. Please hire me so I can update your system.

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    Reply from Oscar

    Oscar HealthFeb 16, 2018

    Hi Jessica, we're sorry to hear your unhappy with your parents' plan choice. All of our plan structures can be found on our site here: https://www.hioscar.com/individuals/plans/nj . For more in depth information, you can click "Compare plan features" for detailed information on how coverage on each plans work. As for incorrect data when searching for a doctor, we do our best to keep all of our information up to date, but sometimes contract information that provider offices send over to us is not always up to date. In these cases, just give us a call to let us know what was incorrect about the information and we'll be happy to escalate it internally to be updated. We're also always here to help you understand your benefits, so please don't hesitate to reach out to us: 855-OSCAR-55.

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    B Patel
    February 15th, 2018 Austin, TX DETAILS
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    Absolutely terrible. Their technology doesn't work and their customer service doesn't make up for it. After we signed up, I tried calling their doctor on call service and it would not authenticate me. I called Oscar and after several calls it was an issue with my account in their system. I ended up just going in to a local doctor. A month later, I tried their doctor on call service again and it seems I'm in the same position.

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    Reply from Oscar

    Oscar HealthFeb 16, 2018

    Hi B, we're very sorry to hear this! This certainly isn't the experience we hope to offer our members. Give us a call at 855-OSCAR-55 and we'll be happy to troubleshoot and escalate the issue as needed. We're also able to transfer you over to one of our telemedicine doctors if you'd like. We apologize again for the negative experience.

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    Susan Persaud
    February 7th, 2018 Baldwin, NY DETAILS
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    I was an Oscar member for the year 2016 through the NYS of Health system and I was extremely pleased with the service, the incentives, options, doctors on call, the fitbit, gym reimbursement, etc. The customer service was amazing, the representatives are helpful, knowledgeable, friendly, empathetic and seem to love their jobs. In 2017, I changed to UHC (United Health Care) because (1) the rumors about Oscars reduced network was scaring me and (2) a friend said that the coverage for infertility was better with UHC and "UHC was the best insurance" if I was planning to have a necessary surgery. I was disgusted and disappointed the entire year. I could not get 2 referrals approved IN ONE YEAR... one for a back specialist for my husband and an eye doctor for me for an infection; the customer service is the worst I've ever experienced, the cost was substantially more than Oscar, less items were covered in my deductible, and the list of medical professionals, while expansive, did not rate the doctors so that you could choose based on reviews (Oscar does this). I hated 2017 with UHC and would never again use that insurance. In 2018 I'm back to Oscar, with a slightly less payment, but a zero deductible (the deductible was $ 4000 each with UHC) and I'm so pleased. I love my doctors, I love the system, I feel important when I call, solutions are simple, and I will not be changing ever again.

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    Reply from Oscar

    Oscar HealthFeb 09, 2018

    Hi Susan, thank you for taking the time to share this! We're sorry that you had a negative experience with another insurer, but are certainly happy that you've had a great experience with Oscar. Welcome back! :)

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    Heather McCormick
    February 5th, 2018 Austin, TX DETAILS
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    BEWARE THIS COMPANY!!!! I NEED CANCER SURGERY AND THIS COMPANY WON'T GET ME TO A SURGEON. I was diagnosed with melanoma (skin cancer) by an Oscar network dermatologist and told to get scheduled right away for a resection of melanoma and sentinel lymph node biopsy with a surgical oncologist. I live in Austin and there are plenty of qualified surgeons to do this, but not one of them is in Oscar's network, which tells you how inadequate their network is. First Oscar referred me to doctors who only do breast cancer. Then they again referred me to two more inappropriate doctors who do only endocrinology and breast cancer--obvious from their bios if Oscar had bothered to read them or call. Their latest third option now is to send me to a hick town in Taylor, TX 75 miles away, with a doctor who specializes in pancreatic and liver cancers but does other stuff (because it's a small town), and who doesn't have surgical availability for weeks, rather than find me an appropriate doctor who deals with melanoma every day and can do the surgery timely. I even offered to go to Dallas or Houston or another metropolis if I had to in order to have an appropriately qualified doctor and have my surgery timely. But Oscar can't seem to manage that either, or to authorize an out of network surgeon here in Austin, even though I would be paying some or all out of pocket from my high deductible. They give you a "case manager" who can't authorize anything, and then when you ask to speak with someone who can, they tell you the authorization people don't speak to customers. And then random people who know nothing about your case text you inappropriate physician referrals instead of your case manager managing anything. Zero urgency, zero competency, zero caring that I am not getting the surgery my physician told me to get promptly. This is how you will be treated when you have CANCER people. Stay away from this company at all costs!!!

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    Reply from Oscar

    Oscar HealthFeb 06, 2018

    Hi Heather, We’re very sorry to hear this, thank you for bringing this issue to our attention. Due to privacy laws, we’re unable to discuss the specifics of your care or private health information here, but our representative Katie along with nurse Elizabeth, are working to bring this to resolution ASAP. They will be keeping you updated on the process as well as next steps. Please don’t hesitate to reach out to them with any questions or concerns. We apologize again for the negative experience.

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    lori
    February 5th, 2018 North Royalton, OH DETAILS
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    Signed up with Oscar on 12/17/2017. Still waiting for welcome kit and insurance card. Was told it has been sent twice. They are sending again should take 5-6 days from NY to Ohio, really!! Would not overnight it. Would not cover the Lyrica that I have been taking for almost year, but would cover gabapentin. I took gabapentin before and did not work for me. They won't cover because because of cost, Lyrica is a name brand and has no generic brand. It's all about cost, not what works for you. They require prior authorization from your doctor on just about everything. If your dr. writes a prescription then you need it, why would your dr. need to say it again that you need it. Prior authorization's take forever with this company I believe they do it on purpose so that you will give up. Many drugs they will only cover for example 15 pills for 25 days when you dr. prescribes 30 pills for 30 days. They are an insurance company not a medical professional. Another medication I am prescribed needed a prior authorization per their drug company, CVS caremark, although Oscar said no prior authorization was needed and Oscar sets the policy. Spoke with two representatives at CVS caremark and one, Karen, spoke generically about Ohios new law which has nothing to do with my policy or prescription from my doctor, the other representative, Crystal, asked me if I had taken this medication before. Crystal has no right to ask me these types of questions, she is not a doctor, nurse or in the medical profession. What bearing does my answer have on if Oscar will cover the medication. I will tell you NONE . I am sorry that I signed up for this insurance. Their website is geared to millenials you do not even have insurance.

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    Reply from Oscar

    Oscar HealthFeb 06, 2018

    Hi Lori, we’re sorry to hear you’re frustrated. Due to privacy laws, we're unable to discuss the specifics of your private health information here, but we're happy to address your general concerns. Some medications do require prior-authorization for coverage or certain quantities. This means that the prescribing doctor needs to submit documentation through CVS Caremark, our prescription partner, indicating that the prescribed medication or quantity is medically necessary. Once the prior authorization is received, it will be reviewed by a clinical team then approved as long as it is indeed deemed to be medically necessary. Any prior-authorization requirements will be listed in our online search. To access this information, you can follow the following steps: visit hioscar.com/search > enter your plan type and location > using the dropdown menu on the left, toggle the search feature to "drugs" enter the medication you're looking for. From there, any quantity limits or prior-authorization requirements will be listed. We also apologize that you had a negative experience when you contacted CVS Caremark. If you reach out to us at 855-OSCAR-55, we’ll be happy to look into this and escalate the issue as needed. As always, please don't hesitate to reach out to your concierge team with any questions or concerns.

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