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Oscar Health Insurance Review

63 Customer Comments & Reviews - see all comments
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Founded in 2012, Oscar Health is a tech-based health insurance company that focuses on simplifying the typically complex search for healthcare while providing patient-centered services. Based in New York City, Oscar offers insurance in select ZIP Codes in the states of New York, New Jersey, Ohio, Tennessee, Texas, Arizona, Michigan, Florida, and California.

What's Included with Oscar?

  • Dedicated concierge to schedule appointments, resolve billing issues, give health advice (through a licensed nurse)
  • Free, 24/7 Doctor On Call service saves patients a visit to the doctor
  • Oscar Center provides exclusive primary care services (only in New York City)
  • Step-Tracking program earns rewards for meeting walking goals (up to $100/year)
  • No referrals
  • Free preventive care, including annual physicals and most vaccines
  • Request prescriptions by phone
  • Oscar Network includes nationally ranked "honor roll" facilities and specialists
  • Cost Sharing Reduction (CSR) plans available

Types of Health Insurance Plans

Businesses and Organizations Yes
Individuals and Families Yes
Short-Term Health Insurance No

Plans Reviewed

Backup Plan

The Backup Plan is ideal for generally healthy people who want to know they will be covered in case of a major injury or illness. With this plan, the patient has a choice of three metal levels with different individual deductibles and out-of-pocket maximums. Before meeting the deductible, the patient pays the full price for services like primary care, specialist visits, urgent care, labs, and all drugs. After meeting the deductible, all services under the Bronze and Silver levels are $0. Under the Gold level, they are 20% of the total cost.

BACKUP PLAN Bronze Silver Gold
Individual deductible $6,500 $4,500 $1,500
Individual Out-of-Pocket Maximum $6,500 $4,500 $4,500

Simple Plan

The Simple Plan is the signature Oscar plan. There are four coverage levels, including the Secure level, designed for people who only have routine care needs. With the Secure and Bronze levels, most services must be fully paid by the patient before the deductible is met. Under the Silver and Gold levels, most services have copays that range from $10 to $50, depending on the service. Once the deductible is met, all services under every Simple Plan level are 100% covered by the insurance. Additionally, since the deductibles match the OOP maximums, there is no cost-sharing under the Simple Plans.

SIMPLE PLAN Secure Bronze Silver Gold
Individual deductible $7,350 $7,350 $7,350 $4,000
Individual Out-of-Pocket Maximum $7,350 $7,350 $7,350 $4,000

Classic Plan

The Classic Plan follows the structure of traditional health insurance plans, which may be ideal for people with chronic illnesses who need ongoing care. Four metal levels are available, with the Platinum level offering no deductible and copays for every service. With the Bronze level, on the other hand, all services must be paid in full before the deductible is met. After the deductible is met, the patient pays 50% of the total cost for most services and copays for prescription drugs. The Silver and Gold levels are similar in that most services must be paid in full before the deductible is met. Once the patient meets the deductible, copays are charged for the different services, with the Gold level offering the lowest post-deductible copays.

CLASSIC PLAN Bronze Silver Gold Platinum
Individual deductible $4,000 $2,000 $600 $0
Individual Out-of-Pocket Maximum $7,150 $6,750 $4,000 $2,000

*Information stated above is for customers residing in the state of New York

Summary

Oscar sets itself apart from the competition with its wide range of plans. Any customer can find a plan that fits their health care needs—and their budget. Oscar also offers a variety of additional services at no cost, like a concierge that can help customers get the most out of their plan. Services like this really make a difference when it comes to customers deciding between plans. Consumers can receive an instant free quote online by entering a few personal details like zip code, age, and income. Unfortunately, Oscar is only available in New York, New Jersey, Ohio, Tennessee, Texas, Arizona, Michigan, Florida, and California, though they expect to expand to other states in the future.


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63 Customer Comments & Reviews

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mmsignup0000
9/7/2024
DO NOT sign up with this insurance company... You will regret it!


Gary N
7/29/2024
Just signed on with Oscar 2 months ago. Worst decision ever! I can't get a refill on a prescription I've been taking for over 4 years. So far I've received a different reason from the pharmacy the doctor and Oscar insurance. What a fraud. DO NOT TRUST THIS CARTEL.


mike.8.11.2007
6/9/2024
I thought I would try OSCAR because Florida Blue started making me pay full price for my prescriptions. OSCAR told me that all my meds were covered but I have since learned that some are not like insulin which I need for diabetes. But according to their medication guide, it should have been covered and also my cholesterol medicine too. My doctor ordered my prescriptions a week ago and OSCAR keeps giving me the run-around. First they said they need authorization from my PCP which they had and then received again 2 days later. Then they said I need to provide a reason why I need my medication and I provided for each one. Then they said they need it again. WTF? Now they are asking for another... Read More


doreenmack
5/22/2024
Most horrible insurance company I have ever dealt with! Months and years later they audit your claims then you can't get money back from the provider you paid to pay the other provider you now owe money to. Claims disappear from your claim's history, they tell you the claim was denied but there is no evidence in your history regarding that. In fact, the evidence in your history is the opposite. If you don't meet your deductible, they are ok but the minute you meet your deductible they do everything in their power to deny your claims and go back and forth with denials and approvals, changing what you owe or have paid providers. They are of no assistance when you message them for help.... Read More


fancynancy4946
5/15/2024
Try to get a prescribe drug by doctor filled for two months,Help on phone useless,they read off same thing on the letter that was sent and fail to help in getting it corrected ,try on line no help either,constant run around, i would avoid ,PS brought there second best policy,not happy


L
Lesley
1/27/2024
We were basically forced to go with Oscar because it’s all we can afford. Totally unimpressed and disgusted by the lack of docs that are affiliated with or taking Oscar. I’m paying over $300/month for 2 people. And half my meds are not covered!! And if I needed to see any additional specialists for some of my current health needs-the ones I’ve searched aren’t avail or if they are they are OUT of network which costs more. Way to screw people over who can’t afford the better insurance they previously had


C
Coreen H
7/21/2023
This is the worst insurance you can have. I've had 3 eye surgeries and they paid for none of them. Do Not get this insurance. Run and get something else.


dallasmark777
7/4/2023
if ther was a zero star rating i would give it im going to call the insuance commisioner tommorrow


J
Joe L
6/27/2023
I have used them for two things this past year: prescription refills and a yearly physical. The prices I've been charged for refills does not match what is in their formulary and they denied costs for my annual physical. I emailed about the physical and they responded with a generic response. I went everything (bloodwork, etc) with my IN NETWORK doctor and these costs are always covered with other insurance. Now, they just stopped responding to my emails and other attempts to contact them. Signing up was even a nightmare - for being a tech company is was kind of odd how they couldn't get my account in the system. For now, I am avoiding the doctor or hospital until I can switch. If I get... Read More


Jacquie C
4/16/2023
They are very disorganized. They have now twice denied a doctor’s order. I have been trying to get medical treatment authorized since January 24, 2023. It is now April 16, 2023. I contracted with Oscar through the HSA. I will reconsider them in the future. They are being paid nearly $1200 per month to insure me. It’s really unbelievable.



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