Oscar is a newer name among health insurance providers, but it has grown from its initial startup since its founding in 2012. The company values simplicity and communication, so it seeks to simplify policies in order to better cover the needs of its clients.
With Oscar, customers can find plans with health savings accounts (HSAs) and traditional health insurance plans for individuals and families. Oscar also offers Medicare. Oscar does not offer dental or vision coverage.
Oscar Health Insurance was created to give customers a new, simple way to get health insurance and affordable care. Its plans include perks for things like reaching a fitness goal.
Oscar puts a strong emphasis on technology to cater to customers’ needs and add convenience to health care.
Open Enrollment for 2020 health care plans runs November 1, 2019-December 15, 2019. If you missed the open enrollment period, check to see if you qualify for a special enrollment period.
Oscar tries to ensure that all clients find an easy health care plan to suit their individual needs. Oscar offers 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. Under the Affordable Care Act on- and off-exchange plans must cover essential health benefits, like primary care, hospital stays, and mental health services. (The health insurance exchange is a government-created marketplace, also called the health insurance marketplace.)
Oscar's coverage options include: Health Savings Account (HSA)-compatible plans and self-funded options. From the company's website, t's unclear what kinds of networks Oscar's plan options include. It's common for health insurers to offer plans with in- or out-of-network coverage. For example, Health Maintenance Organization (HMO) plans only cover in-network care, except in emergencies. Preferred Provider Organization (PPO) plans cover in-network care and out-of-network care. Even though a PPO plan offers more flexibility with providers than an HMO plan, your out-of-pocket costs will typically be higher if you see an out-of-network provider than for seeing an in-network provider with a PPO network plan.
Oscar also offers Medicare Advantage plans. It does not offer Medicaid services.
Oscar offers three plan options:
These plans are also organized using the metal tier system created by the Affordable Care Act. Depending on your area, each Oscar insurance product can be a bronze, silver, gold, or platinum plan. Bronze plans put the most cost-sharing on policyholders, while platinum plans put the least. Bronze plans also have lower deductibles. Platinum plans typically have much higher deductibles.
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 on 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 before the deductible is met 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 the money in 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 can receive free quotes of premiums from Oscar's website or by phone. With this tool, a customer can answer a few general questions about themself (zip code, age, how many people they want to cover) as well as about their expected medical needs in the next year. Through this brief process, Oscar can direct clients to the most cost-efficient health plan with the person's health in mind.
Individuals are then able to see all of Oscar insurance plans, costs (deductibles, copays, out-of-pocket maximums, and health insurance premiums, including government subsidies if you qualify), benefits, and recommended options to help decrease out-of-pocket costs.
After clients pay the first premium, 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. The online account and health insurance app allow users to search for health professionals covered by Oscar's plans, book appointments with healthcare providers, and view detailed doctor credential information and reviews to find the one(s) best suited to handle their specific needs. The Oscar app makes the features of the member portal more convenient to access on the go.
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 the company emphasizes simplicity, Oscar has taken many steps to remove the complication of choosing a health insurance plan and registering. It also seeks 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 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 $240 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.
Oscar health insurance plans are only available to customers in some parts of the United States, including 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. To check availability, input your zip code on Oscar's website to see the plans available to you.
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.
Oscar doesn't work with customers on Medicaid. Depending on your plan, you may 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 may also mean that 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. Be sure to understand how your health coverage works when looking for health care providers.
Oscar insurance customers should also make sure they understand the terms of their health care plan. They should understand under what circumstances they need prior authorization and what kind of coverage is available for pre-existing conditions.
Okay pricing for the insurance and they have amazing customer service.
I have thoroughly enjoyed my experience and now on my second year with Oscar. Customer Service is great and the parameters are clear from the start. The app is super easy and helpful to use especially for teledoc calls and concierge service! I have told many friends to use Oscar if they are business for themselves like me. Highly recommend!
I had never heard of Oscar until I moved to Texas and needed to get insurance through healthcare.gov. I had them for almost 2 years and really loved how easy they made my healthcare. Being able to get a Dr. on the phone at no charge to me was a lifesaver more than once. I’m only giving up Oscar because my new employer doesn’t use them for health care.
Excellent company. I have been covered by an Oscar insurance policy for 1 year and just signed up for another year. The level of sophistication in their software and processing leaves others like my old insurance company (one of the BCBS types) in the dust. I'm a big fan of their $1/day reward to walk 10,000 steps/day (the maximum reward is $100 per year). Recommended.
easy and quick. Dr gave me good advice and called out a prescription for me
So far so good. The app is easy to use and the coverage is affordable.
