Oscar
3.3
7.2
Overall Score
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Rich Olmsted Falls, OH
Recently went to The Cleveland Clinic (Oscar was only Insurance available for CC through Healthcare.gov). My doctor requested a Hep C test. I received the bill. $2,153.00 !!! My girlfriend had the same lab work and test done at University Hospital and was charged $548.00 for the same lab work and analysis. To add further insult, Cleveland Clinic had to run this laboratory test three separate times to get results that they could trust. They are "partners with Oscar". My out of pocket cost was $889.51 !!! Additionally I have had issues with medications that were covered by my former healthcare insurance provider (and prescribed by my family doctor at Cleveland Clinic), that are not covered! If I could give less stars I would. I will now have to switch healthcare providers in order to get insurance that is reasonable relative to total costs. BTW I pay $953.67 monthly!!!!!!!!!!!! I cannot believe the Cleveland Clinic would make such a poor choice in Insurance providers. I wonder what other poor choices they making?
5 years ago
Reply from Oscar
Hi Rich, we’re sorry to hear you’re not satisfied with your experience. Depending on the plan you’ve chosen, you may need to reach a deductible for non-preventive services, including lab work, before cost sharing applies (preventive services are always covered). This means that you'll be responsible for the full negotiated rate of those services up until the amount of your deductible is met. We’re unable to comment on rates that other providers and insurers have, however if you have questions about costs of specific medications, tests, or services your Concierge team would be glad to help. Anytime you call or send a message through the app, you’ll speak to the same people every time. Please don't hesitate to give us a call to discuss this or any other concerns: 855-OSCAR-55.
Jul. 11th, 2018
Lee Pasadena, CA
I don’t want to give any star to this insurance company. First of all the clinic told me they have network. I have received claim declined letters from Oscar since they are not network. But they are network... I have visited the clinic manager to make sure if they really are network with them. The manager called the insurance and they admitted they are network with this insurance provider.
Again I have received another declined letter from the insurance. I contacted with insurance to ask what’s going on. They said they will need to confirm so need time.
I am wondering why they don’t know if they have network with the clinic...
I have no idea ... this is ridiculous.
I don’t know what I am paying for.
This is huge mistake to pick this insurance.
Please don’t ever get this insurance.
It’s not worth it at all
5 years ago
Reply from Oscar
Hi Lee, we’re sorry to hear you’re frustrated. Due to privacy laws we’re unable to comment on anything related to specific claims here. We’d like to connect you with our team to further address your concerns. Please send us a private message here with your member number and someone will be in touch. Or you can call us any time at 855-OSCAR-55.
Jul. 13th, 2018
kristen yee San Francisco, CA
THIS COMPANY GETS YOUR BUSINESS BY LYING TO YOU
If you have need medicine or have a pre existing condition run as fast as you can away from this company.
First if all their "negotiated costs" for some medicines is no different than paying at a retailer with a Good RX card.
I spent multiple phone calls with them to make sure all my drugs and durable med equipment was covered. Even gave them id's so they could check. When I went to order they only covered one, and not with the suppliers I gave id's for but with a third party. One of the items I need they charge MORE than if I buy direct from supplier out of pocket.
Their idea of a negotiated cost is 175 bucks for a 20 day supply of insulin. I can get that with a good rx card without insurance. They don't tell you this before you sign up. Not to mention this is a pharmacy order BUT they won't apply it to the $500 pharmacy deductible. They apply it to the $6000 deductible which means they never help with the cost.
The website is a joke. You call a doctor on the site they have never heard of Oscar. Even when you call them they give you names of doctors that have not heard of them nor take their insurance. 6 months I have been trying to get appointments.
We are self employed and we pay ALOT for really nothing...and don't even get me going on the pediatric dental.
This company is a scam to rob you of your money. Can't wait for 2019 so I can be done with them.
5 years ago
Reply from Oscar
Hi Kristen, we’re sorry to hear you’re frustrated with your plan. Due to privacy laws we're unable to discuss the specifics of your private health info here. Depending on the plan you’ve chosen, you may be subject to the full negotiated rate for prescriptions and services until the deductible is met. Please be aware that Oscar works with a third-party partner for all durable medical equipment requests and if filled with an in-network provider, any costs would be applied to a plan’s deductible or durable medical equipment cost-sharing. Our Concierge team is standing by to help find providers that meet our members’ needs – they can supply a list of potential providers according to a member’s plan. If you’re open to it, we’d like to have your Concierge team get in touch to help further. In that case, please DM us your member number, or call us at 855-OSCAR-55 and we’ll connect you with them directly.
Jul. 9th, 2018
Pete L Brooklyn, NY
I've been going back and forth with Oscar and Mt Sinai hospital over an unpaid claim, which Oscar of course assured me was taken care of. It's been 4 months. I found out today they denied the claim because "it was supposed to go to Optum - who handles our mental health claims". This was for a consultation for basal cell carcinoma, NOT a mental health issue.
Not only did they deny the claim without telling me, they actually told me it was paid and now I'm past due! I'm on hold right now with Oscar and the agent told me I had to call Mt Sinai and deal with this myself. This is absurd!
NEVER EVER insure with Oscar. I'm going to find a new insurance company for my business as soon as I get this fixed.
5 years ago
Reply from Oscar
Hi Pete, we're very sorry to hear this. Due to privacy laws we're unable to discuss with anything regarding your private health info, such as claims, here. Give us a call at 855-OSCAR-55 and we'll be happy to look into this further and escalate your concerns as needed.
May. 15th, 2018
Geraldine Merola Sag Harbor, NY
Not worth the price! You have to pay the full price of EVERYTHING at the docs office till you meet the deductible. So much for budgeting a feely paycheck! My last 15 minute appointment cost me $215 out of pocket!!! The network hospital is over 1.5 hours from my home. I have a local hospital and a full network of docs 20 minutes away and must now drive past all of them to get to Oscar's network! This plan should not be sold in an area if the local hospital doesn't take it!! If you haven't checked on their website yet- the search function to find a doc is useless- or I'd have discovered the paltry network when I shopped for a health plan.
5 years ago
Reply from Oscar
Hi Geraldine, we're sorry to hear you're frustrated with your plan. If you have a high-deductible plan, preventive services are covered in full, but any non-preventive services will be subject to the deductible. This means that you'll be responsible for the full negotiated rate of those services up until the amount of your deductible is met. We do have a curated network of providers, which means that our network is made up of select providers and hospital systems who, like us, are interested in keeping costs down for our members without sacrificing any quality of care. Our full network of providers is searchable on our site at , but we're also always happy to help you find in-network options. Additionally, if there's ever an emergency, your plan covers emergency care at out of network emergency rooms as well as urgent care at out of network urgent care facilities. Please don't hesitate to give us a call at 855-OSCAR-55, we're always here to help.
May. 1st, 2018
Teresa Hanan Austin, TX
I am SO frustrated by my dealings with OSCAR and the company who provides their Physical Therapy services, eviCore. I and my physical therapist office have talked to them on MULTIPLE occasions to try to get the services that my Therapist, my doctor and myself, feel I need. EVERY time I call their representative to try to get some clarity, I am given information that does not match what I have been previously been told or that my therapist have been told. so, one complaint is that they do not keep good notes and are unclear about what they are doing. My second complaint is that they are disregarding my best interest. I have been in pain for over a year and am finally feeling better and seeing a light at the end of the tunnel. My therapist has said to them on multiple occasions that she feels like if she were able to work with me for 4 more weeks then I should be good to go but they are not allowing that. She has now requested 2 more visits to set up a home plan because they told her they would not give anymore and she was able to get them to consider the 2--even thought this is not what she thinks I need. (btw, I am already doing LOTS of exercises she has given me at home, I am still having trouble sleeping due to hip pain and am not able to walk or sit for any amount of time with out discomfort, not to mention get any kind of exercise) I am so frustrated as is my provider.
