Is Oscar Health Insurance Worth Buying?

by Tanmay Joshi
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Wanna go for health insurance that gives you great member benefits? Then, Oscar Health Insurance may be your ideal suit. This newbie in the health insurance field is offering its members good perks and app-based services.

Besides, its dedicated and member-focused care team is always there to take care of you. And getting virtual preliminary care visits totally free of cost is a bonus to that. 

So, is it worth buying? Of course, that depends on your decision as Oscar health insurance has both positive and negative sides.

And, after knowing it all, if the company suits your purpose, then, of course, it’s worth buying. So, let’s proceed and see what its upsides and downsides are. Also, let us know, What plans does it offer? Come! Follow me!

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What Is Oscar Health Insurance?

It’s a startup or new health insurance company whose technology contrasts it with conventional insurance providers. It provides access to health or medical professionals through doctor visits, 24 hours daily consultation services, healthcare professionals’ individualized team building (within the network) assistance, etc. 

From January 2022, It became possible to purchase Oscar insurance either directly from the organization or through the Obamacare exchange program.

Oscar insurance customer service offers some small plans to the people of 22 states. The plans include the offers of free doctor-on-call service as well as no referral requirement for seeing specialists provided they are in-network. 

With this calling card of Oscar, you can get accessible healthcare services along with concierge health assistance. And for that, you are required to choose an insurance plan.

Moreover, the members of Oscar health insurance receive cash incentives of $100/year or less as they keep up with their day-to-day step count using the smart pedometers and watches set within the app. 

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Features Of The Oscar Health Plan Of Georgia: 

  • It offers its customers many benefits such as a 24/7 on-call doctors facility, faculty of a care committee who helps you navigate your plans, health-related cash incentives, etc. 
  • It’s user-friendly and provides personalized services to its customers. 
  • People in 22 States can get Oscar’s service as it is available in twenty-two states. 
  • It puts forwards 4 plans in front of its customers. Each plan’s price is based on many factors such as the plan’s type, the permanent inhabitation place of the customers, customers’ age, their family size, etc. 
  • Oscar expects its members to stay within their company’s EPO. Otherwise, they have to pay the entire amount for their doctor’s visit. 

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Oscar Ratings 2022:

NCQA (The National Committee for Quality Assurance) rated 3/5 to Oscar health insurance for attaining overall consumer satisfaction, deterrence and services offered.

However, this rating is average if compared with Oscar’s competitors’ ratings regarding complaint rating, NAIC (The National Association of Insurance Commissioners has given it a rating of 3.49.

This implies that the customer complaints of Oscar are even more than three times more than any other same-sized average insurer.

If talked about Oscar’s app, the users of Apple have given it a rating of 4.7/5. So you can understand how valuable the app is for its customers. 

Oscar Insurance Customer Service:

Oscar Health Insurance Customer Service
Oscar Health Insurance Customer Service

The customers of Oscar Insurance company are, on the one hand, pleased with its facilities of unique member perks, mobile app, etc.

They love the benefit of getting quick access to health care (medical care) from all the locations. Simultaneously, on the other hand, Oscar’s areas of overall consumer service, locating in-network doctors, and billing practices have amassed the dissatisfaction of certain customers. 

So, in case you have decided to enroll yourself in Oscar health insurance, first ensure that the insurance company will provide you coverage for your preferred doctor’s fees or not.

Oscar also has failed to satisfy most of its customers because of its limited choices for plans and lack of coverage for dental and vision-related problems. 

Standard Oscar Health Insurance Payment:

Oscar Health Insurance Payment
Oscar Health Insurance Payment

The average expense for a forty years old adult person’s Oscar health/medical insurance policy (all metal tiers) is $525/month. Oscar health insurance rate is above average compared to other insurance companies for health within the industry. However, some shoppers believe that the mobile app of Oscar and its care benefit justify its extra cost. 

