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.
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
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
Maria r fabbrocile
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.
David Woolverton Sr
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
Oct 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
Oct 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.
Debra G Vasquez
Medical insurance coverage has been a learning experience. Oscar excels in their communication from concierges (staff) but falls short on services such as an available list of Durable Medical Equipment providers (DME). My son needed a special knee brace to wear following surgery and there was no list of DME providers available. So I had to eat the considerable expense of going out of network. Getting every procedure and x-ray approved has been time-consuming. I admit to choosing to take a low monthly premium and a very high deductible, taking a chance that my family would only need regular preventative care. An unexpected injury requiring surgery changed everything. I will be re-evaluating our coverages and health insurance provider based on this experience. I'm willing to pay high deductibles for in-network, but not having medical provider lists for everything is not good business. Nor is waiting 72 hours to get a list of providers.
Reply from Oscar
Oct 12, 2018
Hi Debra, thank you for sharing this feedback. Due to privacy laws we're not able to discuss anything regarding your son's personal health info on Best Company, but we escalated your message to the Care Team and received confirmation that we're working with you directly to resolve this concern. As always, if you have questions or would like additional assistance, we’re here for you. You can reach us at 855-OSCAR-55 or by sending a secure message from your account or the app.
I’ve had several health insurance providers over the last 10 years and Oscar is the best by far. Good providers, excellent service and it’s very easy to manage my account.
So far I like it, easy to work worth and great customer service.
Quick response and accurate information. Our time under Oscar health insurance has been very good.
Most Doctors, quality Nursing Homes, Medical Equipment Companies do not accept Oscar Insurance. Only the desperate and fly-by-night accept Oscar. This is why only a one star rating. Oscar employees are caring and perform their jobs well. They get five stars.
Reply from Oscar
Oct 09, 2018
Thank you for providing this feedback, and we're sorry to hear you're dissatisfied with our network. Oscar has a curated network of providers built around provider systems who, like us, are focused on keeping costs down for our members. 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.
I have never had as good as an experience as I have had with Oscar! I give them a 5-star rating but it goes much higher than that, a 10+ star rating. I have been a member of Oscar for 3 years and they have been the best years I have ever had with my health insurance experience. The customer service is outstanding! The representatives are very friendly and answer your questions fully and easy to understand. In addition, I have had support from my care team and my nurse case manager. He has gone beyond the call of duty and makes sure that the care and services that I receive are accomplished and if there is anything I need further, he is right there to help. He has checked in with me frequently to check on how I am doing and if I need anything. He answers my questions and just simplifies the insurance process, insures that I get the treatment that is necessary. I plan to remain a member with Oscar for many years to come! There really should be more businesses like Oscar; they just make this a better world!
Reply from Oscar
Oct 10, 2018
Thanks for the love, Gabrielle! Don't hesitate to reach out if there's ever anything we can do to help.
Best insurance I've had ever! I really enjoy the case management part of my plan because i am highly forgetful. It is great to know that there is someone making sure I dont miss out on any of my health related obligations and benefits.
Scam artists. Please do not choose this horrible health insurance company. The documentation to revise a plan was sent by the NYSoH and they refuse to accept it and have my account changed. I plan on suing for harrassment
Reply from Oscar
Oct 09, 2018
Hi Sachit, we're very sorry to hear this. We escalated your feedback to our team who let us know that they are aware of your message and have already worked with you to resolve it. If you'd like to discuss this matter further, please call us at 855-OSCAR-55 to be connected directly with your Concierge team.
My experience with the Oscar associates Angie and Scott have been extremely positive. They are caring thorough and have followed up with my questions and concerns in a timely manner. They really have made a difficult situation manageable Thank you for their help
When ever I call the help desk immediately comes up with a solution to my problem. My only complaint is the monthly cost to maintain my policy and the deductible is so high
Have had a great experience for my business. My employees love the free telemedicine option. My Oscar representative has been a huge help.
