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.
Oscar is amazing, they have doctors on call
Website easy to navigate Always a person to speak to if you need help
I love how easy it is to use the Oscar app. I have used the Service "Talk to a Doctor for Free". and it has saved me a great deal time and I was impressed with how quickly they responded.
Ease of use, benefits work, no need for approval or reference for specialists.
Oscar is great. Customer service is very friendly and knowledgeable.
The thing I enjoy most about Oscar is the mobile app. I use that app all the time whether it be to see my steps or just get information. It’s very easy to use and very convenient. Customer service is great and haven’t had a problem so far.
Great customer service. Affordable rates. Can’t complain.
When I had trouble getting money back from a doctor’s office, customer service helped me quickly! But I always prefer to go to my native language(Japanese) speaking doctor, but there is no Japanese doctor in the network!
Love the teledoc. If you have regular doctors that you enjoy, I would make sure you confirm they take oscar before switching, as quite a number don't. For how little my husband and I need medical attention, our premiums seem outrageous to me, personally. Otherwise, they've been easy and pleasant.
I love the doctor phone line. It was super easy to get a prescription for a small recurring issue.
Great affordable plan. Works for my situation and lifestyle.
Used the 24 hours doctor service and was very satisfied. My call was returned quickly and the doctor was able to call in a prescription for my gum infection. This all took less than an hour.
I am pleased with Oscar. The premium is affordable and the selection of doctors is okay. I have used the plan only once, for a flu shot, and it worked out very well.
The customer service is very good and both the website and app and very easy to use. The number of doctors that accept the plan is ok but I wish they had more Hospitals in the network.
The oscar app is awesome, you have everything you need. From looking for a doctor to a specialist and they pay you $1 everytime you reach your step goals. Friendly customer service
Good so far but too expensive for the benefits/deductible
My favorite thing about Oscar is that I'm always able to get a hold of an agent if I need anything. No robots, no automated voice, no long queues - If I need to speak with an Oscar representative I'm almost always instantly connected with a real person. They're always very helpful and very friendly.
This is an affordable insurance plan with access to great doctors and hospitals.
Overall very happy with Oscar and the plan. Your ux is great, the website and app is easy to navigate.
A great insurance program that saved me a lot of money
I love the app and being able to text a doctor. Have also had the receive a callback and both have worked great. Both times felt like they took the time and they called in RX for me. Great experience.
Like most insurance companies, Oscar will refuse to pay for most tests and medical care until you pay their outrageous deductions first. It's only worth it having insurance with them if you plan to spend a lot of time in the hospital and have heavy medical expenses. If you have moderate expenses, you will spend thousands out of pocket, on top of your premiums, before Oscar pays for anything. We need to get rid of companies like this and institute universal, not-for-profit healthcare.
The app is great; paperwork and reports are clear; and the drug coverage is excellent. I have no complains after about 14 months enrolled (though admittedly I haven't had any out-of-the-ordinary health needs). The only reason I gave 4 stars rather than five is the very high cost of the plan, which went up $100 after my first year, and is slated to go up about $140 after the second. (But then again, skyrocketing costs probably aren't limited to Oscar!)
They have all the healthcare services i need for a low, affordable price
Modern insurance company with fair pricing, good selection of doctors, and good coverage. We needed basic health insurance to cover our catastrophic needs. We also wanted reasonable pricing on our everyday health needs. So far Oscar has delivered what we expected. Their website and app make it much easier to interact with the company.
As a retired RN, I did extensive research prior to deciding which insurance provider to choose. The Oscar plan we choose is a perfect fit for us. They are very easy to work with and are accepted by my first choice medical providers. Help is just a phone call away as they have a concierge to help with any off time concerns you may have. They also have a Doctor on call that is a great peace of mind to us. I would absolutely recommend Oscar to anyone wanting to control their health care costs.
Cameron B Belcher
Best health insurance provider I have experienced yet. I'm in my mid-20s and just starting independent health coverage. My only complaint is that I had to switch because of the rise in my premium, where the cost more than doubled from year to year. I was very sad to have to leave because my new provider is less than subpar to how easy and simple Oscar was to use. Wish I could go back.
They DO Not Pay for RX your Primary Doctor writes... fight and find a way out is their policy!!!
