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.
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.
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.
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.
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.
Oscar health insurance plans are only available to customers in New York, New Jersey, California, Texas, Ohio, Michigan, Florida, Arizona, and Tennessee. Small businesses may also be eligible for Oscar coverage in California, Tennessee, New Jersey, and New York.
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.
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.
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An outrageous scam! Not insurance, not even close. Not even an indemnity catastrophic plan.. The recent positive reviews are all FAKE by employees and greedy Wall street bankers trying to deceive unsuspecting consumers to make a buck during Open Enrollment period. Read all the 1 star reviews from January to September. Hardly a single positive 5 star review for 9 straight months! My son was diagnosed with a very serious illness, and Oscar continued to deny claims, charge ridiculous copays and narrow our network so much that it was impossible to find a doctor. We received tens of thousands of dollars in excess charges, unpaid prescription bills, denials, and I can't take it. It would have been less stressful having no insurance at all and working out a payment plan with providers myself. If you care about yourself and loved ones, this insurance will rip you to pieces. The only thing it does it makes billionaire techies richer off the backs of poor folks, while allowing them to claim to be doing good by "offering health insurance" to those very same poor people they are screwing. And by the way, the online "doctor on call" visits are a complete joke, like paying $10 for those online medical advice websites run out of someones basement in a foreign land. BEWARE AND YOU HAVE BEEN WARNED !
I found Oscar health insurance to be very efficient . Good communication, excellent healthcare coverage, and a willingness to research questions and respond- either by email, or phone call. I am hoping they will enter the Medicare field, so I can continue to have such excellent service. Thanks, Oscar!!!!!
Good insurance. Would be better if more providers were available. A great physical therapy office no longer takes Oscar because they state that the paperwork and phone calls take up too much time (difficult to work with) compared to other insurances.
Super fast and complete responses to messages. Excellent doctor network. Great plans. Terrific autopay. Fast paperwork processing. All around best in class.
I've been nothing but pleased with Oscar. Everyone has been super nice and friendly. The website is easy to use. Looking for care is great. All of my doctors are in network. I hope to stay with you.
Very good insurance. They help however they can, and also very affordable.
The app is very easy to use. The docs on call have all be very helpful the handful of times that I have requested a call.
You are very efficient. This is extraordinary in the Health industry.
So far Oscar Health is a great coverage program and very convenient access to the network I am familiar with. I was looking for a program that would allow me to stay with CCF and Oscar Health was it! I look forward to exploring more of what Oscar Health has to offer in the future.
Very nice customer service ! Quick to help and on phone return calls ! Nice !
So far, so good :) I haven’t had to use my insurance too much but when I have it has been an easy process.
Very helpful,answered all my questions. Called the Pharmacy to check the status on my order that had been taking long to get delivered. Reassured me that he would keep me updated . I'm very happy with how I get taken care of
Everything has been wonderful with Oscar. They always keep you up to date on things. The cost is decent and affordable. I have not had any problems with Oscar in the in the two or three years that I have been with them. They also bill you on time.
Easy to get answers from real people using the app.
The website is easy to use. The chatting feature is super quick and responsive so I like the fact I'll hear back within a day usually. The Amazon rewards program is the best.
I've had Oscar for a couple of years now a think it is fantastic. The App and concierge is very helpful. My favorite function of the App is that it keeps track of my steps and then pays me with an Amazon gift cars.
i was uninsured for decades. when ACA came along i was initially insured with another company. it was more expensive and complicated and i felt i wasn't entitled nor could quite afford the "care" i might have needed. with Oscar, i feel i am able to afford the cost of insurance as well as the copays i can use my HSA to cover. so far, the Oscar folks have been super helpful if ever i've had a question.
In my experience I have never had any trouble with having to see my regular Dr or any specialists that I have needed. Always quick to get referrals or approvals usually with in a week no more than two weeks. Other insurances take much longer to get approvals. The doctors in network that I have had so far are all veru good at what they do. I had surgery and all of that went great including hospital emergency room.i want to keep this same policy if the price stays with in my range of income and affordability.