Additionally, I drive 30 minutes to go to a therapist because you guys had only ONE of the many physical therapy groups that my Doctor (who is in your plan) recommended. I think this is unacceptable.
6 years ago
Reply from Oscar
Hi Teresa, we're sorry to hear this. Due to privacy laws this isn't something we can help with here directly but Chelsey, one of the representatives on your concierge team, will be keeping an eye on the next steps in the authorization process. We understand that this has been a frustrating process and will share your feedback with our team so we can work to improve this. Please don't hesitate to reach out to Chelsey or any member of your concierge team with any additional questions or concerns: 855-OSCAR-55.
Apr. 5th, 2018
Nate Adams Beverly Hills, CA
Oscar was the least expensive plan in my area, had a nice website, and promised to basically be "techy" and "new." I signed up. I have my first claim. It's under $70, and I'm not even seeking reimbursement - only want the payment reflected in my deductible since I paid out of pocket. It has been nearly two months and they have denied my claim without even speaking to my doctor. I call them to figure out why they haven't spoken to my doctor and they lie and tell me they tried calling them several times and faxing and they won't respond. This is a major nationally-known hospital, not some family practice with a 68 year old receptionist who can't use a computer. In my experience, they are just in the business of denying claims. Luckily for me it's less than $70 and was only for a follow-up appointment, but what of all the people they are doing this to who have life-threatening conditions? Who don't have the money to cover these mistakes by Oscar while it gets "figured out?"
My experience so far: seems to be a scam company. And wouldn't you know it, Jared K.'s brother is the founder. I'd pay double next year for any other insurer. It's not worth it.
6 years ago
Reply from Oscar
Hi Nate, we're sorry to hear this. Due to privacy laws we're unable to help with anything regarding your claims here, but if you message us with your Oscar ID number, we'll be happy to have someone from our team look into this for you. Apologies for any frustration.
Apr. 4th, 2018
Heather Montclair, NJ
I chose Oscar simply because it was the cheapest option in my area with my doctor in network. I'm regretting it. They don't accept credit cards. Given how "secure" we know systems are not these days, I NEVER give my debit card out. And, yet -- now I have to to these people. Plus -- EVERY time I've gone to the site to either pay or look something up, I have had nothing but trouble. And, you can't call after hours to pay a bill over the phone. They're terrible at user functionality. I haven't had to use the actual coverage yet. I'm worried given some of the reviews and the fact that it's hard enough just to pay them.
6 years ago
Reply from Oscar
Hi Heather, we do not accept credit cards due to the high fees that they charge. We do our best to keep costs down for our members whenever we can. A minimum of $0.85 of every $1 we receive in premiums is spent directly on health care claims for our members. Unfortunately accepting credit cards would mean potentially raising premiums to accommodate this and we're not interested in raising rates for our members whenever we can avoid it. We apologize for any inconvenience. As for our site, we did have a brief outage with our payment vendor for about an hour on Friday 3/2. During this time, the payment are of the site was indeed down. This has since been fixed and you should be good to go, apologies for any frustration this outage caused!
Mar. 5th, 2018
Jamie Los Angeles, CA
Believe all the other reviews - Oscar is awful. RUN in the other direction. My health insurance broker mistakenly signed me up for a February start date instead of March (even though I already had coverage from another company for February). No problem, I was told by my concierge, if I could provide proof of overlapping coverage for February, Oscar would refund me the payment and my policy could officially start in March. Great - I provide the proof, I get my refund and everything is all set...or so I thought! By total chance, I happened to sign into the Oscar web site a few days later - only to discover they had cancelled my entire membership (without alerting or warning me). I asked my concierge about it, and DESPITE HIS ORIGINAL ASSURANCE THAT MY POLICY COULD START IN MARCH, he now told me that receiving a refund meant I had to give up my entire policy. Again, he did not originally tell me this! I was offered NO apology for the mistake. When I explained this would potentially leave me without health insurance for all of 2018, he insisted my health insurance broker had to call Oscar and verify that he was the one to mistakenly enter the wrong start date before they would even consider reinstating my policy (and even then, it wasn't guaranteed) - first, I was told my broker had to call a certain number; then, it changed to an e-mail he had to write; the information was never consistent. And, again, keep in mind that I discovered my terminated policy by accident! They never even told me about it. By an extreme stroke of luck, I had actually not yet gotten around to cancelling my coverage with my previous health insurance provider - thank God, because it means I can leave Oscar behind and know that I do in fact have health insurance for 2018. I am now so grateful and happy to be giving my previous provider my money. If I had not randomly decided to check my Oscar profile online, I would have been in for a MAJOR rude awakening come March. Worse yet, none of them cared about this huge mistake - there was no sense of concern or remorse. Just an utterly unethical, deceitful, mismanaged company.
6 years ago Edited September 14, 2021
Reply from Oscar
Hi Jamie, we're very sorry to hear this. This certainly isn't the experience we aim to offer our members and would love to look into this further. If you're comfortable doing so, please private message us your last name and/or former Oscar ID number and we'll be happy to investigate this and the representative you spoke with. We apologize again for the confusion and negative experience.
Feb. 28th, 2018
Marie Standing Santa Monica, CA
I have the unfortunate experience of trying to use my Oscar "insurance." Don't buy into the "cool" company hype...it is a total scam. I am on the phone right now trying to find out the cost of an in network procedure. But guess what? They don't do "price checking." According the the uninformed agent I am speaking with, there is no way to know the negotiated rate until the claim is processed! So you just go in network and wait for a bill to find out the cost. Oh, you want to speak to a supervisor? Nope, none available. This is really outrageous.
Update: I received a response from Oscar. It consisted primarily of a list of irrelevant excuses for refusing to disclose the negotiated rate for a specific procedure with an in-network provider. Completely unacceptable.
6 years ago
Reply from Oscar
Hi Marie, unfortunately cost estimates are difficult to provide for two reasons. While we typically know why we're seeking care (maybe for a general check-up or a specific concern) we don't always know the kind of care we're going to need. Even when we do know the care we're seeking, the treatment is provided as a part of a care episode and may include other supporting services we're not anticipating. For example, if you go to see your provider for a cough, you will expect to pay for the office visit; however, diagnostic tests administered within the visit - such as breathing tests, labs ordered, or prescriptions sent may result in additional charges. Moreover, the charge you incur will vary depending on the setting in which you see a provider as well as that provider's specific credentialing and qualifications. While we are committed to providing cost transparency when and where we can, these factors make cost estimates hard to pin down. Above all, we want to make sure we're providing you an estimate that we can stand by so that you can make a decision with confidence and would never want to provide an estimate that could be inaccurate. We are aware that this is a pain point for members at this time and are working hard to improve this experience for the future. Your request to speak to a supervisor was escalated by the representative you spoke to and someone will be reaching out within 48 business hours.
Feb. 26th, 2018
KB Los Angeles, CA
Oscar: You will be expected to cover 100% of the negotiated rate.
Me: Understood. What is the negotiated rate for this mammogram.
Oscar: Oh, we don't have that information, can no tell you and no one will.
(Verbatim)
I have one question. How is this legal?
They refuse to say what the costs are, even when provided with CPT codes and the Tax ID# of the facility. Absurd. One thing they do expect is for their members to pay the bill when it does come.
Oscar. Your system is broken. I have shared with our entire work network, friends, family and regional points of contact that your company is not a good option for anyone.
