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.
It’s very hard to find doctors in my area!!! Very frustrating!!!
Reply from Oscar
Aug 07, 2019
Hi Isa, if you need help finding a doctor in your area your Concierge team will help you out. Give them a call at 1-855-672-2755 for help finding the perfect specialist, whatever your needs.
Superlative Customer Service with their concierge program and 24/7 Doctor on Call! Our experience with Oscar so far has been quite good. Yes, you are limited on docs and pharmacies, but we have had great doctors, and CVS is everywhere. Our in network hospital is one of the best in town. Our son got sick while out of state, and the Doc on Call was able to help us, get him a Rx, and virtually shopped with me on the phone for OTC items at CVS while I was waiting for the Rx. The Doc was free, the scrip was 5.00. If you are tech savvy, you will love Oscar. I do everything on my phone, and I love all the things I can do on my mobile.
If you live in an area where Oscar offers coverage it is a good affordable option. They work with top doctors in Orange County and the app makes it very easy to find providers. They also reward you with $1 Amazon credit per day that you meet your daily step target which is a fun perk.
Totally like Oscar - the selection of providers, great value for the price, the app, the doctor on call. So sorry I moved to a different state where Oscar is not yet available :(
I purchased Oscar insurance because I wanted insurance for the Cleveland Clinic. It is expensive. There seems to be some confusion about co-pays. Enrollment was trying but I was persistent and got it done.
good rates, excellent communication via email, easy to use services.
I love Oscar Insurance is really affordable and it has cover all the doctors visits. I have no complains about this insurance.
Oscar, like all modern health insurance companies, has its problems. Healthcare is expensive, and insurance never covers enough of the costs. But if you put aside industry-wide complaints about those costs, I find Oscar is pretty good in one big way that sets it apart from competitors in New York. They have excellent customer service who is very helpful at navigating the world of healthcare with you, explaining everything and trying their best to help you get the care you need. They make the service worthwhile over other similarly priced companies that don't offer such helpful service.
Very easy to navigate website. Good customer information package.
I've enjoyed being with Oscar. They are friendly and their app is good. Wish they convered more on allergies.
The insurance cost is to high, my prescription are less if I go online and find a coupon. I have to spend 6,000 a year for what?
My annual checkup and labs were covered 100%
Easy to sign up but premiums and deductible are fairly high.
It’s been good The network is the best and it was easy to get a primary care physician.
Billing and service provided by Oscar has been outstanding!!!
Oscar is a great health care option for individuals like myself living in the Los Angeles area. It is affordable especially for individuals under 30. Its network of doctors COULD be larger, there are not many urgent cares to go to which is what I use most when I get sick. Have not used their doctor on call option which might be a good alternative to going to a urger care (I hope) Their app is great, makes it very easy to contact someone if you have questions with the online chat feature. Overall I would totally recommend Oscar. Im also rarely sick so not sure if its a great option for someone who goes to the doctor all the time? But great for individuals like myself who are averagely pretty healthy.
Doctor on demand was really helpful! I totally recommend it!
Great service. Very clean office. I recommend.
So far I have had no problems with Oscar insurance . Other than being limited to Quest labs it has been good insurance.
Ease of signing up for benefits and communication is awesome. Doctor on Call is a great feature.
Every time I have a problem I call Oscar and always help me ! I am very happy with Oscar Insuranse .
I like Oscar Insurance... I like the convenience have using the phone app to check to see what doctors and specialists will accept my medical plan... And if I do not know how to use a phone app I can always call the Oscar concierge team to have them assist me in finding a doctor of specialty that I may need. Every single doctor that has been recommended to me by the Oscar concierge team has been excellent doctors with excellent reputations and I could not be more happier... This is insurance that you do not need a referral in order to see a specialist it is a very good insurance plan.
Good app. Their website inaccurately listed doctors as being in-network, even when they weren't.
We love Oscar, especially the Oscar app!
Searching for the right Health Insurance plan for you can be a major headache, but I believe that Oscar is a great option when it comes to saving on Health Insurance and still receiving good benefits. Customer service is quick, easy and informative. Also, Free Doctors visits and Well-Women exams coupled with easy to access resources like the Oscar Center and Doctor on Call make Oscar an Insurance company I would be more than comfortable recommending.
This has been a more affordable plan , then the BCBS, that we had for years, they have great primary doctors on the plan and a good web site, and other features. This plan seems to pay the doctors the same as the BCBS did, and I have had no complaints about the payment. As the cost if insurance is rising and the benefits are lowering , Oscar is a good choice.
I have access to many doctors and hospitals and a concierge team ready to help me at any time. The phone app is easy to use with the information I need at my fingertips. I do wish the annual deductible was lower but otherwise, this insurance company has made it all very easy to navigate.
Deductibles are stupidly expensive on all insurance plans, essentially I have to pay $7,900 to get any real costs covered. Who can afford that? The only reason I have & pay for insurance is because I’m afraid of a catastrophic accident/illness but I know if that happens and I get cancer my deductible will be $7,900 and my $2-3 million will go away fast (due to the US having costs double any other country) then I will be out of luck
Great rates! It’s a great insurance very affordable and they provide a lot of great services via internet
Good doctors and hospitals network, easy access to a doctor by the app 24/7 and it's free.
Great company, great customer service.
needed to ascertain whether a nurse practitioner visit would be covered and was able to do so quickly and conveniently
The first time I've used an on call doctor was with Oscar. It made my question very quick and easy. Great idea. I was able to go to a pharmacy right away with OTC products.
I love the smartphone app! Very easy to use! Customer service is great at answering/explaining any questions I have.
Cindy F Puk
I love that I can talk to a live person or my own team on line. So far my experience has been great with this company!
I like Oscar. I especially like the doctor on call option because it helps me when I need it most.
The customer service is amazing. Everyone is so patient and polite and informative! I love the phone app and that I can see my lab results, appointments, prescriptions etc. they give you more than enough info on all of those and it’s very user friendly
.i haven’t used the program much but I did like the fast service of doctor on call. Very responsive and efficient.
I've been very pleased with the customer service (concierge team). They always do as much as they can to solve my issues. If they had a more robust provider directory, I would be completely satisfied.
It has been ok. The app is amazing but the network of doctors isn’t as good in my opinion.
A good choice of doctors however expensive premiums
Oscar has great customer service. I love the doctor on call feature, it makes it really easy to ask a question when my schedule doesn't allow me to go to the doctor unless I absolutely NEED to.
Great insurance company, easy to sign up. Informative brochures and the app makes things easy.
Customer service/concierge is great. Management/executive team takes forever to process a response if there’s an issue that needs to be escalated to them. Premiums are the cheapest around but you get what you pay for - higher co-pays.
Any time I have had questions they have been quick to respond and treat me as if I really matter to them.
Customer service was very helpful in initial sign up process. Had an excellent experience when I needed to find a doctor in my area.
Oscar is very user friendly, clear on what you’re receiving and how to implement.
They answer all my questions and find the answers quickly.
Good customer service. Doctor on call is useful. Premiums and deductibles too high.
Oscar has been good for me. Haven’t been sick much, but I love how you can track your steps and get rewarded for reaching your goals.