What Is Oscar Health Insurance?

Oscar Health is a startup insurance company that provides health insurance policies to individuals and businesses. The company is a technology-driven firm based in New York that offers coverage in a limited number of states. Since it was created in 2012, the company has experienced large growth with a network of over 500,000 policyholders today.

The company uses data analytics and claims to be one of the best operations for directing patients to care with in-network doctors to treat specific conditions. Let’s take a closer look at the Oscar Health Insurance company.

Oscar Health

Oscar Health was created in 2012 in the era of the Affordable Care Act. The idea was to provide simple health insurance with a user-friendly approach. Like many health insurers that evolved out of the Obamacare time, the company found success with offering universal health plans backed up by government subsidies. The company states that it wanted to “humanize health care” and provide the best customer experience for individual and family policies. The company relies heavily on technology platforms to provide service and access to policyholders. Based on the membership, Oscar Health Inc. has become the third-largest for-profit national insurer.

Oscar tries to set itself apart from other health insurance companies by offering simple plans that come with benefits such as free doctor visits, preventive care, and generic drug prescriptions. Additionally, they also offer free telemedicine visits for patients to speak with a doctor at any time. The company’s founders Mario Schlosser, Josh Kushner, and Kevin Nazemi say they wanted to offer the personal, high-quality, affordable health care they would want for their families. Today the company provides health coverage in 291 counties across 18 states.

Health Care Plans

Oscar Health initially offered plans for individuals and families and later incorporated group health plans and Medicare Advantage plans. The company offers high deductable plans that include health savings accounts. Regular adult health plans do not include dental or vision coverage. However, pediatric plans and Medicare Advantage policies do. All of Oscar’s health plans include no co-pays or coinsurance fees.

Most of the Oscar Health plans are exclusive provider organization plans (EPOs), which means that they only cover in-network care with the exception of medical emergencies. Their plans provide customers with options for coverage based on the frequency of healthcare needs. They provide tiers for “frequent,” “occasional,” and “infrequent” medical needs. Their individual plans include out-of-pocket maximums that range from $5,000 to $8,500. The plans have deductibles that range from $0 to $7,300 with unsubsidized premiums of around $500 a month. Depending on location, the actual costs for plans and out-of-pocket costs can vary.

Member Benefits

Oscar Health offers coverage for the ACA’s 10 essential benefits that include things like preventive care, surgeries, hospitalizations, prescriptions, and mental health. Basic Oscar Health plans provide free-of-charge coverage for all doctor visits, preventive care, and generic drugs. Policyholders typically pay for other expenses until they reach the out-of-pocket maximum for their plans. The plan will then pick up all of the additional costs after that point.

The Oscar mobile app and customer service line allow policyholders access to plan information and medical advice 24 hours a day. Members can speak with board-certified doctors about a host of issues at any time of the day. Additionally, Oscar Health provides Amazon gift card reward incentives for linking Google Fit and Apple Health accounts and hitting their step goals. They also offer virtual urgent care visits and virtual primary care visits.

Oscar Health offers affordable insurance plans through its website and the health insurance marketplace. Their technology and ease of access allow patients unlimited resources for finding in-network care and virtual medical treatment. As one of the ACA insurance companies, they cover many no- or low-cost healthcare services.

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