6 years ago
Reply from Oscar
Hi KB, we apologize for the frustration. Unfortunately cost estimates are difficult to provide for two reasons. While we typically know why we're seeking care (maybe for a general check-up or a specific concern) we don't always know the kind of care we're going to need. Even when we do know the care we're seeking, the treatment is provided as a part of a care episode and may include other supporting services we're not anticipating. For example, if you go to see your provider for a cough, you will expect to pay for the office visit; however, diagnostic tests administered within the visit - such as breathing tests, labs ordered, or prescriptions sent may result in additional charges. Moreover, the charge you incur will vary depending on the setting in which you see a provider as well as that provider's specific credentialing and qualifications. While we are committed to providing cost transparency when and where we can, these factors make cost estimates hard to pin down. Above all, we want to make sure we're providing you an estimate that we can stand by so that you can make a decision with confidence and would never want to provide an estimate that could be inaccurate. We are aware that this is a pain point for members at this time and are working hard to improve this experience for the future.
Feb. 23rd, 2018
brendan Pelham, NY
Premium rises every month to cover careless spending on Oscars behalf. I began paying 100, now I pay up to 200 a month. In addition, Oscar refuses to cover any of the costs of my medication or OON doctor. My monthly health insurance bill without (physically sickness) doctor visits, dental, etc = 2900 a month.
Oscar is an expansion of Obamacare. Without tax paper funding Oscar doesn't exist. Let me ask you? Did Obama envision a bill - that is going to drive sick people in credit card debt as they cant afford "affordable" health insurance ? He did not care, he pushed it through when it was not ready. Now we are all suffering the consequences. Companies like Oscar can now take advantage of loopholes and ensue with predatory practices. I think it is disgraceful.
6 years ago
Reply from Oscar
Hi Brendan, we’re sorry to hear you’re frustrated. It sounds like there may be a bit of confusion happening. Please be aware that premiums never change mid-year unless you have a subsidy from the State that is adjusted by them. While we did increase the premium price of some plans for the 2018 plan year as a result of the rising cost of health care services like doctors, hospital care, and drugs, the premium will not be subject to change again until the 2019 plan year. Rest assured that a minimum of $0.85 of every $1 we receive in premiums is spent directly towards health care claims for our members, the other 15% is used for our operating costs.
Oscar is an EPO (exclusive provider organization) which means that, with the exception of emergency care, we only cover services with in-network providers. This information is included in all of the plan documents you received upon enrollment. We also do not offer any adult or vision services on our health plans. We’re always here to help you understand your plan and benefits, please don’t hesitate to reach out at 855-OSCAR-55 and we’ll be happy to answer any questions you have.
Oscar is an EPO (exclusive provider organization) which means that, with the exception of emergency care, we only cover services with in-network providers. This information is included in all of the plan documents you received upon enrollment. We also do not offer any adult or vision services on our health plans. We’re always here to help you understand your plan and benefits, please don’t hesitate to reach out at 855-OSCAR-55 and we’ll be happy to answer any questions you have.
Feb. 22nd, 2018
Francisco Bell, CA
This insurance is of no value to me. The plan that I had cost over 220 dollars and the deductible was over 4,000 dollars. It included no coverage what so ever unless you had already paid over 4k in medical expenses. At least with previous insurance they gave me 2 urgent care visits and a checkup. This insurance offers nothing. What a rip off. I don't recommend it for anyone. Even if you have obama care, it is junk. In fact, I think it is because of obama care that insurance companies get away with this because obama care subsidizes it.
Customer service was quick on the phone when I called but guess what? the doctors listed on their site don't want to take the insurance because of high deductible even when they are listed on their web app as providers.
Also online support cannot answer cost of blood work or services, they say they don't know because it is a negotiated rate. It is a total scam. Obama care is like free money to the industry and why would a negotiator negotiate in your favor if they have no stake in anything (because free money).
Oscar was not able to deliver any value to me. Money down the drain. I am upset.
6 years ago
Reply from Oscar
Hi Francisco,
We’re sorry to hear you feel this way. A deductible is the amount you pay for non-preventive covered services prior to your insurance provider contributing. If you’re on a plan with a deductible, you will be responsible for the full negotiated rate of non-preventive services. All of this information is provided on our website upon enrollment as well as included in your welcome kit that was sent after you enrolled. Please be advised that all Oscar plans cover preventive care in full prior to the deductible being met (such as an annual physical with an in-network primary care doctor). For more information on your fully covered preventive benefits, give us a call at 855-OSCAR-55 and we’ll be happy to review this with you.
As for providers not accepting Oscar because of the deductible, please give us a call and let us know which providers told you this and we’ll be happy to reach out and educate them. Our network is non-discriminatory and providers are in-network with us for all of our plans, not just some. Let us know the specifics and we’ll certainly get in touch with them to rectify this.
Unfortunately cost estimates are difficult to provide for two reasons. While we typically know why we're seeking care (maybe for a general check-up or a specific concern) we don't always know the kind of care we're going to need. Even when we do know the care we're seeking, the treatment is provided as a part of a care episode and may include other supporting services we're not anticipating. For example, if you go to see your provider for a cough, you will expect to pay for the office visit; however, diagnostic tests administered within the visit - such as breathing tests, labs ordered, or prescriptions sent may result in additional charges. Moreover, the charge you incur will vary depending on the setting in which you see a provider as well as that provider's specific credentialing and qualifications. While we are committed to providing cost transparency when and where we can, these factors make cost estimates hard to pin down. Above all, we want to make sure we're providing you an estimate that we can stand by so that you can make a decision with confidence and would never want to provide an estimate that could be inaccurate.
We’re sorry to hear you feel this way. A deductible is the amount you pay for non-preventive covered services prior to your insurance provider contributing. If you’re on a plan with a deductible, you will be responsible for the full negotiated rate of non-preventive services. All of this information is provided on our website upon enrollment as well as included in your welcome kit that was sent after you enrolled. Please be advised that all Oscar plans cover preventive care in full prior to the deductible being met (such as an annual physical with an in-network primary care doctor). For more information on your fully covered preventive benefits, give us a call at 855-OSCAR-55 and we’ll be happy to review this with you.
As for providers not accepting Oscar because of the deductible, please give us a call and let us know which providers told you this and we’ll be happy to reach out and educate them. Our network is non-discriminatory and providers are in-network with us for all of our plans, not just some. Let us know the specifics and we’ll certainly get in touch with them to rectify this.
Unfortunately cost estimates are difficult to provide for two reasons. While we typically know why we're seeking care (maybe for a general check-up or a specific concern) we don't always know the kind of care we're going to need. Even when we do know the care we're seeking, the treatment is provided as a part of a care episode and may include other supporting services we're not anticipating. For example, if you go to see your provider for a cough, you will expect to pay for the office visit; however, diagnostic tests administered within the visit - such as breathing tests, labs ordered, or prescriptions sent may result in additional charges. Moreover, the charge you incur will vary depending on the setting in which you see a provider as well as that provider's specific credentialing and qualifications. While we are committed to providing cost transparency when and where we can, these factors make cost estimates hard to pin down. Above all, we want to make sure we're providing you an estimate that we can stand by so that you can make a decision with confidence and would never want to provide an estimate that could be inaccurate.
Feb. 22nd, 2018
Jessica Pompton Lakes, NJ
I enrolled my parents into Oscar and I feel terrible about it. At the time of enrollment, the market place website did NOT say thy were responsible for FULL PRICE visits/tests/etc until they met their deductible. What is that? My parents pay for full contracted rates for visits and now my father needs to see his doctor frequently. Once he meets his deductible, they'll cover 50%. Seriously? This was not on the website. I wish I could replace their place but unfortunately I will have to live with this regret for the entire year. Free incentives? None of them make up for what they have to pay. Also, everytime I search for a doctor on the website, 90% of the time, the doctor is not really the type I searched for or their office info is outdated. It gave me a MD that was 1 mile from my house but in reality, that MD hasn't been in that office for over 10 years. Please hire me so I can update your system.