I went for my "free" annual checkup in-network and had a blood table done and my bill is still $6,188.34 two months later. There are 3 general practitioners in Austin and 9 total in Central Texas (within 2 hours of Austin) that are available in-network. This company is a compete joke playing a dangerous game with people's lives. I would hate to be in a serious situation where I'm getting denied for what most other providers cover. Positives: cheap premiums (though denied when you use it), their app is easy to use, HSA available. Oscar may be good for something catastrophic but think twice before you dare use it unless you're on your deathbed.
Really unhappy with this company. Have a standard, uncomplicated pregnancy and the policies of this company are completely opaque. What they do and do not cover really not clear. Every time I call the concierge line, they give me different, conflicting info. Seems despite paying $700 monthly premiums, I will be paying somewhere between $7500-$15000 to have this baby as they cover exactly $0 for actual delivery. This is completely unacceptable. Wish I'd read the fine print before signing up for this insurance. It's kind of a total scam.
Great sign-up process, customer service, user friendly website and app. However, the app does crash frequently, there are limited plan benefits, and it's expensive compared to Ambetter Health.
So far, I’ve been pleased, haven’t had opportunity or time to really use. & explore .. like dr call & customer service .. premiums are way too high, if not for discount it would not be affordable for me
Oscar has the best auto-payment system for premiums.
Good, however conflicting information on Parent aging off @ 65 and enrollment of 4 remaining children - over age 18 but under age 26.. Confused the client AND Agent B... complicated where did not have to be....
Affordable price ,beeing able to talk to the doctor online and high quality service.never been happiest.so from my family thanks to Oscar!
First time I have ever had a customer service rep call me to explain an error made (before I even knew there was an error) which was very impressive. I am new to OSCAR this year and so far have been very pleased.
Great plans, great customer service, and the best plan I’ve ever had. You won’t regret selecting Oscar as your health care provider.
I like the benefits of my plan. I would like to see more doctors added to the plan. The doctor that we were seeing in the plan is no longer in network. While looking for a new doctor, I noticed a list of doctors no longer in network. This concerned me.
I had no choice as an individual buying insurance. I Had to choose Oscar if I wanted to use the Cleveland clinic Doctors. The changes for individual insurance have been a crime.
So far it's ok . I wished it had Texas Tech & UMC as providers
Reply from Oscar
May 29, 2019
Hi Veronica, thank you for leaving this feedback! We'll send it over to the team to look into for you.
Need better customer service and more doctors available.
Reply from Oscar
Jun 18, 2019
Hi Tawab, thank you for taking the time to leave this review. We're going to share your feedback with our team, but DM us your Oscar ID number and we'll be happy to have someone from our team get in touch to further address your concerns.
Doctor-on-call service is very good and prompt.
I shared it in the survey. Doctors offices didn't want to take me as a patient because Oscar is so difficult to deal with . I was told that on more than one occasion. However, the OBGYN I ended up selecting I am happy with.
Reply from Oscar
May 29, 2019
Hi Michelle, we're so glad to hear you're happy with your OBGYN. Even so, we'd like to look into the providers you were having trouble with. Please don't hesitate to give us a call at 855-OSCAR-55 and our team will look into this for you.
Oscar has been solid to ensure I have coverage in case of emergencies, and the premiums are affordable. Customer service has been helpful when I've needed information, and the doctor on call feature is great for deciding if something is pressing or not. I don't know much about the more involved plans, though, so if you have a lot of doctor's visits or prescriptions, definitely look into the specifics first.
Always good customer service and my doctors are in my plan.
App and Doctors on Call feature is great. Annual deductible and premium increases are tough to digest. Concierge Team seems unnecessary or perhaps overstaffed.
In my life i have never dealt with an insurance company with this level of customer service Nice people
The best part about Oscar, in my opinion, compared to other Health Insurance providers, is the ease with which to locate services, and communicate with representatives online.
The concierge team is awesome--so friendly and helpful! The doctor on call service is a tremendous help! Though ALL health insurance is over-priced, Oscar is competitive with other carriers.
Rich M Tracy
I signed up for Oscar thru the ACA. By far the worst company, under my plan it cost $250.00 to see my PCP. So much for affordable health care.