Here’s a quick Oscar Health Insurance Review: Oscar Health offers Exclusive Provider Organization (EPO) plans. EPOs are similar to Preferred Provider Organization plans, however, if you visit a specialist, doctor, lab, or hospital that’s not in its network, you’ll have to pay 100% of the costs unless it’s an emergency.
Oscar Health Insurance is a relative newcomer to the health insurance scene. It was founded in 2012 and operates in 18 U.S. states. Some of the perks include no-cost virtual care and preventative care visits and financial rewards of up to $100 per year for meeting walking goals.
The company offers Medicare Advantage Plans, health insurance plans for individuals and families and business health insurance plans, along with a variety of health insurance plans to meet many levels of healthcare requirements.
- Individuals who need basic medical care
- Free preventive care including annual physicals and most vaccines
- Virtual medical care visits
- Up to $100 per year is available for reaching walking goals
- No referrals needed for any plan
- 24/7 doctor on call online visits available
- Variety of plans to fit any level of healthcare needs or budget
- Coverage is only available in 18 states
- Lower deductible or no deductible plans are expensive
- No dental or vision coverage
Oscar Health Insurance Ratings at a Glance
When you’re looking for affordable health insurance, it’s nice to know you have lots of options. Years ago with just a few companies to choose from, now many are competing to be your health insurance provider. One newcomer generating positive reviews is Oscar Health. Founded in 2012, its membership is 250,000 and growing. We’ve gathered key facts and information about Oscar Health to help you decide if it’s the right plan for you.
Oscar Health Insurance Review: Eligiblity
Oscar Health offers EPO plans and Health Savings Account plans and Medicare Advantage plans for:
- Individuals and family members
- Group members (employer-covered plans)
- Members 65 and above or under 65 and disabled according to the Social Security Administration
Oscar Health offers coverage to most people looking for health care plans except low-income individuals seeking Medicaid. Currently, Oscar’s plans are available in the following states: California, Arizona, Colorado, Texas, Oklahoma, Kansas, Missouri, Michigan, Iowa, Tennessee, Georgia, Florida, North Carolina, Virginia, Michigan, Ohio, New York, Pennsylvania, New Jersey.
Oscar Health offers 3 types of EPO plans for individuals and families: Classic, Simple and Saver.
- Classic: Higher in cost with lower deductibles and lower copays for prescriptions
- Simple: Affordable copays for routine care and 100% coverage of care after you meet your maximum; copays for brand name drugs
- Saver: You pay full price; once you’ve met your deductible, you split coinsurance costs 50-50 with Oscar. Once you’ve hit your out-of-pocket maximum, in-network services are covered in full.
Classic and Simple plans are offered in bronze, silver, and gold, with gold featuring the highest monthly premiums. When you visit its site and provide a few answers about your age, location, income and other details, you’ll see different plans and levels of coverage available. Here’s a snapshot of plan costs for a 54-year-old living in Michigan earning $60,000 with 3 children:
| Plan Type | Bronze | Silver | Gold |
|---|---|---|---|
| Classic | $69 per month | $580 per month | $1,203 per month |
| Simple | $35 per month | $823 per month | N/A |
| Saver | $134 per month | $536 per month | N/A |
All of the above plans feature these benefits:
- Doctor on call: 24/7 online visits available
- Step tracking rewards: Up to $100 per year based on steps recorded
- Oscar concierge: A dedicated team of care specialists and a registered nurse
- Preventive care: Services, tests, and consultations offered to prevent illnesses and keep you healthy
- Full network access: Negotiated prices to hospitals, doctors and specialists who accept Oscar Health
- No referrals necessary: With in-network providers
- Prescriptions by phone: Refill ordering by phone without a doctor’s visit
Deductibles and out-of-pocket maximum amounts vary from plan to plan.
According to data from the Kaiser Family Foundation, health insurance rates increased moderately for 2021. Families continue to search for affordable healthcare. With that in mind, take a look at how the pricing for Oscar Health Insurance measures up.
The pricing of Oscar Health Insurance plans varies greatly based on the out-of-pocket expenses and deductibles you can expect to pay. Naturally, the lower the copay and deductible, the higher the cost of your health insurance will be. The simple plan, which offers basic coverage options, costs you $1,373.14 per month on the lower end of the coverage options. The classic plan in the midlevel coverage range ranges in monthly premium from $1,381.50 to $1,770.07. The most expensive policy is the Classic Gold Plan costing $2,011.30.