6 years ago
Reply from Oscar
Hi Jessica, we're sorry to hear your unhappy with your parents' plan choice. All of our plan structures can be found on our site here: . For more in depth information, you can click "Compare plan features" for detailed information on how coverage on each plans work. As for incorrect data when searching for a doctor, we do our best to keep all of our information up to date, but sometimes contract information that provider offices send over to us is not always up to date. In these cases, just give us a call to let us know what was incorrect about the information and we'll be happy to escalate it internally to be updated. We're also always here to help you understand your benefits, so please don't hesitate to reach out to us: 855-OSCAR-55.
Feb. 16th, 2018
Heather McCormick Austin, TX
BEWARE THIS COMPANY!!!! I NEED CANCER SURGERY AND THIS COMPANY WON'T GET ME TO A SURGEON. I was diagnosed with melanoma (skin cancer) by an Oscar network dermatologist and told to get scheduled right away for a resection of melanoma and sentinel lymph node biopsy with a surgical oncologist. I live in Austin and there are plenty of qualified surgeons to do this, but not one of them is in Oscar's network, which tells you how inadequate their network is. First Oscar referred me to doctors who only do breast cancer. Then they again referred me to two more inappropriate doctors who do only endocrinology and breast cancer--obvious from their bios if Oscar had bothered to read them or call. Their latest third option now is to send me to a hick town in Taylor, TX 75 miles away, with a doctor who specializes in pancreatic and liver cancers but does other stuff (because it's a small town), and who doesn't have surgical availability for weeks, rather than find me an appropriate doctor who deals with melanoma every day and can do the surgery timely. I even offered to go to Dallas or Houston or another metropolis if I had to in order to have an appropriately qualified doctor and have my surgery timely. But Oscar can't seem to manage that either, or to authorize an out of network surgeon here in Austin, even though I would be paying some or all out of pocket from my high deductible. They give you a "case manager" who can't authorize anything, and then when you ask to speak with someone who can, they tell you the authorization people don't speak to customers. And then random people who know nothing about your case text you inappropriate physician referrals instead of your case manager managing anything. Zero urgency, zero competency, zero caring that I am not getting the surgery my physician told me to get promptly. This is how you will be treated when you have CANCER people. Stay away from this company at all costs!!!
6 years ago
Reply from Oscar
Hi Heather,
We’re very sorry to hear this, thank you for bringing this issue to our attention. Due to privacy laws, we’re unable to discuss the specifics of your care or private health information here, but our representative Katie along with nurse Elizabeth, are working to bring this to resolution ASAP. They will be keeping you updated on the process as well as next steps. Please don’t hesitate to reach out to them with any questions or concerns. We apologize again for the negative experience.
We’re very sorry to hear this, thank you for bringing this issue to our attention. Due to privacy laws, we’re unable to discuss the specifics of your care or private health information here, but our representative Katie along with nurse Elizabeth, are working to bring this to resolution ASAP. They will be keeping you updated on the process as well as next steps. Please don’t hesitate to reach out to them with any questions or concerns. We apologize again for the negative experience.
Feb. 6th, 2018
lori North Royalton, OH
Signed up with Oscar on 12/17/2017. Still waiting for welcome kit and insurance card. Was told it has been sent twice. They are sending again should take 5-6 days from NY to Ohio, really!! Would not overnight it. Would not cover the Lyrica that I have been taking for almost year, but would cover gabapentin. I took gabapentin before and did not work for me. They won't cover because because of cost, Lyrica is a name brand and has no generic brand. It's all about cost, not what works for you. They require prior authorization from your doctor on just about everything. If your dr. writes a prescription then you need it, why would your dr. need to say it again that you need it. Prior authorization's take forever with this company I believe they do it on purpose so that you will give up. Many drugs they will only cover for example 15 pills for 25 days when you dr. prescribes 30 pills for 30 days. They are an insurance company not a medical professional. Another medication I am prescribed needed a prior authorization per their drug company, CVS caremark, although Oscar said no prior authorization was needed and Oscar sets the policy. Spoke with two representatives at CVS caremark and one, Karen, spoke generically about Ohios new law which has nothing to do with my policy or prescription from my doctor, the other representative, Crystal, asked me if I had taken this medication before. Crystal has no right to ask me these types of questions, she is not a doctor, nurse or in the medical profession. What bearing does my answer have on if Oscar will cover the medication. I will tell you NONE . I am sorry that I signed up for this insurance. Their website is geared to millenials you do not even have insurance.
6 years ago
Reply from Oscar
Hi Lori, we’re sorry to hear you’re frustrated. Due to privacy laws, we're unable to discuss the specifics of your private health information here, but we're happy to address your general concerns. Some medications do require prior-authorization for coverage or certain quantities. This means that the prescribing doctor needs to submit documentation through CVS Caremark, our prescription partner, indicating that the prescribed medication or quantity is medically necessary. Once the prior authorization is received, it will be reviewed by a clinical team then approved as long as it is indeed deemed to be medically necessary. Any prior-authorization requirements will be listed in our online search. To access this information, you can follow the following steps: visit > enter your plan type and location > using the dropdown menu on the left, toggle the search feature to "drugs" enter the medication you're looking for. From there, any quantity limits or prior-authorization requirements will be listed. We also apologize that you had a negative experience when you contacted CVS Caremark. If you reach out to us at 855-OSCAR-55, we’ll be happy to look into this and escalate the issue as needed. As always, please don't hesitate to reach out to your concierge team with any questions or concerns.
Feb. 6th, 2018
Santhosh Jacob San Antonio, TX
I have never seen a insurance change its billing several times after the service was performed. My wife gave birth to our son last January. They covered all the expenses. Later in NOVEMBER, i get a bill for 15,000 because my son was taken care of by out of network doctors in the NICU which I had no idea was being done. How was I supposed to know that? My son also needs a hearing aid. They had a written statement stating that they will cover 100% of the hearing aid price. They then bill us months later sayign we have to cover 10 % of the cost which was about 500 dollars.
I wish I could choose a better insurance company. I am unfortunately stuck with Oscar because of obamacare. Please help me if you guys have a heart. I have been through tremendous stress on trying to come up with the money to pay these bills.
6 years ago
Reply from Oscar
Hi Santhosh, we're sorry to hear this! Due to privacy laws, we're unable to discuss the specifics of your family's private health info here, but please don't hesitate to reach out to us at 855-OSCAR-55 or at and we'll be happy to look into this. Please be aware that Oscar never bills members for anything other than premium payments. If you're receiving a bill from an out-of-network provider, it's possible that they never submitted a claim to us for payment and we can reach out to them to coordinate this. Give us a call and we'll be happy to help in anyway we can!
Jan. 31st, 2018
Korey Kingston Springs, TN
Warning: If you want an insurance company overrules what your Dr. prescribes Oscar is for you! I am very unhappy with Oscar the short time I have been with them. First off, I spent 3 hours of my morning trying to understand why my prescription is not being filled. The reason is took me 3 hours is because their customer service technical issues dropped my call every time I called. Finally, when I spoke with someone they informed me that another company handles their prescriptions. This person from the prescription company said that Oscar will only pay for the 60 out of the 90 pills of adderall I'm prescribed per month. Note: I've been taking this prescription for over 8 years. They said it was because it was an Opioid. I indicated to the rep that this wasn't an opioid and she changed her tune that this was a controlled substance. I'm beyond baffled how an insurance company can decide how much medicine I should be prescribed over a medical professional. Please note that none of this was ever explained to me in my benefits prior to enrolling with Oscar Humana. Please reconsider the amount of money you will supposedly save switching to Oscar. I will be cancelling our service and changing to Blue Cross for myself and my employees.
