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Oscar Health Insurance Review

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UPDATED: Nov 30, 2018

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Oscar Health Insurance
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Oscar Health Insurance is entering the post-Affordable Care Act market with a new approach and a modern attitude. This unusual insurer aims to keep healthcare as simple as possible while still offering comprehensive coverage with a technological edge not seen elsewhere.

Oscar Health Insurance Summary

Oscar Insurance was launched in July of 2013 in response to the Affordable Care Act with the intention of creating a user-friendly approach to health care. The company is known for a somewhat lighthearted and technologically advanced approach to health insurance. So far, the company has outstripped expectations for policy sales, entering the 2014 open enrollment period with 17,000 members, more than the 7500 anticipated by that time.

Oscar Insurance is known for using technology and unique methods of approaching healthcare rates and policies. In December of 2014, the company announced that they would provide insured members with a fitness monitoring device and offering cash incentives to those who use them. The company is also well known for being a very tech-based insurer, using a cloud system of billing and documentation and providing many online and mobile services.

Oscar currently offers their Simple Plans in New York, California and Texas. The company previously offered plans in New Jersey and has plans to return next year, in addition to adding Ohio and Tennessee to the list.

Insurance Products

Oscar Insurance offers what they call Simple Plans. These health insurance products are designed to be simplified and easy to use and understand. They offer a variety of premiums and deductibles. Several plans offer free doctor visits and free generic prescriptions, while others have low co-pays or co-insurance, depending on the plan chosen.

Following the ACA standards, Oscar’s plans come in Secure, Bronze, Silver, Gold, and Platinum coverage choices. Each level has several options. The company’s website shows a comparison chart between the plans. The difference is mainly between the premiums and the deductibles. The lower the premium, the higher the deductible, while the medical care remains the same.

Oscar healthcare plans include a free service known as Doctor On Call, which allows members to call and speak to a doctor over the phone. These doctors can answer questions, listen to symptoms and provide prescriptions to be sent directly to a local pharmacy, all over the phone. The service is designed to prevent members from having to visit a doctor for common illnesses and quickly obtain the needed medications.

All of the plans meet the ACA requirements for deductibles and out of pocket maximums as well as required coverage. Currently, Oscar plans are not available through the online national marketplace for healthcare, but only through the Oscar website directly.

Providers and Networks

Oscar plans are accepted by their network of providers, which can be searched on their website to find doctors and hospitals. The site states that they offer a large network of participating doctors and hospitals.

In an attempt to work with the best hospitals and doctors and ensure the best care, Oscar has reduced their network in New York and are now working with three hospital systems. This is in effect as of 2017. Their previous network included around 77 hospitals and this new network includes around 31. While this is a drastic change, with a lot of criticism, Oscar presses this is the best for their customers and stresses the action was not an attempt to increase their bottom line, though it does increase prices.

Prospective members can search to confirm whether or not their current doctors will accept Oscar insurance prior to signing up for a plan. Oscar does not require a referral to see a specialist except in the case of specific provider types, such as alternative care providers.

Oscar Health Insurance Rates

As with most insurance companies, prices and premiums vary greatly based on the number of people insured, location, and several other factors. Oscar Insurance premiums can be obtained by requesting a quote online or by calling for a quote.

Expect Bronze level and Secure coverage to generally offer the lowest prices, with Platinum level plans at the highest premiums. This is due to the many difference in plans with tiers separated by coverage levels, deductible amounts, co-pays and coinsurance costs, and is common to most insurance companies.

Oscar is known for adding value to their policies in the form of cash incentives for behaviors that help to keep members healthy, which is good for the health insurance company’s bottom line. In addition to the incentive for using a fitness tracker and increasing activity, Oscar has previously offered members a cash incentive to get a flu shot. These offers can help to reduce the overall cost of Oscar plans.

Claims

Healthcare providers submit claims directly to Oscar for processing, as with most insurance companies. The Oscar website includes a comprehensive provider portal that allows doctors and clinics to handle all of their business with the company online – a part of Oscar’s paperless, “cloud” approach to handling documentation.

Oscar members can log in to the company website to review their benefits and claims status, and concerns regarding how benefits are paid can be directed to the company’s customer service line.

Consumer Research and Complaints

Oscar Insurance is very new to the healthcare industry, and although they are not accredited by the Better Business Bureau (BBB), they are rated. The company has an F rating from the BBB due to 14 complaints filed against them, three of which they have failed to respond to.

Oscar Insurance does appear to have had some initial problems with confusion in the wording of their policies and members; one particular complaint received press attention. Oscar seems to be working to improve the miscommunication that led to the issues.

As with most new companies, Oscar Insurance will require more time in the industry to develop a solid reputation, and for a clear picture to emerge regarding complaints and customer service issues.

