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Oscar Health Insurance Review: Great Member Benefits, but Limited Availability

Oscar Health Insurance Review: Great Member Benefits, but Limited Availability

Editor's Rating

Oscar offers good member perks, but plans are not widely available and are more expensive than some competitors

Good for

  • Oscar's mobile member app
  • A dedicated, member-focused care team
  • Free virtual primary care visits

Bad for

  • Available in limited areas of select states
  • Customer satisfaction
  • Lack of vision and dental coverage
  • Cheap rates vs. competitor plans
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Editor's Rating

Oscar offers good member perks, but plans are not widely available and are more expensive than some competitors

Good for

  • Oscar's mobile member app
  • A dedicated, member-focused care team
  • Free virtual primary care visits

Bad for

  • Available in limited areas of select states
  • Customer satisfaction
  • Lack of vision and dental coverage
  • Cheap rates vs. competitor plans
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Oscar Health Insurance sells individual and small business health plans in limited areas of the U.S. Oscar has some notable member perks and an excellent mobile app that customers can use for virtual doctor visits, some free of charge. But the company's individual plans cost more than some competitor plans, and customer satisfaction ratings are average.

Oscar Health Insurance: Our thoughts

Oscar plans are good for consumers who want the convenience of a top-rated mobile app with helpful features like virtual health visits. And the company's dedicated care teams are great for members who want personalized service geared toward their health needs and insurance plan.

While customers are happy with the mobile app and Oscar's care teams, some reported problems reaching a care team member and a poor overall customer experience.

You can buy an individual Oscar health insurance plan through HealthCare.gov or on a state health insurance marketplace, and the company sells small business health insurance plans in limited areas.

Shoppers can also browse plans and Oscar's health insurance provider network on the company's website. The provider search includes interactive maps, reviews and ratings to help with your selection. Once you're a member, you can interact directly with network providers to schedule health care visits.

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Oscar sells health plans in 22 states.

Plans are offered statewide in some states and in limited areas in others. For example, Oscar plans are sold in all of Nebraska but in just two counties in Arizona.

Oscar plans will not be available in Arkansas or Colorado beginning in 2023.

Oscar Health Insurance plan options and costs

Oscar individual plans come in all five plan tiers: Catastrophic, Bronze, Silver, Gold and Platinum, depending on where you live. All plans cover the essential benefits required under the Affordable Care Act (ACA).

Generally, monthly rates are lowest for Catastrophic plans and increase at each metal level, with Platinum plans being the most expensive. But while you pay more per month for Gold and Platinum plans, you pay lower deductibles and copays when you receive health care, making these plans best for people with frequent health care needs.

Average Oscar metal-tier rates in Texas range from $312 to $1,103 per month depending on your age and the metal tier you choose.

Average monthly cost of Oscar insurance

Tier
Age 21
Age 40
Age 60
Bronze$312$398$846
Silver$406$520$1,103
Gold$397$507$1,076

Based on available policies in Texas.

Oscar doesn't sell any Platinum plans on the Texas health insurance marketplace, but it does offer them through the company's website.

In Texas and other states, Silver plans might cost more than Gold plans. This is because Silver plans offer income-based subsidies that help to lower your out-of-pocket insurance costs, and some of that cost may be offset by higher premiums. Compare plans carefully, including potential subsidies, to be sure you're getting the best deal.

Oscar plan categories

Within the Affordable Care Act plan tiers, Oscar may offer one or more of its own plan categories, depending on location: Simple Saver, Simple, Classic or Elite.

picture of calculator
Simple Saver plans have the cheapest rates and a low deductible.

The Simple Saver plan works well for those with less frequent medical needs, as you pay a low, flat copay for primary care visits but higher costs for specialized care and other services. While the Simple Saver plan has a cheaper rate and a fairly low deductible, you pay 100% of the cost for much of your care, including specialist visits and physical therapy, until you meet the deductible. After that, you pay a lower share of the cost for those services, but it's still a percentage compared to a flat copay.

picture of piggy-bank
Simple plans have a slightly higher rate but a lower deductible than Simple Saver plans.

A Simple plan is good for people with medium-level health care needs. It has a lower deductible than a Simple Saver plan, which you can meet quickly if you have more frequent medical needs. Simple plans charge a higher percentage of your medical cost than Simple Saver plans.

picture of wallet
Classic plans have the second-highest monthly rate and deductible among the four categories.

These plans may be best for those with frequent health care needs. With a Classic plan, you pay the highest copays among the four plan types. For those with the most frequent health needs, we recommend Elite plans over Classic plans. Once you meet your deductible, Elite plan copays are lower than Classic plan copays.

picture of promo
Elite plans have the highest monthly rate and medical deductible of the four categories.

Elite plans are best for those with higher health care needs since frequent use means you can meet the deductible more quickly. You only pay about $7 per month more for an Elite plan than a Classic plan, and once you meet the deductible, your copays are slightly lower than with a Classic plan. But some Elite plans have a separate drug deductible, so you'll want to avoid those options if you need help with prescription costs.

Oscar plans cover preventive lab testing, and you'll pay less if you use one of Oscar's preferred labs: BioReference, LabCorp or Quest Diagnostics. If you own or purchase an Oscar policy, make sure to ask your doctor to send any lab work to a preferred provider.