6 years ago
Reply from Oscar
Hi Korey,
We apologize for the frustration! We did have a brief technical issue on January 15th that resulted in some calls dropping, but this has since been resolved. We're very sorry for the inconvenience! Due to privacy laws, we're unable to discuss the specifics of your private health information here, but we're happy to address your general concerns. Controlled substances generally have a quantity limit for coverage. This means that if an amount beyond the designated quantity limit is prescribed, it requires prior authorization from a doctor. All this means is that the prescribing doctor needs to submit documentation through CVS Caremark, our prescription partner, indicating that the prescribed quantity is medically necessary. Once the prior authorization is received, it will be reviewed by a clinical team then approved as long as it is indeed deemed medically necessary. Any quantity limits will be listed in our online search feature. To access this information, you can follow the following steps: visit > enter your plan type and location > using the dropdown menu on the left, toggle the search feature to "drugs" enter the medication you're looking for > Once on the search page for the medication, toggle the dropdown menu to reflect the prescribed quantity. From there, any quantity limits or prior-authorization requirements will be listed. Apologies again for any frustration! As always, please don't hesitate to reach out to your concierge team for help–you shouldn't hit that call issue again!
We apologize for the frustration! We did have a brief technical issue on January 15th that resulted in some calls dropping, but this has since been resolved. We're very sorry for the inconvenience! Due to privacy laws, we're unable to discuss the specifics of your private health information here, but we're happy to address your general concerns. Controlled substances generally have a quantity limit for coverage. This means that if an amount beyond the designated quantity limit is prescribed, it requires prior authorization from a doctor. All this means is that the prescribing doctor needs to submit documentation through CVS Caremark, our prescription partner, indicating that the prescribed quantity is medically necessary. Once the prior authorization is received, it will be reviewed by a clinical team then approved as long as it is indeed deemed medically necessary. Any quantity limits will be listed in our online search feature. To access this information, you can follow the following steps: visit > enter your plan type and location > using the dropdown menu on the left, toggle the search feature to "drugs" enter the medication you're looking for > Once on the search page for the medication, toggle the dropdown menu to reflect the prescribed quantity. From there, any quantity limits or prior-authorization requirements will be listed. Apologies again for any frustration! As always, please don't hesitate to reach out to your concierge team for help–you shouldn't hit that call issue again!
Jan. 16th, 2018
PDrew Austin, TX
So far not impressed. Nightmare really. Switched to Oscar effective Jan. 1, 2018. Went for my annual woman wellness exam on Jan. 10. Doctor found lump in breast and ordered mammogram, pretty routine next step - I'd have had a mammo even if she didn't find lump given my age. Turns out Oscar is not contracted with anyone in my market to do the more advanced mammo given the finding in a routine exam. Isn't this why we have these routine, yearly exams? Spent hours on phone with Oscar and they even called providers in town to locate one and when they transferred me, turns out they don't do this type. Arrgh. So frustrating. Just need to know if this is cancerous and can't find anyone to do the mammo because I'm with Oscar.
6 years ago
Reply from Oscar
We're very sorry to hear that you've been having trouble finding in-network options! Qiana, one of our supervisors, has reached out to you to help. Please don't hesitate to let her know if there's anything else we can do to assist!
Jan. 12th, 2018
Sharon Solomon San Antonio, TX
Kristin A. is a very awesome nurse she answered all my questions and goes above and beyond to get everything my mother need. Thank you for all you do.
6 years ago
Bruce Thomas Richardson, TX
After my Oscar insurance was denied at a Tom Thumb last year for a flu shot (which is supposed to be an Oscar network pharmacy), I was very curious to see if that was a one-time glitch (a flu shot after all is a ACA government mandated benefit), or Oscar's usual practice. In late August, after providers and insurers were heavily advertising "free flu shots," I took my Oscar insurance card to a local Walmart for a shot. Nope; not even enough info on the card to process a claim, I was told. Then I took my card to Tom Thumb. Similar response; not enough info on the card to process a claim. But this very helpful pharmacist offered to call Oscar. After a considerable time on hold and then talking to an Oscar rep, she tells me that the rep said that Oscar would pay for the vaccine, but not for the administration of the shot. But the rep couldn't explain how she was to break that out; she would need to call back Monday she said. Obviously that was bad information, so then I went online. Yep, the Oscar website says flu shots were covered at no additional cost. So I asked the online "concierge" "what you have to do to get the flu shot. First response - the website is out of date; we stopped paying for flu shots last Spring; sorry you missed the deadline. I protested this ridiculous response, then was told maybe that answer wasn't right after all, but he'd have to get further information to be sure he gave me the right information. (I guess you just make it up the first time?) Most of September goes by and no follow up, while every reputable ACA insurer is busily paying for flu shots all over the country. Obviously I'm just getting the run around from Oscar, so I go ahead and pay for my flu shot at a Walgreen's while in the store for other purposes, and plan on submitting a claim manually. A week or so later, I finally get a follow up from the "concierge" that I can now get a "free flu shot"; just don't go to a Walgreen's! Incredible. All this just to beat me out of a flu shot. I can't imagine what would happen if I actually needed serious medical care. We will definitely switch health insurance carriers next year. Even if we have no choices, I would self-insure and pay a tax penalty before wasting my money on Oscar any further.
6 years ago
aaron h Rowlett, TX
Oscar is a complete rip off. they claim you get 1 free visit a year but really don't specify (but I am sure in small print somewhere) that that 1 free visit is only for a physical and/or lab work. me & my husband paid $700/month - neither went to the dr ever - and the 1 time my husband goes for a sinus infection, Oscar doesn't cover it and we get billed.
I call them and they say they don't cover 1 free visit a year if you are sick. are you kidding me!?! so people, just an fyi - if you get a cold or something, you don't get any coverage. I would drop the insurance if you are a well person since you shouldn't be taxed for not carrying it now...
6 years ago
Ken Blackwell
Absolutely the worst Health Care Provider in the US. Period. We've had nothing but issues. Their customer service is the worst part. Let me just say this. I enrolled, paid and was waiting for service to kick in for a month. A month after I enrolled and paid I was not in the system. Every time I called it took hours...literally hours and multiple calls to get to a human. They lied about dental coverage and then called my wife & I liars. Oh yeah, literally called us liars. Rude worthless people that make excuses at every turn, yet some how it always ends up our fault there was an issue. By the way, all this BS and we have yet to file a claim. 4 months in and still the worst experience I've had to date. Not just with health care. In general!!!!!
7 years ago
Tim B Newark, NJ
I have a Family of 4 and unfortunately have Oscar Gold. Truly the worst Health insurance company. Premiums continue to skyrocket -currently paying 1500.00 a month. Premiums increased 60% in 1 year - deductibles to meet for the year 2016 are up to $6000.00. We recently received notice that they are cutting their network back. I have all but one doctor remaining in the Oscar network. Some of my doctors I have been with for 20+ years. They sent us a letter last month Stating our current plan will no longer be avaiible for 2017. The new plan that we will have to get will have a yearly deductible of 8,000 and still do not know what the premium will be!
This month they sent me a fantastic letter stating that on December 31,2016 I will not be eligible for New York State exchange insurance.
To top all of this off. My wife was just diagnosed with aggresive cancer that is affecting the an organ now. I am currently seating in the out patient area of the hospital trying to get a port placement for her chemo treatment. This is something that was suppose to be preformed 3days ago. I arrived at the hospital at 6am Thursday and the nurses started to prep her for surgery, so she can receive her first treatment of chemo. At 6:30am the nurse has made me aware that they have nto recieved confirmation from the Insurance company still. They tell me they have to stop until they get in touch with Oscar insurance and they do not open till 8am.
The good news is that I did submit an application for expensive insurance carrier which has extremely great coverage. I will struggle to pay the premiums, but how can I put a price on my wife's care !!!! This is a true event!!
