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.
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.
Good customer service and app is very continent. Does feel like I’m paying a lot on premium for very little benefits day to day and a pretty sizeable deductible. Again, the customer service has been very friendly, knowledgeable, clear and helpful
They answer pretty fast, info is really good. Haven’t checked into it much
Generally responsive to concerns, unfailingly polite and reassuring in style of customer service, like Trader Joes in a way. Coverage away/outside of NY area severely lacking and makes it pale compared with larger competitors like EBC/BS
website, smartphone app is good, easy to access the plan details
Customer service has been very good. Need to expand network of doctors and facilities in Michigan.
Seems to be a normal working Insurance company. The rates are high as are most anymore. Minimal benefits for the monthly bill.
Oscar has been a cost effective and a technologically efficient solution for my healthcare.
It’s sometimes hard to find things on the app but once you know where it is it’s easy
Very easy to understand and use. Does not break the bank.
W V M
The app experience has been awesome. So easy and convenient.
It is great to have your own concierge so you talk with the same people when you call with any questions.
I am sick of insurance companies trying to raise premiums by double-digit percentages year after year. I am tired of paying cash for medical services rendered because my level of insurance doesn’t have co-pays. I might as well not have insurance, save the fact that if I was in a catastrophic accident/diagnosed with a disease, I would need insurance desperately, as many do. It is a shame that profitability is the most important priority for this company and the rest of the health insurance companies that I have had to change from every year, and I imagine that this year will not be different. Please reconsider your proposed increase of 22% for Bronze Value plans.
Oscar is an OK health insurance company. Wish they have more doctors in network and better customer service.
Very High Premium and deductible. Selection of Providers is very good. Customer service has been very good. The website is simple and easy.
excellent app experience and customer service
So far, so good. We have used your customer service several times and your in-network doctors. Everything has been fine so far.
The best part about Oscar is the one call doctor. The call you back so quickly and get to the root of the problem quickly. I would recommend Oscar based soley on this! No more needing to make useless doctors apportionment for stuff you just need a quick fix on!
customer service reps are excellent. they always answer my questions and offer to help in any way
the best customer service, good cancellation of service
Great in theory, but bad in practice. The telehealth function sucks. Those docs are not qualified. Some can't speak English. Many don't follow through on requests.
The premium doesn't reflect the coverage I get.
Really glad to have your coverage - I lost employer coverage when I went on LTD - your coverage is a good bridge between what I used to have and pending medicare.
Oscar is good health service provider with its large and premium network members.
Oscar has excellent customer service and responsiveness. They are new, so still sometimes unknown to the receptionists of my doctors, but I have not had any issues obtaining approvals or coverage with any of my needs. So far an excellent experience.
Doctor on call feature to allow speaking with doctor for free through smartphone is a great benefit.
Although the premiums are high, the network of doctors and the customer service has been awesome!
Being able to message or call a doctor through the app eases my mind as I don’t have to go to a clinic just for a simple question.
Oscar has been easy to deal with ad people are helpful.
I've had mixed experiences. My first appt was canceled after it was booked, my prescription medication was not covered, and the doctor I went to for my checkup sent me to two other doctors for the lab, which was very time consuming.
Easy process to sign up. havent used benefits yet, going to get/look for my gp as soon as i get a free min
Plan is Ok except for prescription copays. They are very confusing; I never know what I'm going to pay... Veven for same medication.
Oscar plan has been the best medical plan to deal with. They answer all my questions immediately. My medical bills are paid promptly. I recommend Oscar to everyone.
Scheduling through Oscar is difficult. It’s easier to contact doctors directly or go through Cleveland Clinic website.
Limited doctors. Significant rate increase. Radiologist not covered in plan, they were still waiting over 1 year for approval.
Just wish the benefits were better all is is good can’t think of anything else
Oscar is a very easy insurance platform to use. My agents are helpful and re-ordering my prescriptions is fast and seamless. I have had a great experience and I would recommend.
Great app, helpful people that are always there to help through the app
Oscar is an awesome Insurance Provider . I'm very happy with the app, concierge team and the ability to get a call in with a Oscar Dr at anytime I need it . The out of pockets , deductibles and prescriptions are nice and low too The walking incentive is great as a motivator also . Just get Oscar best move you can make .
UPDATE June 15 2019 -- Oscar sent me a letter letting me know they will increase their premiums 22% at the end of the year. 22%?!! Of course their CEO gets a fat pay package, but obviously he's not doing a good job if he can't control prices. Can you imaging your Utility, your internet service provider, etc., increasing their prices 22% per year?? It's an OUTRAGEOUS GOUGING of their customers. Looking elsewhere and fighting the increase with the NYC Dept of Health Services. OLD REVIEW: Oscar lives up to the hype. Doctor on call or on the app is great. Concierge is very responsive. Have been pleased with the service so far.
Low premiums, high deductibles. It is okay while I am healthy, otherwise might be a pain
Oscar is a very good insurance sometimes your customer service people are not aware of benefits details but not all the times ,
Using the Oscar app has made healthcare enjoyable. I am easily able to speak with a provider and customer service. Everything I have needed was found on the app either through set features or with the messaging service.
The sign up process is easy and the customer service is exceptional.
Good price for insurance just in case I need it
lower monthly deductibles. and add more doctors offices to the list of in network doctors