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The Good
- Positive Customer Reviews
- Plan Options Offered
- Easy Quotes and Plan Comparison
- Helpful Welcome Kit
- Web Account and Mobile App
- Unique Features
- Helpful Concierge Team
- Telemedicine Access
Positive Customer Reviews
Oscar has received many positive customer reviews on BestCompany.com. Reviewers frequently praise Oscar for its concierge team, customer support, and telemedicine access.
Customer Review: Penny Altman from Van Nuys, California
"Oscar has always been there when I needed them. Their concierge team has answered all of my questions and they're always available. They pay their claims without any problems. Good network of doctors available. Overall, I have been very happy with Oscar compared to other insurance companies I have had in the past."
Plan Options Offered
The insurance provider tries to ensure that each Oscar customer finds 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, it'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:
- Classic Plans
- Simple Plans
- Saver Plans
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.
A bronze plan puts the most cost-sharing on policyholders and tend to have a lower monthly premium, while platinum plans put the least and tend to have a higher premium.
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.
Coverage for telemedicine is a rising trend in health insurance, so this offering makes Oscar a competitive insurance provider.
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 for an Oscar Simple plan 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.)
Some 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 and Secure plans are a low premium, high deductible option designed for healthier people who was to save on upfront medical expenses.
Easy Quotes and Plan Comparison
Before becoming a member, potential clients can receive quotes on 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.
Helpful Welcome Kit
After Oscar members pay the first premium, they receive 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.
Web Account and Mobile App
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.
Unique Features
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.
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.
Helpful Concierge Team
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. Each Concierge team consists of a care guide and a registered nurse. This unique model provides customers with additional support.
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. This assistance with scheduling appointments, finding a doctor, and care coordination are benefits of working with Oscar.
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.
The access to a concierge team to help you navigate your health plan and receive the care you need makes Oscar stand out as an insurance carrier. Other insurers offer similar case management services to members who meet eligibility criteria.
Telemedicine Access
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.
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The Bad
- Negative Customer Reviews
- Limited Availability
- No Dental or Vision Insurance
- Limited Plan Types
Negative Customer Reviews
While a majority of Oscar's reviews are positive, it has also recieved a high percentage of 1-star reviews. Negative reviews are common for the health insurance industry. 1-star reviews mention difficulties with communication, finding an in-network doctor in the area, scheduling appointments, and billing issues. These issues are concerning, and Oscar is responsive to these reviews.
As you consider working with Oscar, pay attention to where reviewers are from. If reviewers in your area have good experiences, that's an indicator Oscar may be a good fit. If reviewers in your area are mostly negative, you may decide to work with another company.
Limited Availability
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.
No Dental or Vision Insurance
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.
Limited Plan Types
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.