7 years ago
Iman Saleh
I went to one gyno visit for an annual checkup after being with Oscar for over a year, and they already are trying to scam me by making me pay for what was supposed to be a free annual checkup. I did everything right, picked one of their network doctors, and yet now I'm stuck in this red tape hell and the issue is not resolved, the doctor claiming Oscar won't pay for the HPV preventative test (which I didn't even ask for, but is supposedly routine) while Oscar claims in does pay for it, but that the doctor did not enter it as a preventative HPV test. The doctor said yes I entered it as preventative, and insisted on a three-way call. Finally after hours of getting passed around the Oscar people said oh gosh actually yeah looks like it was listed as preventative--AND YET IT'S STILL NOT OVER. They have to have a committee decide or something. It's an issue of $124 for something I was promised would be free. I've paid this company over $5,000 at this point, am healthy with no issues, went to one checkup and they're fighting me over $124.
7 years ago
Jim New York, NY
I have had Oscar for a year and was satisfied until July when my doctor dropped out of a group and Oscar refused to admit him to their network. So, I must pay $100 to see my family doctor, which is something I can live with. However, Oscar is dropping the entire NYU Network at the end of 2016 and they dropped the Cornell-NY Hospital network in March 2016 so I am reluctant to stay with Oscar as they may drop more doctors and hospitals during the year 2017 - they can drop providers but once one is committed to them, the subscriber is married to Oscar for an entire year - not fair. Their customer service gives me bulls**t every time that they are forming their own network but I wonder if Oscar will even last the entire 2017 year a smaller and smaller networks will eventually lead to going out of business. Therefore, if I stay with them in 2017, it will not be for a platinum plan but may just take a gold plan as I don't really know too much about the other companies. But right now, I am investigating all and every option out there for me in the NY area. I feel that by cutting their network options in more than half, Oscar is telling its subscribers to go to h*ll.
7 years ago
Peter Lorre Spring Valley, NY
A startup designed to profiteer off of the affordable care act. Bumped me from the catastrophic plan, as I turned 30, resulting in a 333% increase in premiums and an increase of 300$ in deducible. If that wasn't obscene enough they're slashing their network for 2017 as well as hiking premiums and deductibles across the board. They flood the subways with colorful cartoon advertisements in an attempt to snare as many people as possible and then provide virtually no coverage whatsoever, Maybe they could reallocate some of their advertising budget into providing a decent service. American medicine is a grotesque show of human greed and indecency and Oscar is the perfect posterchild.
7 years ago
Liz New York, NY
Oscar used to be ok, now totally horrendous. Horrible and useless customer service, things that are covered on paper, aren't necessarily covered in practice, and now the network of providers has shrunk drastically, so finding a decent doctor who would take this insurance is mission impossible type of thing. AND their rates have just gone up too.
So, all in all, they don't want to pay, they don't want to help, they don't care if you have any healthcare-related issues. The only convenient thing is the app, which doesn't work that flawlessly, especially the steps program... they just sync as many steps as THEY would prefer, so even if you did walk over 10,000, the app might just show 9,000 or something, so you don't get your dollar.
Wouldn't recommend this health insurance, as it is expensive, offers small network, has really bad customer service and won't cover pretty much anything.
7 years ago
Debbie Christine Tjong Astoria, NY
This is the worst health insurance company I've had to deal with. My doctor left the network in the middle of the year, but I had to have follow up appointment with him. I applied for a Continuation of Services and was approved on June 20th 2016. Upon receiving this information by phone (both my provider and I), we proceed to schedule an appointment for July 5th. Shortly after, we received a letter saying that the Continuation of Services expires on June 30th 2016. What were we suppose to do with such a short amount of time? My provider and I both called it to ask about this because it seemed like a mistake, and they said that they would issue another letter to extend the dates to cover the appointment on July 5th since that was made AFTER we received the approval. THAT NEVER HAPPENED. It also mysteriously disappeared from the notes they had on file. After the July 5th appointment, my doctor told me I have to have surgery on my throat and we again tried to extend continuation of services. this time it was denied. My only solution now is to wait till next year when I switch insurance. I can't work, because I cannot use my voice and I need surgery to be able to use it. Now I'm stuck with a bill of $1783 for the doctor's appointment made on July 5th because Oscar would not cover it, stating that the Continuation of services only last 3 months from when the doctor's left the network. That is ridiculous.I applied for the continuation of service beginning of June, and did not get approval till late june, and it expires end of June??! That does not make any sense. It seems that Oscar is just trying to wiggle their way out of paying for bills. My provider only made the appointment for me because we got the call that the continuation of services was approved. I'm at a loss of what to do now because I cannot receive health care i need, and I'm stuck with this bill. DO NOT GO WITH OSCAR. When it really counts, they do not help. I've spoke today with Margery from member's services who, aside from reading back the notes on file to me, could not help me, could not direct me to Jennifer, with whom I've spoken with before, could not transfer me to a supervisor, and seemed offended when I tried to ask her for her name. No empathy, no help at all. I feel bad for everyone who's sick and needs healthcare and have to deal with people and a company that don't care about the health of their members first.
7 years ago
Christine Kessler Pierce San Antonio, TX
Signed up for Oscar Gold plan due to need of medical equipment. Trying to order a wheelchair since January 2016 and STILL getting the run around. They've been caught in lies blaming everyone else for the delay. They don't pay for most medications, including my son's inhaler or any kind of inhaler. They call it an uncovered script that is out of network and all inhalers are out of network - so if you have asthma DON'T CHOOSE OSCAR!! My Dr. said he is having the same issue with his other patients who have this insurance. THEY DON'T HELP THE OSCAR MEMBER - THEY ONLY TAKE YOUR MONEY, LIKE MY $712 A MONTH. SHAME ON THEM. OSCAR IS A RIP OFF COMPANY IN MY OPINION - However, they did pay for my 24 hour hospital stay for a minor procedure after I paid the first $3,000 so I will rate them a 3. I am very disappointed with Oscar - more because their phone/email assistants have "canned responses" to why they are dragging their feet on getting my son his wheelchair. Their delay is physically hurting my son. I'm thinking of seeking an attorney for the irreversible damage they are causing my son to incur.
7 years ago
Emilie Ladera Ranch, CA
I was initially sold on Oscar due to their marketing towards millennials and claims to be different than other health insurance companies. However, from the first day that my insurance plan with Oscar went into effect, I realized that they are all smoke and mirrors. It took me hours of calling providers listed on their website as "in-network" to find a doctor that actually took Oscar insurance. Finally, after finding a doctor that took Oscar, there were issues with figuring out which services were covered. Literally every single time I have contacted the customer service phone number, I have received complete misinformation from customer service representatives. They are clueless about everything. I am currently pregnant and after contacting Oscar representatives I was specifically told where to order a breast pump from, and when I went to place the order, the company said they don't work with Oscar!! Of course this was frustrating, but imagine my frustration, when, 7 months pregnant... And now the SECOND company Oscar reps told me to order from also denied me for a breast pump saying they are not contracted through Oscar! The severe lack of communication across the board, from educating physicians offices they are listing as in-network to providers of government mandated medical supplies to communication with customers... Oscar should be embarrassed of themselves for how horrible their service is.
7 years ago
Annie Marter New York, NY
I had to cancel my service because I got a new job with a new plan, and received a bill after my insurance was terminated- when I tried to pay the bill, I was not able to log in to the site nor access the billing information because my account was no longer active. When I told this to the operators who answered the call, they told me "there was nothing they could do" and were not able to provide me with the information as to how to pay my bill. All I was trying to do was pay my bill. It took about 2 hours to resolve this ridiculous issue. Not to mention, their deductible is preposterously high and there are no good doctors that accept their plan. THIS IS THE WORST HEALTH INSURANCE I HAVE EVER HAD.