The Plan Information stated below is based on a married couple with 1 dependent child residing in the state of Texas.
Oscar Simple Plan
The Oscar Simple Plan is designed for families who need basic medical care, including annual check-ups, preventative care, primary care visits, specialists visits, mental health care and physical therapy.
| Simple Plan | Individual out-of-pocket maximum | Family out-of-pocket maximum | Individual deductible | Family deductible | Monthly premium |
| Basic | $8,500 | $17,100 | $7,300 | $14,600 | $1,373.14 |
Oscar Classic Plan
The Oscar Classic Plan is designed for families who need basic medical care, including annual check-ups, preventative care, primary care visits, specialists visits, mental health care and physical therapy
| Classic plan | Individual out-of-pocket maximum | Family out-of-pocket maximum | Individual deductible | Family deductible | Monthly premium |
| Bronze Classic | $8,550 | $17,100 | $6,000 | $12,000 | $1,381.50 |
| Bronze Classic PCP Copay | $8,550 | $17,100 | $6,000 | $12,000 | $1,418.02 |
| Bronze Classic Next*This plan includes Rx deductible of $5,550 for individual and $11,000 family | $8,550 | $17,100 | $0 | $0 | $1,679.45 |
| Bronze HDHP | $7,000 | $14,000 | $5,200 | $10,400 | $1,475.92 |
| Silver Classic Off-Ex | $8,500 | $17,100 | $5,000 | $10,000 | $1,537.32 |
| Silver HDHP | $7,000 | $14,000 | $3,000 | $6,000 | $1,542.99 |
| Silver $1500 Deductible | $8,550 | $8,550 | $1,500 | $3,000 | $1,770.07 |
Oscar Classic Gold Plan
For individuals and families with high medical needs, the Oscar Gold Classic Plan offers comprehensive care ideal for those who require medical care frequently. Members who sign up with the Class Gold Plan receive annual checkups, preventative care, primary care visits, specialists visits, mental health care and physical therapy.
| Classic Gold Plan | Individual out-of-pocket maximum | Family out-of-pocket maximum | Individual deductible | Family deductible | Monthly premium |
| $6,000 | $12,000 | $2,500 | $5,000 | $2011.30 |
Oscar Saver Plan
Oscar’s Saver Plan is designed for individuals and families with occasional medical needs, including annual checkups, preventative care, primary care visits, specialists visits, mental health care and physical therapy.
| Saver Plan | Individual out-of-pocket maximum | Family out-of-pocket maximum | Individual deductible | Family deductible | Monthly premium |
| $8,550 | $17,100 | $6,200 | $12,400 | $1,859.63 |
Benzinga gives Oscar Health Insurance a 3 out of a 5-star rating on the price of its plans, with 5 being the highest. Oscar falls midrange on pricing. While it is not the most expensive health insurance, it is also not the cheapest.
Oscar Health Insurance vs Competitors
According to data from the Kaiser Family Foundation, health insurance rates increased moderately for 2021. Families continue to search for affordable healthcare. With that in mind, take a look at how the pricing for Oscar Health Insurance measures up.
The pricing of Oscar Health Insurance plans varies greatly based on the out-of-pocket expenses and deductibles you can expect to pay. Naturally, the lower the copay and deductible, the higher the cost of your health insurance will be. The simple plan, which offers basic coverage options, costs you $1,373.14 per month on the lower end of the coverage options. The classic plan in the midlevel coverage range ranges in monthly premium from $1,381.50 to $1,770.07. The most expensive policy is the Classic Gold Plan costing $2,011.30.
Here is a cost comparison based on a health insurance quote for a married Texas couple in their 50s with 1 teenage child with a deductible ranging from $2,500 to $5,000.
| Company | Friday Health Plans | Blue Cross and Blue Shield of Texas | Oscar Insurance Corp. | Blue Cross and Blue Shield of Texas |
| Price | $1,547.99/mo | $1,593.29/mo | $1,714.23/mo | $2,295.85/mo |
| Metal level | Gold | Gold | Silver | Silver |
| Plan type | Exclusive provider organization (EPO) | Health maintenance organization (HMO) | EPO | HMO |
| Deductible | $2,300 per person ($4,600 per family) | $1,100 per person ($3,300 per family) | $1,500 per person ($3,000 per family) | $1,250 per person ($3,750 per family) |
| Coinsurance | 20% | 30% | 50% | 50% |
| Out-of-pocket limit | $8,250 per person ($16,500 per family) | $8,550 per person ($17,100 per family) | $8,550 per person ($17,100 per family) | $8,550 per person ($17,100 per family) |
- Best For:No-cost virtual and preventive caresecurely through Oscar Health Insurance's website
- Best For:Nationwide coveragesecurely through Blue Cross Blue Shield Health Insurance's website
We give Oscar Health Insurance a 3 out of a 5-star rating in the area of customer service. The company has received both positive and negative reviews online. Customer reviews on the Better Business Bureau (BBB) website are primarily negative, with an average 1.38 out of a 5-star customer service rating. The majority of the BBB complaints were in the area of billing and collections issues.