Wonderful customer service. I best ever!!!! Love that there are no referrals needed for in network doctors. App is easy to use and a great resource for doctor/drug coverage. I wish that Oscar had additional hospital networks in plan as I need a specialists that is not in network.
The only way to view claims and deductible for my child is to call them. The information is not provided online....yuck! So far, I am not impressed at all. I have already paid the first premium so I will keep for the year, but I will not be keeping it next year.
Had Anthem BC before. Now have Oscar insurance with same coverage, but lower premiums. Oscar is more efficient (automated with a simple website). You don't get a lot of unnecessary paperwork in the mail like with Anthem. Of course, the deductible is high, but compared to Anthem, Oscar is much more user friendly. If you have a question, you can email the Concierge and someone will get back to you. You don't have to wait on hold on the phone, only to have someone not able to answer your question, requiring a callback. Just much easier to use than Anthem.
I have Oscar this year because it was the least expensive health insurance on Marketplace. I have paid thousands in premiums and they have not covered anything. Now, they are claiming that my Appendectomy was not medically necessary and they are refusing to pay my hospital bill. The only reason I have health insurance is to cover medical emergencies. I have been severely ripped off by this company and plan to tell everyone that I know.
I am very happy with my experience with Oscar so far (a year). Materials are very clear and the concierge service has always been terrific. They make it easy to be prepared and ask questions--which is really important for all patients to do in order to help manage costs.
I complete my registration and premium payment for oscar. I received an email "your enrollment is almost done" and send me the receipt for the payment, but you are not allow me to log in the app.
Reply from Oscar
Dec 06, 2019
Hi Alayou, thanks for choosing Oscar! Your Concierge team would be happy to help you out with this. Please give the team a call today at 855-672-2755 to get started.
Oscar pays for all of my visits to Mount Carmel Health facilities and doctors. It also pays for my prescriptions. It does not pay for OSU or OhioHealth facilities or doctors. It also has a poor eyecare insurance payment.
professional modern Insurance company with reasonable plans
Covered CA messed up when I tried signing up and the Oscar team was very helpful and patient in the multiple phone calls needed to get my application processed. The reps were very friendly and helpful.
I have had Oscar for the past year and absolutely love them. I live in the Orlando, FL area (they just came to FL last year) and have had no problem finding doctors for any specialty. They partner with all Advent Health Hospitals and affiliated doctors which is great. I love the App and the ease of finding the information I need from a digital ID card, to the concierge team, to the 24/7 on call Teledocs (which I have used twice) and I have also already earned $100 reward just for tracking my daily steps!
What a great company. I see so many bad reviews and I think the main reason for this is b/c people don't know how to use Oscar. If you use the Oscar app this policy works amazing! Dr. on call is a lifesaver! Customer service is great with an amazing insurance agent as well. 100% will recommend and I am looking forward to the new Classic next Bronze plan that is coming out with all copay's and a $0 deductible!
VICTOR E SCHALLER JR
Excellent customer service from a trusted company
William C Turner
I signed up for a high deductible Oscar plan through the ACA because it covered two doctors that I see regularly. Follow up tests and specialists were generally reasonable, but some had high unexpected costs. I was able to get some answers to health questions through their app or website. And one of their doctors called me to give me a lower cost alternative to one of my expensive medications. While premium costs remain low, one of my specialists has been dropped for 2020.
One of the good insurance provide, very affordable price and great online service and website
I will recommend you to not use Oscar as your insurance. Every step except paying money to them is always pain and waste of time. When something is going wrong be ready to spend hours to speak with them and get zero results. Awful bureaucracy.
I just switched over to Oscar this month. I really like their interface and they have been very responsive and easy to get in touch with. HOWEVER, I have a 2 year old daughter, and am 16 weeks pregnant with my second. I have been trying to find an in network pediatrician in my area and have only come up with a list of pediatric dermatologists and mental healthcare specialists (both through my own online search and their concierge team) Where do people who have this insurance in the Columbus area send their kids to the doctor!?!?! I am very upset with this huge hole in their network and will likely have to switch insurance so I can get my kids proper medical care.
Reply from Oscar
Nov 04, 2019
Hi Rose, we appreciate this feedback and we'd like to help you out. DM us your Oscar ID number and we'd be happy to have someone from our team get in touch to help find a provider that meets your family's needs.
The website information regarding Oscar doctors is user friendly though I learned not always up to date & accurate.
I was not a customer. I was a victim of a scam. after paying $1,000s in premiums I went in for an annual physical. The doctor coded it as an office visit and tried charging me $200 (it should have been 100% covered). Oscar colluded with the doctor and refused to work with me to correct the billing error. They claimed the doctor's office was correct without justification and ignored the evidence I provided showing I only received preventative care. This is not a healthcare company, it is organized crime. Do not give this illegitimate organization your money.