7 years ago
Marla Pinsky New York, NY
Terrible insurance company. If you call you will wait on hold for long periods of time. You will get hung up on and transferred around. Forget trying to get actual medical care. NO ONE takes Oscar. When I was first looking for a primary care physician I spent 6 hours calling doctors from the list that was provided on their website. 3 of the phones were disconnected. I called a realty office, a florist and an auto body shop. I thought maybe I misdialed. No such luck. One doctor on the list had didn't work at the practice at the number provided for 3 years. Oscar hasn't even been around that long. So after calling trying to find a doctor I called Oscar customer service livid. I said I spent the day calling to try to find a doctor and was unsuccessful and that they were going to have to find me a doctor. The next day I get an email with 3 phone numbers on it. I call them. One was a rheumatologist. One was a pediatrician. only one was a primary care doctor. When I called the primary care doctor they said they were taking new patients but they couldn't get me in for a month. I said thank you no. I called customer service again. They at least said they were sorry. To make a long story longer I did finally find a primary care physician. Oscar did find the doctor and they did set up the appointment. I am no longer with that doctor because a full blood panel isn't covered at by Oscar from the lab they use. I am financially unable to pay over $300 for a full blood panel. The prescription care is laughable. I was prescribed eye drops and an inhaler for allergies. The eye drops weren't covered at all and the pharmacy said they would cost over $300. The first inhaler was going to cost over $200. Apparently seeing and breathing isn't a priority for Oscar insurance. They just want my money.
7 years ago
Daniel Wilson Brooklyn, NY
I spoke with my provider and they had a list of tests I needed that were approved by Oscar but that they could only give me their "standard" prices on, not the negotiated prices. For that I would have to call Oscar.
So I did.
Talking to Oscar the woman I spoke with just kept insisting that those costs were not available. Which seemed strange as they are the company that negotiated them. So they exist, but they just choose not to share them. So now, I have no way of knowing how much I will have to pay for these procedures in advance which is ridiculous. What other product/service can you be refused knowledge of the price before you buy?
They did offer to give me ballpark prices for procedures which I was NOT having done. Which was, as you can imagine, extremely helpful.
7 years ago
Maria Brooklyn, NY
The only good part about Oscar was the Dr on call feature, which I took advantage of when I knew I had an ear infection and needed antibiotics. For anything else, beware. I had the cheapest most basic coverage because I'm generally healthy person. One day, I had to call 911 to go to the ER for what I thought was appendicitis. The ER doctor wasn't sure but was worried, so they admitted me for observation and further testing. At first, Oscar only covered my ambulance ride and told me I should have been treated outpatient, that my life was not in danger. Clearly my life was in danger if they felt it necessary to admit me. I fought their lack of coverage, which was a huge time and energy suck. Customer Service reps would often open my file and end up saying "You know what, I really want to investigate this further. Can I call you back tomorrow?" and then never call. Oscar ultimately ended up with them covering my stay (I mean, at least I think they have...with Oscar, you never know when you're going to receive a new EOB or bill!)
7 years ago
[email protected] Quinlan, TX
Not helpful when you call them. make excuses not solve problem, unable to get on oscar website and they suggest you try other programs to access their site, or that the public servers are not working. Total bull. Not helpful when trying to fill first drug order for the year - they have collected money for 6 months with no pay out...now they are not interested in correcting the website problem so I can get online to order my meds. Did finally manage to get them to give me the phone number to caremark cvs to do mail in medication renewal..Course I will be without my medications for a couple of weeks because of this.
7 years ago
George cancelled OSCAR Los Angeles, CA
OSCAR Health Plan in CA is nothing other than a list of providers that don't even know they signed up to accept the plan. Impossible to get any doctors to accept the plan in spite of their supposedly being a provider. OSCAR customer service is always apologetic and says their new in CA, but at the end of the day, it's the members who pay the horrible price of not getting care when and where they should. Additionally, the customer service is on the east coast and totally unaware of the logistics in CA which results in their trying to help send members to doctors, in some cases, hours away. Call backs from complaints and resolutions are two days from the day you help but you'll be luck to get a call back to resolve the issue completely. This plan should be rejected from being offered in CA. It's been an awful experience all the way around.
7 years ago
Eug Sli San Antonio, TX
Totally terrible company. In Texas there were only 4 endocrinologists listed for San Antonio, a city over 1 million people. One, when called said they were mislabeled and not endos, another only took existing patients.
I had a gastric emptying study cancelled twice day before procedure because it was suddenly "private pay", same for a nerve conductivity study and 1 appointment with one of their listed endos. I paid $600 out of pocket for a gastric emptying test out of need, and now?
I went to pick up insulin from Walgreens today. Doctors office verified it was a tier 2 preferred drug. I checked Hioscar.com and same thing. Tier 2 preferred are $35 each. Walgreens charged me $100 and $70 and said it was oscar's formula. I call and of course there's no CS after hours, I even posted to the bbb and shocker.... They're not accredited.
I can not imagine how people in need are surviving. Such is the greatness of America I
8 years ago
Roman Livingston, NJ
My wife an I are both 57 years old, and bought Oscar plan after selecting it from the marketplace. We pay $1,250 a month for the two of us. The particular plan we selected outlines "free" primary care visits and $50 co-pay for visiting specialists that are in their network.
My wife needed to visit an ophthalmologist specializing in retina disorders. We carefully checked and confirmed with Oscar that the doctor is a part of the network. In a month we received a bill from the doctor's office for $136 for services that Oscar didn't cover, that are in addition to $50 co-pay. Spoke with Oscar, and they explained that the procedures were diagnostic in nature and therefore are outside the scope of covered procedures. I suggested to them that going to a specialist is by definition diagnostic, and asked them to give me an example of a reason to go to a specialist so that they would not need to diagnose the issue. Specifically, we suggested that an eye doctor checks eyes using various machines that do not perform and "preventive" procedures. So what is the $50 co-pay intends to cover? They said is it for the office visit. We told them that we went to the doctor, not to the office, and suggested to clarify the scope of covered procedures with an "in the network" specialist, and asked to show to us specific language we should have been aware of when buying insurance that would clearly distinguish between services that are covered and not. Al they kept repeating is that $50 is for the office visit (I suppose there would be a different charge if the doctor would see us in a garage as opposed to an office). And that is all after the humongous monthly premiums!!!
Be aware of what you are buying because Oscar's marketing is deceiving!
8 years ago
Roxanne Brooklyn, NY
They are great until you get cancer!
I was diagnosed with breast cancer in November 2015 while I was insured by Oscar Health. My breast surgeon was an in-network provider with privileges at Mount Sinai Beth Israel Medical Center in New York City. At the time, Oscar Health had no plastic surgeon that specialized in breast reconstruction with privileges at Mount Sinai Beth Israel Medical Center in their network. In other words, Oscar Health did not have an in-network provider with the appropriate training and experience to meet my needs.
As I understand my position as a health care consumer, I have the right to go out-of-network when my health plan does not have an in-network provider suitable for my needs. To that end, on December 15, 2015, my breast surgeon's assistant submitted paper work, and supporting documentation, on my behalf to Oscar Health requesting an out-of-network authorization so that I may see a plastic surgeon who specializes in breast reconstruction, and has privileges at Mount Sinai Beth Israel Medical Center. I had breast cancer and this was a timely matter that needed to be handled quickly.
In the following days, my surgeon's assistant and I repeatedly called Oscar Health to inquire about the status of my out-of-network request. The customer service agents at Oscar Health frequently put us on hold for long periods of time, and often our calls were disconnected entirely. Repeated requests to speak with a supervisor were declined, and promises were made that a supervisor would return our calls. No supervisor ever called. As the days wore on, I became more and more anxious about the status of my request. I could not move forward with my breast cancer treatment without first consulting with a plastic surgeon who specialized in breast reconstruction. I feared it would be weeks or months before I could move forward with treatment, meanwhile I continued to live with cancer and the uncertainty of my diagnosis.