Very happy with Oscar. Everyone I have encountered has been knowledgeable and professional. Quick and accurate responses. I’ve called for both medical and insurance issues. Both were handled extremely well!
Oscar has been the best healthcare provider I've ever had. The staff at Oscar are very professional and go beyond the call-of-duty responding quickly to questions. It's the best customer service I've ever experienced.
The Oscar app is unlike anything I've experienced. It has everything you need. You can get ahold of a doctor at any time for questions. Your concierge team answers anything you find confusing. I've found amazing health care professionals based on their reviews. And they give me money for making appointments and staying active!
Excellent providers & customer care over the Phone
Everyone that I have spoken with at Oscar has provided me outstanding service and customer relations. I have used the Dial a Doctor feature multiple times with complete satisfaction. I am looking forward to signing up with Oscar for 2019.
This is the easiest health insurance I have had had. The help and customer support people are genuinely helpful and kind.
Love your app. Though I haven’t used your online doctor it’s nice to know I can do that. Love the magnets you sent me so I know where to go that’s covered without looking it up. Love that I can get paid for walking
A good plan that handles all my medical needs.
I love Oscar. They are always so helpful! I love the program.
This is the best health care company ever! The customer service from the main office is outstanding. And the help from the Call A Doctor program is fantastic!
It's always easy to make appointments, see my history or upcoming appointment details, communicate about pricing before going to an appointment, and the pricing is very transparently broken down within the app. I honestly have no complaints.
I love that Oscar pays you for your steps!
So far I have had a great experience with my health insurance. Easy to navigate I love the app
My experience with oscar has been amazing . from answering my questions on claims and copays. A agent has always been able to assist me on any questions that i have
Oscar is great I haven't had any problems with them, when I had a problem with one of my claims they took care of it .
Healthcare simplified! Billing is clear, concise. Customer service is helpful and quick to respond. Seems like Oscar avoids bombarding its' customers surplus information / advertising etc. A refreshing experience compared with the more established Healthcare Providers...
Good rates and easy to use website. I haven’t used much of the medical benefits since I’ve been blessed with good health, but they are available. If you hardly see doctors and maintain good health, this plan is the most practical.
Your website needs a lot of improvement.
Oscar reps are great, the center is also a great office & the physicians are very helpful & caring!
Reply from Oscar
Oscar HealthOct 12, 2018
Thank you for taking the time to leave a review, Thalia! We appreciate the feedback.
Although between my husband and I we pay over $25,000 a year Oscar they denied the anesthesia I needed for a nerve block. I ended up paying $300 out of pocket to cover the anesthesia.I appealed the case and I was still denied with Evicore the company that decides what procedures are and aren't covered. I also appealed with Oscar and I have never heard back. I think it's ridiculous to pay this amount of money and not have anesthesia paid for. Nerve blocks are not painless procedures. I don't see the point of having insurance if it will not cover what is medically necessary.
Reply from Oscar
Oscar HealthOct 16, 2018
Hi Nereida, thank you for reaching out about your concern. Due to privacy laws this isn't something we can help with via Best Company, but we've shared your feedback with our team, and they've informed us that they are currently working on resolving your case. If you'd like to discuss this matter further, please call us at 855-OSCAR-55 to be connected directly with your Concierge team.
I am self employed and have had Anthem health insurance, and Medical Mutual for the past several years, I currently signed up with Oscar health insurance and I have to say I am very pleased the pricing is fair, the coverage is great and the billing is a breeze to understand. I give in a thumbs up. 👍
Was hesitant initially as I could not find anything in Texas about Oscar but the policy #'s were what I wanted , unfortunately within a month of service I required very exstensive medical care , Oscar has been the best ! Seriously after describing my experience to individuals paying double the premium they all felt cheated by there insurance companies.