The National Association of Insurance Commissioners (NAIC) scores Oscar Health Insurance (Minnesota, Missouri, Tennessee, Texas and Virginia) with a 4.83. This index compares the complaints received against other companies in the same market. It received a 1 on the National Complaint Index, meaning the complaint index for Oscar Health Insurance in the states listed is almost 5 times higher than other health insurers in the same market.
However, other websites such as BestCompany.com give the company a 3.3 out of a 5-star overall rating with a service rating of 4 out of 5 stars.
Oscar does not disappoint with its mobile app, and Benzinga gives it its highest rating — 5 out of 5 stars. The app is convenient and gives policyholders a seamless experience. A member can use the app at any time of the day or night to enter illness or condition and be provided with a toll-free phone number to call or a visit to a doctor, including the estimated cost of service. This is what today’s health insurance consumer is looking for — quick and convenient service.
Benzinga gives Oscar Health Insurance a 3 out of 5-star overall rating. The company is a fairly new health insurer but has built a solid reputation in the area of online service for customers and a convenient mobile application.
Oscar Health Insurance is ahead of its competitors in the area of telemedicine. The Doctor on Call free service is a favorite of customers. Members can call and speak with a doctor over the phone, receive a diagnosis and have the physician call in a prescription to a local pharmacy.
Although pricing is higher than some of its competitors, the company does offer health cash incentives for members who adopt health behaviors that can help reduce the overall cost of healthcare.
Shop Around for Health Insurance
Shopping for a new health plan is just as important as looking for a new home or car. You wouldn’t make a major purchase without considering the pros and cons, your needs, pricing and overall value. Although Oscar Health Insurance Company plans have garnered positive reviews, there are hundreds of other insurance plans on the market, all competing for your business. Talk to family members and friends about their plans and narrow your list down to a few top contenders.
Choosing a new health insurance plan will impact your health and well-being for years to come, so take extra time to decide. Visit healthcare.gov to learn more about insurance options.
Frequently Asked Questions
What is the average cost of an Oscar Health Insurance policy?
The average premium when factoring in all available Oscar Health Insurance plans is approximately $1,600 per month.
How do I get set up with my new Oscar plan?
You can buy an individual health insurance plan through Oscar Health Insurance during the open enrollment period, which may vary by state. You can read more about the open enrollment process at https://www.hioscar.com/blog/the-ins-and-outs-of-open-enrollment
User Reviews
joseph
Oscar is the worst! They lie and don't cover even very basic things!
CIndy
App is useless. Website is useless. Tried telehealth, and the doc basically said can't help you without seeing you in person. No in-person docs available. The few PCP docs aren't affiliated with area hospitals or medical groups. Trash policy.
M Judd
You can never ask for a prescribed refill of a prescription and get it. You must talk to a doctor, you must get a blood test, you can only get 30 days at a time...
Patricia Solis
Terrible coverage, bad doctors, can’t get an appointment for 4-6 weeks for anything. Psychotherapists need their own therapy, as they are the sick trying to heal the sick. Tried to get an appointment for a physical in January. May only available! BAD
Alycia Shapiro
VLC
Cannot recommend. Rx coverage sucks. Have to upload med records for review or see an Oscar virtual doc. A joke.
VLC
Pro: ease of seeing specialist.
anthony
this healthcare service sucks ass the app sucks ass im just looking for a family doctor and the numbers they provide on their website were for a planned parenthood a hiv specialist a infectious disease specialist and then a regular doctor not only that wh
Tim Callahan
Stay away from Oscar! Worst customer service ever. I had Oscar Health Insurance through Covered California from 2020-2021. They wrongfully terminated my coverage, and I had to appeal to the California Department of Managed Healthcare to get my coverage re
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About Janet Hunt, Insurance Agent
Janet has been working in, and writing about, the insurance industry for over 20 years.