Oscar cost vs. competitor plans

The graph below compares Oscar's Silver prices to its main competitors in Texas. Oscar is more expensive than Molina but cheaper than Celtic/Ambetter and BlueCross BlueShield of Texas.

Oscar vs Competitors

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Oscar business health insurance

Oscar is working with Cigna to offer small business group health plans based on the number of employees. Oscar business plans are only available in specific areas:

  • Kansas City and St. Louis, Missouri
  • Chicago, Illinois
  • Select California counties
  • Select Arizona counties
  • Throughout Georgia, Tennessee and Connecticut

Plans are EPOs or PPOs, depending on location, and they are available to businesses with between one and 50 employees.

Oscar Medicare Advantage

If you're eligible for Medicare, Oscar has Medicare Advantage plans available in limited areas. All plans are HMOs with drug coverage and cost an average of $3 per month.

  • Houston, Texas
  • Broward County, Florida
  • Bronx, New York
  • Rockland and Orange counties in New York's Hudson Valley

Only the plans in New York have been rated by Medicare, and each received 3 out of 5 stars for customer satisfaction, which is lower than most major competitor plans.

The Medicare Advantage plans in Broward County are available to patients who receive their health care through Holy Cross and Memorial Health medical providers.

Member resources and unique features

Oscar has many standard health resources but also offers some unique policyholder benefits compared to other health insurance providers. All of these resources can be accessed through the Oscar smartphone app or website.

In the app and website, you can monitor your progress toward the deductible and view relevant health topics like managing your mental health. You can track your steps in the app and get rewarded with up to $100 in Amazon gift cards per year if you reach your step goal.

Once you buy an Oscar health plan, you'll get a welcome kit that includes your plan ID cards, a summary of the policy benefits, and a list of all the perks and extra benefits.

A dedicated care team

Oscar assigns you a dedicated care team to help you with your insurance and health care needs. This is a group of professionals, including health care guides and nurses, who provide on-demand advice about your health. Your care team helps with billing issues and policy questions, and it can help you find an available doctor or the best urgent care clinic or emergency room for your situation.

Your dedicated care team won't change, so you get the same Oscar employees each time you need help. This allows your team to get to know you and your specific health insurance needs and policy. You can access your care team and video conference with them through the Oscar mobile app.

Oscar Care

Oscar Care provides free virtual urgent care and, in some areas, free virtual primary care. With virtual care, you can have a face-to-face visit with an Oscar doctor remotely, from any location at any time. Through an Oscar Care visit, your doctor can diagnose your issue, order prescriptions and even make an appointment with a specialist for you if needed.

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Customer reviews and complaints

Oscar Health customers are happy with their unique member perks and the company's mobile app.

In fact, Apple users gave the Oscar app 4.7 out of 5 stars. Oscar members also like the Oscar Care benefit, which allows quick access to medical care from any location.

Still, Oscar falls short in the areas of overall customer service, billing practices and finding an in-network doctor. If you have a preferred doctor, it's best to confirm that you can use that provider before buying a policy. Oscar members also are unhappy with the company's limited plan choices and lack of dental and vision coverage.

The National Committee for Quality Assurance (NCQA), which rates health insurers for customer service and quality of care, rated Oscar 3 out of 5 for overall customer satisfaction, prevention and health care services, which is an average rate compared to competitor plans. Oscar earned a complaint rating of 3.49 from the National Association of Insurance Commissioners (NAIC). This rating means Oscar has more than three times more customer complaints than the average insurer of its size.

Frequently asked questions

What is the average cost of an Oscar health insurance policy?

The average cost of an Oscar health insurance policy across all metal tiers, for a single 40-year-old adult, is $525 per month. This is above average compared to other health insurance companies within the industry. For some shoppers, Oscar's mobile app and Oscar Care benefit may be worth the extra cost.

When can I enroll in Oscar Health?

You can enroll in an individual Oscar Health plan during the annual open enrollment period, which begins Nov. 1. You also can apply for coverage during a special enrollment period if you have a qualifying life event, such as moving to a new location or adding a new family member.

What type of insurance is Oscar Health?

Oscar Health provides individual health insurance sold through federal and state insurance marketplaces or on the Oscar Health website. The company also offers small group insurance to businesses with up to 50 employees and Medicare Advantage plans in limited areas.

Is Oscar a good company?

Oscar's plans cost more than many competitors' plans, and customer satisfaction ratings are average. But Oscar has been expanding its health insurance offerings to new areas of the U.S., indicating good financial stability for the company. If Oscar is available in your area, compare plan options, costs and provider networks carefully before committing to a policy.


Methodology

To evaluate the cost of Oscar health insurance, ValuePenguin gathered sample rates for Oscar's four levels of health plans — Simple Saver, Simple, Classic and Elite — across the five tiers of Affordable Care Act coverage including Catastrophic, Bronze, Silver, Gold and Platinum. Cost comparisons were developed using 2022 public use files from the Centers for Medicare and Medicaid Services (CMS). Calculations were based on provider, location, age and plan tier.

ValuePenguin also compared Oscar's prices to major competitors. For each company, we collected sample Silver plan rates for a 40-year-old in Dallas.

To analyze Oscar's customer service, we collected customer service ratings from the National Committee for Quality Assurance (NCQA) and the National Association of Insurance Commissioners (NAIC).

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Editorial Note: The content of this article is based on the author’s opinions and recommendations alone. It has not been previewed, commissioned or otherwise endorsed by any of our network partners.

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