Since I have purchased Oscar, the questions I get from all of my doctors receptionists have been reduced to zero. It is easier now to check in as they see all of my information online. Easy to pay my bill and I believe they truly want to be the very BEST insurance provider in the country! They constantly educate you on how easy it is to contact a doctor.
I am so pleased with ocar insurance. The office is accessible, the online portal and dr's on call are responsive and eager to help.
Daughter was sick can’t. Talk sore throat high fever and they want her to go on website to fill out paperwork before helping even though paperwork already done twice before ,can’t go to hospital cost to much no doctor in maspeth area to see less than 10days out so to me not very good
Reply from Oscar
Sep 14, 2019
Hi Robert, thank you for letting us know about this. DM us your Oscar ID number and we'll be happy to look into this and have someone get in touch with you to help.
I'm 63. I pay over $5,000 a year for medical insurance with Oscar. I have a $7,000 deductible so I don't go to doctors if I can avoid it. It's hard to put a positive spin on this. That said, if I could do better elsewhere, I would switch insurers. (I will be voting for the Democratic Presidential candidate in 2020...) I give Oscar credit for how they have streamlined the experience of getting information, even if the information I get is regrettable. Their Web site is uncluttered and intuitive; the customer service representatives work hard to answer my questions in a timely manner and are always pleasant. What is it they say about democracy--that it is the worst form of government except for all the other forms? Well, though I give Oscar a 2, I give all the others a 1.
Everyone is always so helpful and very knowledgeable about everything I've ever asked about. If the answer wasn't known right then, they would find out and get back with me. Usually very quick. The only thing I would like to have had was a larger selection of specialist for adults
The support system is a valuable resource to guide the patient through the process either via messaging or phone. Willingness to review surprise bills is comforting. Quick response by the support team for any request is crucial. The silver plan has fair coverage for a reasonable cost.
Although I had a few hiccups with Oscar the first year I was with them, my concierge team worked with me on a daily basis to fix the problems. We succeeded getting everything worked out within a reasonable amount of time. Since then, I have not had a single negative issue - only positive ones. I was able to pick the plan that was right for me and I have to say, Oscar has many to choose from. I am very happy with the plan I’ve chosen as I have had some health issues and it has been smooth sailing these past few years. Would highly recommend Oscar Health Insurance.
Working with Oscar Insurance has been incredibly easy and makes scheduling a breeze!
It was easy to pick the doctor through Oscar app and schedule the appointment. Verdugo Hospital Orthopedic team is great!
The overall experience with Oscar is great. Good website and app, generally forward thinking features. My only complaint is that there is a very limited selection of doctors in their network.
You continue to Thorn my side sending paperet bills and uiur website demanding I OWE payments. I hope you go out of your New York RUDE attitude business down the road.
Reply from Oscar
Sep 03, 2019
Hi Mary, we'd be happy look into this for you. Due to privacy laws this isn't something we can help with via Best Company, but DM us your Oscar ID # and we'll be happy to have someone from our team get in touch with you to help.
I'm very happy with this Insurance (OSCAR), because they have a very good Professionals on the web.
oscar has been great for my healthcare coverage. the app is very easy to use and you can schedule everything straight from it. there are very good choices for doctors.
It is what it is - they do what what they say they'll do. Easy to find doctors and hospitals then read reviews too. Only drawback is using Quest Labs vs. doing Labs at the doctor's office.
Solid price/ratio offer on the market. Good network coverage, responsive customer support (concierges specifically). Modern-looking app and a nice perk of being rewarded for a daily steps goal.
Is a good medical Plan inrecomended to everybodey
happy with the doctors and hospitals. very unhappy with the cost.
It is better then most and is their when you need them
While my plan is relatively limited and relatively costly, no health insurance is a cup of tea in this backwards country. Oscar does make it easy, however, to navigate my plan and my benefits via their website and smartphone app, making for a more accessible and seemingly transparent health care experience. I only wish coverage was wider-ranged and less expensive...
Much easier than blue Cross of texas to navigate
I am really happy with Oscar. Everything is easy and I’ve seen the best doctors and specialists.
Robert R Hodge
It is relatively good. It is the monthly premiums that I am having difficulty with.
This is an affordable program to use short term.
Their network of doctors and hospitals is very limited. There is a good chance you could be driving 30+ miles to visit a doctor. The information on their website is not correct. The list doctors as in network when they actually aren't, and they don't list all the doctors that are in network.
Great experience. Concierge is quick to respond to your messages.
Great app and Doctor on Call is terrific!