Places In Which Oscar Health Insurance Is Sold: 

The Oscar plans are extended by the company in some states and other limited provinces. They are sold in all places throughout Nebraska but only in 2 counties of Arizona. From the beginning of 2023, the plans will be unavailable even for Arkansas and Colorado.

The places in which Oscar insurance plans are sold at present include Alabama, Arkansas, Colorado, Georgia, Lowa, Michigan, Nebraska, New York, Ohio, Pennsylvania, Texas, Arizona, California, Florida, Illinois, Kansas, Missouri, New Jersey, North Carolina, Oklahoma, Tennessee, and Virginia. 

Different Plans Of Oscar Health Insurance And Their Costs: 

The plans of Oscar health insurance include five tiers. They are the Catastrophic plan, Silver plan, Platinum plan, Bronze plan, and Gold plan. The plans are made based on the place of the customers. Each of these plans covers ACA-approved (Affordable Care Act approved) essential benefits.

Commonly, the Catastrophic plans’ monthly rates are the lowest. The rate increases with each metal level, thus making Platinum plans the most expensive.

However, though the plans Gold and Platinum cost more, the customers have to pay lower deductibles as well as copays while they receive health care.

So, both of these plans are considered best for those people who have frequent health care requirements. 

Texas’s average Oscar health insurance metal-tier rates range from 312 dollars to 1103 dollars. The exact price depends upon your age (Date Of Birth) and the metal-tier plan you prefer.

The average monthly expense for Oscar insurance in the case of the Bronze metal-tier plan is 312 dollars for people 21 years of age, 398 dollars for people 40 years of age, and 846 dollars for people 60 years of age. 

The Silver plan is 406 dollars for people 21 years of age, 520 dollars for people 40 years of age, and 1103 dollars for people 60 years of age. For the Gold plan, the average monthly expense is 397 dollars for people 21 years of age, it’s 507 dollars for people 40 years of age, and 1076 dollars for people 60 years of age. 

The platinum plans of Oscar are not sold in the marketplace of Texas Health Insurance. However, you will get it online by visiting the company’s website.

Oscar’s Silver plans cost more than its Gold plans for the states of Texas and some other places. The reason for it is that the Oscar Silver metal-tier plans offer its customers some income-based subsidies that lower their out-of-pocket insurance expenditures.

Also, some of its costs are offset by bigger premiums. Customers must compare the plans carefully before deciding on their Oscar plan so that their plan can cover potential subsidies and other things that could make the deal the best deal. 

Categories Of Oscar Health Plans Based On Location: 

The Oscar plans, within the tiers of the Affordable Care Act plan, can also be divided into 4 categories based on the customers’ location. They are: 

Simple Saver Plan: 

If you want the cheapest premium rate for health insurance and a low deductible amount, then you can hit your target with the Simple Saver Plan.

However, this plan will benefit you in case you are a less frequent visitor of nursing homes and occasionally requires any medical checkups. With this plan, you have to pay a meager amount of money with a flat copay for principal care visits. 

However, you have to bear higher costs for specialized care visits or other kinds of services. Though the Simple Saver Plan rate is comparatively cheaper than other plans with a moderately low deductible, you have to bear a hundred percent of your main care cost, including the cost of specialist therapy, physical therapy, etc. You have to bear their costs until you confront the deductible. 

Later, you can pay a meagerer share of those service’s costs, which will be; nonetheless, a percentage approximated to the amount of a flat copay. 

Classic Plans: 

If you are searching for an Oscar plan with the second-highest monthly rate or deductible among its four categories, you can consider enrolling yourself in its Classic Plans. However, once your deductibles are met, you will find the Elite plan copays lower than the Classic plan copays. 

Simple Plans: 

Simple plans, if compared with the Simple Saver plans, possess a rate that is slightly higher than the latter one. However, this plan includes a lower deductible if approximated with the deductible of the Simple Saver plans.

Are you a person whose health care needs are medium-level? Then, Oscar Simple Plan is made for you. With this plan, your frequent medical needs will help you quickly meet its lower deductible.

