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A new kid on the block in the health insurance industry, Oscar Health prides itself on doing things differently than the competition. Oscar offers more coverage with less inconvenience. It also provides perks for its customers.
This review will provide more facts about Oscar Health Insurance and look at the pros and cons this company has to offer. This should give you a better idea of whether Oscar Health would be a good private health insurance option for you and your family.
In this review:
- Oscar Health Insurance Background
- How Oscar Health Insurance is Different
- Oscar’s Availability
- What Are the Different Oscar Health Insurance Plans?
- Pros of Oscar Health Insurance
- Cons of Oscar Health Insurance
Oscar Health Insurance Background
Oscar Health was founded in 2012 in New York City as a private health insurance company and startup by Kevin Nazemi, Mario Schlosser, and Joshua Kushner, who is a brother-in-law to headline-maker Jared Kushner, the son-in-law of President Donald Trump.
Since that time, the company has expanded, created various partnerships, and is now valued at $2.7 billion.
How Oscar Health Insurance is Different
With many insurance companies and different health plans available, it can feel like you have to unlock a secret code just to find a doctor who will take you if you aren’t an established patient when you need medical care. And if you haven’t been to that office in more than three years, they might consider you a new patient and refuse to see you if they aren’t accepting new patients.
If you do get a doctor’s appointment, it can be frustrating to pay for that visit and wait potentially a long time before being told you have to see a specialist.
This is one way in which Oscar Health as an insurance provider is different—it makes telemedicine a high priority.
Doctor On Call Via App
If you need to get some medical advice or need help, you should first use the Oscar app to reach the Doctor on Call service the company provides. This service gives you free access to the doctor, and you don’t have to wait for an office to open; it’s accessible 24 hours a day.
While it can’t treat every condition, it will work for basic issues like rashes, the flu, eye problems, colds, and UTIs. Plus, it can allow you to get refills without physically seeing a doctor for some types of medications. That’s good news for policyholders because it can save time and money, and for people who rely on other people for rides to doctor appointments, it can save the headache of lining up transportation.
Help Finding Available Doctors
When you need to physically see a doctor for primary care visits or for some other reason but aren’t sure which one would be appropriate or you don’t already have a doctor, you’ll contact the Concierge team.
You can contact that team, which includes a nurse, to make up a list of doctors who have the availability and experience needed to take care of your problem. They do the legwork to save you the hassle. You won’t spend your time calling 20 names before finding a doctor who can see you.
If you already have a doctor, you can search their name in the app to make sure they accept Oscar insurance. It’s easy to find that information, unlike with some health insurance plans.
If you want to see a specialist, you never need a referral from another doctor with Oscar. You can contact the specialist, knowing the insurance won’t fight your claim because you didn’t get the referral.
Healthy Lifestyle Incentives
If you like to be proactive about your health rather than reactive, you should like the walking incentive they offer. The Oscar app allows you to sync your steps to your fitness tracker, and once you reach your daily step goal, you can earn $1 a day. You can cash that money out in exchange for an Amazon gift card at any point. So you’ll get shopping money for walking around.
Oscar is only available in certain areas right now. For example, in California it’s available in Los Angeles and Orange County as well as San Francisco. In Texas, it’s available in larger cities like San Antonio, Austin, and El Paso. Oscar is available in New Jersey and other major U.S. cities like Detroit. You should check to see if Oscar’s healthcare plans are currently available where you live.
What Are the Different Oscar Health Insurance Plans?
You’ll have four tier choices with Oscar Health. Each plan covers a different amount of your health care costs, with higher monthly premiums for the more coverage you get. The levels are:
- Bronze: covers 60 percent
- Silver: covers 70 percent
- Gold: covers 80 percent
- Platinum: covers 90 percent
Pros of Oscar Health Insurance
Oscar Health is a bit different than what many people are used to with health insurance. It has pros and cons to consider before signing up.
Here are some of the pros:
- Oscar Health has a unique approach to healthcare and places an extra emphasis on wellness practices. Getting $1 a day just for walking may appeal to the more active policyholders.
- It may help fill certain holes in health insurance coverage, such as supplementing your employer insurance and Affordable Care Act (ACA) plans (also known as Obamacare).
- It can be handy for minor health problems because you’ll be able to call health care providers and take care of some business over the phone instead of paying for a trip to the doctor and taking time off of work to go during their office hours.
- Oscar insurance describes mental health as being as important as physical health, so they provide service options in this area as well.
- The app is easy to use and convenient.
- The company places a high emphasis on customer service and gives assistance when it comes to finding doctors.
- Oscar members are eligible for a free annual physical, which will give you a good indication of how your overall health is holding up year after year.
- They are good about announcing their breaking news, such as new features and events, on social media. They make announcements on Twitter, Facebook, and Instagram.
Cons of Oscar Health Insurance
- Even the platinum tier only covers 90 percent of your costs. That remaining 10 percent can be expensive. One major medical problem, something like an MRI, or surgery could result in thousands or tens of thousands of dollars in unpaid medical expenses.
- The company recently decreased the size of their available network by about half. That gives policyholders fewer choices.
- There is still a large amount of legal ambiguity with how the policies work with the ACA.
- If you don’t live in New York, you miss out on some of the benefits of having this insurance, such as wellness events at the Oscar Center, their primary care facility in Brooklyn.
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The Bottom Line
Oscar Health insurance offers decent coverage plans but it is still severely lacking in certain areas, such as the number of medical providers that take their insurance. And it’s still a new company in the health insurance industry, so they may keep tweaking their formula, such as they did with decreasing the size of their available network.
But the company does have some upsides that may intrigue people who are frustrated with having to go to doctors for mild problems that could easily be treated over the phone or those who like to be rewarded for their healthy habits.
If you are interested in learning more, getting a quote from their website is easy. You’ll just provide some basic information and you’ll be able to see what kind of rates you might have to pay.