I have been with Oscar now for 6 months and have absolutely loved it! From the outset, it was so easy and intuitive to enroll and find a doctor in NYC. The whole platform is so easy to use and to navigate. No headaches trying to decipher claims or bills and someone is always available to help when needed. Oscar has worked seamlessly with my providers, saving me time and hassle that I'v experienced before with other companies haphazard bills. At the end of the day, I love having my healthcare at my finger tips. No matter where my day takes me, I know that I've got Oscar.
Craig E. Morris
In my three and a half years on the Obamacare program, with each year being under a different insurance provider, I feel that Oscar was the best. The pharmacy coverage portion of my policy was outstanding and was great help financially. Unlike my options with the other Obamacare provider choice for 2018, with Oscar I was actually able to keep my doctors. Since I became eligible for Medicare in October, 2018, I did not meet my full deductible amount so some of my out of pocket costs were a bit pricey. To my knowledge, prior to 2018 Oscar was an unknown provider in the Nashville, TN area. From comments by medical offices I have visited, Oscar is now well known and favorably accepted. All things considered, Oscar has been a good medical insurance plan for me.
I am a business owner, and we offer Oscar Insurance to our team. I can honestly say that the entire experience from the onboarding process until now has been exceptional. Managing team members who receive the insurance (both new employees and when terminating employees) is quick and easy. I would recommend Oscar, as they are connected to a good group of doctors and hospitals and according to one person who is pregnant, the service has been very smooth and comforting.
Oscar is an easy-to-use, friendly and simple healthcare service that has made the transition from university to real world no problem at all. I look forward to seeing their services grow as the company grows.
I am the CEO of Ripe and we use Oscar for our team. I love the product for my personal use and for my employees. Setting up Oscar was easy and has been a huge value add for keeping my best employees happy and healthy.
I don’t usually post reviews about companies, but I’ve had a really good experience with Oscar so far. I’ve had a lot of questions about doctors and who’s in network since there’s is a bit smaller than BCBS, but their customer concierge has always answered. Big fan of the call-in doctor too. Definitely plan on sticking with them for a while. Got Oscar because it was the cheapest Obamacare plan in my network. The app has been my favorite part. I haven’t really needed to go to the doctor, but the three or so times I’ve used the app to talk to a doctor it’s been great. Really easy to get a prescription if I need it. It’s a big time saver and didn’t cost me a co-pay either. Definitely way better than my experiences with other insurance companies. Feels like the company really wants to make people happy. Network is small and plans are getting more expensive, but I like how easy it is to use. Feels like it was made this century. When I had to go to the ER this year Oscar was really on top of coordinating. I had never had the experience of someone on customer service reaching out and seeing if everything was okay. Billing was really straightforward too. OSCAR customer for about a year. Some of my old doctors aren’t in network anymore, but I’ve been happy with their service so far. I like their tech. It makes it easy to find doctors in the OSCAR network. The customer service people have been good too. Always answer the phone or text pretty fast.
My daughter is seeking health Insurance now that she is no longer age-eligible to be insured under our family health insurance plan. She asked me to take a look at Oscar online and what an impressive and easy website to navigate for researching options. She decided to sign up btw!
I wanted to write a review on OSCAR because my health is super important to me. Normally, health insurance is so complicated, but what I have found with Oscar is they make it easy. I love the OSCAR app. I have used the app to speak to a doctor several times this year. The doctor was awesome, and it saved me a copay. The doctor phoned in my prescription. It was so great. I didn't have to miss work which is huge for me since I'm paid hourly. I have had OSCAR for the last year. I know that with health insurance sometimes the doctors are not in the network anymore, but I've found terrific doctors in the network to replace my previous ones. Customer service for OSCAR has been hands down better than any other insurance company that I have used. I don't feel like I'm a number; I'm treated like a real person. OSCAR responds quickly to me. Thanks OSCAR for making insurance easy, and taking care of me!
Great customer service! Everyone I spoke with was super helpful and really engaged in answering all my questions I had. Would definitely recommend to family or friend looking for help with their healthcare.