However, you also have to pay more for your medical cost in Simple plans of Oscar than what you pay in the Simple Saver plans. 

Elite Plans:

Are you someone who requires frequent visits to a nursing home or doctors for your health care needs, therapies, or some kind of surgery? Then, Oscar’s Elite plan will suit you the best. This is because frequent use means one can meet their deductible more quickly.

So, only if you have a higher health care need, join this plan. With this plan of Oscar health insurance, you have to make a payment of $7/month more than what you had to pay for a Classic plan.

Notably, some Elite plans have a detached drug deductible. So, one would like to forgo these options if they require benefits with the prescription costs. 

Whichever is the plan, every plan of Oscar gives coverage to preventive lab testing. Also, you have to pay less if you choose to use any of the preferred labs of Oscar Health Insurance company. The name of its labs is BioReference, Quest Diagnostics, and LabCorp. 

So, if you decide to purchase a policy of Oscar, don’t forget to plead with your doctor to send any lab task to a selected provider.  

Is The Rate Of Oscar Health Insurance More Than The Rate Of Its Competitors?

Oscar health insurance is, no doubt, more costly than its competitor Molina insurance but is cheaper than its other competitors, Celtic/Ambetter & BlueCross BlueShield of Texas.

So, where Oscar’s average medical insurance rate is $520, Molina, BlueCross BlueShield of Texas, and Celtic rates are $470, $552, and $598, respectively. 

What Is Oscar’s Business Health Insurance?

Working with Cigna, Oscar recently offered a few minor business denomination health plans. These plans are based on a firm’s total number of employees and are available only in some particular places such as Kansas City & St. Louis of Missouri, Illinois (Chicago), a few selected counties of California and Arizona, Connecticut, Tennessee & Georgia.

Any business group situated within these provinces can apply for Oscar’s business health insurance if their firm possesses anywhere between 1 to 50 employees. The business-based plans are either EPOs or PPOs, hingeing on location.

Oscar’s Medicare Advantage Plans: 

Oscar has also brought its Medicare Advantage plans into the market, but they are available in limited provinces. Each of the plans is HMO. They cost around $3/month and give coverage for drugs (medicines).

Oscar’s Medicare Advantage Plans of Oscar health insurance are available in Houston of Texas, Broward County of Florida, Bronx of New York, Rockland County, and Orange County of Hudson Valley in New York. 

It’s New York’s Medicare plans got a rating of 3/5 by Medicare for customer satisfaction, though the rating is much lower than the ratings of its other major competitors’ plans. 

FAQs

Q.1. What type of insurance is Oscar health?

Answer: It’s a kind of startup health insurance corporation that, with the help of technology, has differentiated it from other traditional insurance providers.

It provides access to medical experts like free doctor visits, 24/7 consultations, healthcare professionals’ individualized team building (within the network) assistance, etc.

Q.2. Is Oscar the same as Cigna?

Answer: No, Cigna is not the same as Oscar. Rather, Oscar, in collaboration with Cigna, works together for small businesses.

Cigna’s strength of nationwide as well as local provider networks, along with Oscar’s member-focussed experience, is currently providing minor group health insurance to the employees of various business-related firms, understanding their needs. 

Q.3. Who is Oscar Health owned by?

Answer: Oscar Health declared that its company was founded by Kevin Nazemi, Josh Kushner & Mario Schlosser (three Harvard Business School classmates) in 2012.

In March 2020, Mother Jones announced that both Joshua Kushner & Jared Kushner were the owners of Oscar’s parent company (Thrive Partners III) at the time of the incorporation of the business in 2013.  

Q.4. Is Oscar an HMO or PPO?

Answer: Though Oscar comprises plans for both HMO & PPO, it’s an HMO/EPO for most plans. That means most of the plans of Oscar only give coverage to care with in-network type providers. This assists in keep down the costs for the members of Oscar.

Also, these plans work well when the customers have time to scheme their care in advance. However, in case of medical emergencies, Oscar knows that time might not remain the same way on its customers’ side.

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