Ultimately, I was compelled to pay $450.00 to consult with a plastic surgeon on December 24, 2015 while I was still covered by Oscar Health. I was desperate to move forward with treatment. To this day, I am still waiting for that authorization and the subsequent reimbursement of part or all of the $450.00 consultation fee. It is fortunate for me that I was able purchase a new health care policy from a different insurance company and move forward with my treatment. I have no doubt that if I were still insured with Oscar Health I would be waiting to receive my out-of-network approval, and I would still be living with cancer. Oscar Health acted negligently, and I venture, unethically, in this matter. I fear for health care consumers who have neither the resources nor faculty to purchase a new policy. They are at the mercy of a negligent company, Oscar Health.
8 years ago
Amy Woodmere, NY
If your not healthy don't use this company! I have an electrical issue with my heart. Only one brand name pill works for me which I have been on for years. I was promised I would be covered and have to pay 60 a month which was fine. Go to refill my pill and they told me it would cost 1800 a month. My dr appealed it, after hours of back and forth and questions. Now they approved my appeal. Once again I go to refill it since its been approved. Now they tell me it's 1,600 a month Bc I will have to pay a Dispense as written penalty! Told me my dr again has to appeal. Basically they are playing games with my HEART pills and my life! Also no eye vision care which who would think to ask? The worst is not being able to get my heart pills to live. Also my EKG HAS BECOME WORSE BC I WAS FORCED ON GENERICS! They lied!!!!! They are still playing games. Who has ever heard of a DAW PENALTY! This has been going on now for 3 months!
8 years ago
Medard Etienne Dacula, GA
So far, we phave been happy with Oscar. It is much, much better than my wife’s insurance .
8 months ago
Max Peterson Austin, TX
Incompetent company, can't even manage to take a small independent practice off their roster months after termination.
They upcharge their patients 200% while paying providers 20% less.
Bad for patients and providers, a headache for practice managers to deal with months after termination.
8 months ago
Reply from Oscar
Hi, thanks for reaching out. We’re very sorry about this experience and we’d like to help. Please send us an email at [email protected] with a brief description of your issue, and we can assist you with this.
Any information sent through email is inherently insecure. If you send Protected Health Information (PHI) and/or Personal Identifiable Information (PII) through email, you do so at your own risk.
Any information sent through email is inherently insecure. If you send Protected Health Information (PHI) and/or Personal Identifiable Information (PII) through email, you do so at your own risk.
Jul. 28th, 2023
Elif Plymouth Meeting, PA
This company is very much a SCAM! I received a recent claim on my account for a telephone care service. After a couple of months, they say, "It looks like you received care from a provider outside the Oscar network, so the care you received with them isn't covered by your plan." Now I DO NOT UNDERSTAND THIS! I used Oscar's own platform to connect with the telecare service. It was OSCAR who matched me with the physician. How come the doctor they matched me with on their platform is out of their network? OSCAR SERIOUSLY FAILED! THEY SHOULD PAY FOR THIS!
1 year ago Edited February 6, 2023
Reply from Oscar
Hi Elif, thanks for reaching out. We’re very sorry about this experience and we’d like to help. Please send us an email at [email protected] with a brief description of your issue, and we can assist you with this.
Mar. 14th, 2023
Lola Aparicio Orlando, FL
THE WORST CUSTOMER SERVICE THAT i HAVE EVER EXPERIENCE IN MY LIFE. WATING FOR A YEAR FOR A CLAIM. MY DAUGHTER WAS RUSHED TO THE HOSPITAL AND THEY DONT WANT TO PAY THE AMBULANCE BILL BECAUSE IT WAS OUT OF NETWORK.. ARE YOU KIDDING??? I CALLED 911!!!! IT WAS AN EMERGENCY... WHO SEARCHS FOR AN IN NETWORK AMBULANCE.....?????????????!!!!!!!!!!!! ITS AN EMERGENCY FOR GOD'S SAKE!!!!! YOU CALL 911 AND THEY SEND AN AMBULANCE PERIOD!!!!!!!!!!!!! I HAVE CALLED OVE R AND OVER ABOUT THIS . THEY DONT KNOW WHAT THEY ARE DOING. INSANE!!!!!!!!!!!!!!!!!
1 year ago
Reply from Oscar
Hi Lola, we’re sorry to hear about this experience and our team would like to learn more about what may have occurred. Please check your inbox for a followup message.
Jan. 3rd, 2023
Victoria Krassa
I wish I could give zero stars. H
Oscar is the worst of the worst, they charge extortionate monthly fees but never pay for any medical care of any kind, they lie outright to you about what they will cover, they send you to sub par doctors for sub par care in dangerous neighborhoods. They are rude and unhelpful when you try to ask questions. I feel traumatized be the entire ordeal. Getting off of this insurance plan at my earliest opportunity.
1 year ago
Reply from Oscar
Hi Victoria, we are sorry to hear that you are frustrated and our team would like to learn more about what may have occurred. Please check your inbox for a followup message.
Nov. 18th, 2022
adam katz Scottsdale, AZ
I honestly do not think they have covered anything since I’ve had them. The premiums were a little less expensive, but there’s not a doctor or dentist that I go to for which they will provide coverage. Coverage on my 2 medications is not available and one of them is for a congenital disease. I cannot find a doctor that they provide coverage for. I’ll be switching come open enrollment.
1 year ago
Reply from Oscar
Hi Adam, we are sorry to hear that you are frustrated and our team would like to learn more about what may have occurred. Please check your inbox for a followup message.
Sep. 13th, 2022
susan nezami Glendale, CA
The main problem with this company is the roster of doctors and facilities in its network, the majority of whom and which are pretty terrible. While administratively Oscar is responsive, unfortunately that can't make up for having to make a choice between mediocre to bad doctors or facilities that illegally try to overcharge with Oscar's inability of do anything about it. My suggestion is to either opt for a PPO or go straight to an HMO like Kaiser. They seem to remain the best. I have been with Oscar this year but I will be switching over to Kaiser next year to avoid any more headaches.
1 year ago Edited August 18, 2022
Reply from Oscar
Hi Susan, we are sorry to hear that you are frustrated and our team would like to learn more about what may have occurred. Please check your inbox for a followup message.
Aug. 10th, 2022
Ted Allen San Antonio, TX
Horrible coverage, and the “concierge team” is a total scam. Expect to be hung up on, spend hours on hold waiting for simple answers that you’ll eventually find yourself. Don’t be surprised when your deductible is $8,000 and they continuously edit out of pocket expenses. Your only doctor will be 100 miles away (I live in a major city). This company is owned by the Ks and it’s definitely a grift. If you enjoy burning money and wasting time on hold, this plan is for you!
1 year ago
Reply from Oscar
Hi Ted, we are sorry to hear that you are frustrated and our team would like to learn more about what may have occurred. Please check your inbox for a followup message.
Aug. 10th, 2022
Scott French Orlando, FL
I actually thought I was getting a hood healthcare plan but all I got was a place collecting my money and denying benefits for my children getting healthcare check ups and shots which are required by schools.
The Healthcare Facility ST Vincent’s Ambulatory Care was a approved facility, but the Doctor they saw wasn’t an approved Dr.
Question is when you go to a facility like this you don’t know which Doctor you will get u til they come in to treat you.
I will be canceling my insurance with them and filing a complaint with the State Insurance Commission.
1 year ago
Reply from Oscar
Hi Scott, we are sorry to hear that you are frustrated and our team would like to learn more about what may have occurred. Please check your inbox for a followup message.
Aug. 10th, 2022