Financial Strength

Rating Company Grade Financial Outlook
AM Best N/A N/A
Fitch N/A N/A
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Bottom Line

Oscar is a very new company with a modern approach to health insurance that may appeal to those who have been frustrated with traditional insurance companies in the past or find the plans elsewhere too complicated. The company has had some issues with customers that do not seem to be greatly affecting their presence in the marketplace, and seems to be improving with time. Healthcare customers who prefer a technologically advanced insurance company are likely to find Oscar a good choice, as well as people with relatively simple healthcare needs.

For a list of companies that we recommend, visit our Best Insurance Companies page.

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Review Information

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About Eric Stauffer

Author: Eric StaufferI am a former insurance agent and banker turned consumer advocate. My priority is to help educate individuals and families about the different types of insurance they need, and assist them in finding the best place to get it.

54 Comments

  1. WORST SHAM INSURANCE COMPANY!!! AVOID THEM LIKE THE PLAGUE!!! I HAVE BEEN WITH THEM FOR TOO MANY YEARS, AND I FINALLY WOKE UP. THEY ARE FULL OF CRAP. WHY IN THE WORLD CAN’T YOUR INSURANCE COMPANY EVER BE ABLE TO TELL YOU WHAT YOUR OUT OF POCKET OR NEGOTIATED FEE WILL BE? THEY ALWAYS GIVE THE SAME ANSWER, THAT THEY “CAN’T PULL IT UP…ITS AN ESTIMATE AND NO ONE EVER HAD THAT PROCEDURE, SO WE CAN’T TELL YOU. HAVE THE SURGERY AND THEN WE’LL LET YOU KNOW. WTF??? AS SOON AS I CAN CHANGE COMPANIES IN JANUARY, ADIOS! THIS COMPANY ACTUALLY MAKES YOU SICK AND NEED HEALTH INSURANCE!

    P.S OSCAR…DON’T BOTHER RESPONDING WITH YOUR [redacted] REPLIES TO THE PREVIOUS COMPLAINTS… THEY’RE AS DISHONEST AND DISINGENUOUS AS YOUR SERVICE.

    Reply
    • Blue Shield PPO is the same in that respect. They only disclose their negotiated rates once the provider submits the medical codes for your procedure AFTER your procedure. SUCKS and a huge flaw in the system. I agree with you. But unfortunately, it’s not unique to Oscar.

      Reply
    • Absolutely. Amazing that consumers are forced to pay out huge sums of money for no coverage. The premiums should go into an account that protects the consumer, not to the profits of a company. Incredible system.
      Re-name it the “gimmick insurance company”

      Reply
    • Mark is right! Same experience in Texas!

      Oscar claims to be the solutions to healthcare and it turns out they made the problem worse.

      In May 2019 they fired the good doctors from their plan in San Antonio and only do business with the less capable/experienced doctors in the Baptist network that they feel they can control.

      My Bronze plan pays for nothing! $640+ and they won’t even pay for part of the blood panel required for my annual physical – required by the ACA.

      If when I signed up I knew I would lose all the doctors I do business with on May 1, I certainly would have not renewed them for the 3rd year.

      YOU ARE WARNED! Stay away – they are a young insurance company already desperately cutting benefits.

      Reply
  2. I purchased an Oscar Health insurance for my daughter in Jan 2018 but the only thing my daughter received was a pamphlet from Oscar New York with no agent involved. We did not understand its meaning regarding in network vs out of network. My daughter became pregnant and for one her doctors appt for just 20 minutes we were billed for $320. We cannot believe that an insurance company like Oscar could deceive the consumer. Yet I can the policy for Jun 2018 and being billed closely to $5000 I paid. Oscar insurance is very deceitful and we decided to bring complaints to the Attorney General of Texas due to fraudulent practices. Also, the Better Business Bureau will also be contacted about this problem. Now we know not to ever purchase Oscar Insurance in Texas.

    Reply
    • John, wondering how you were able to resolve this. I am supposed to pay over $6,000 and I never even went to one doctor. I would love to connect with you about this if possible. Thank you.

      Reply
  3. Do not use this insurance company. Back in 2016, my doctor recommended that I get a Cologuard test. The Dr and I both contacted Oscar to make sure the test was covered. Oscar advised us both it was covered and sent out written confirmation that the test had been covered and paid for by Oscar. One year later, I get a notice from the lab that Oscar hadn’t paid them. Oscar is now claiming the lab is not in-network even though this is the only lab that provides this test! When I realized I wasn’t getting anywhere, I appealed their decision and was told I no longer had the right to appeal because the case is too old! Please don’t get fooled by the cutesy graphics – this is a terrible company.

    Reply
    • Before you had the Cologuard test did you check to confirm that the lab used was in-network or out of network? If not, then this wasn’t an Oscar issue. They very clearly state in their contract that out of network providers are not covered, even when they have pre-approved the procedure. If the lab was not in network and no other in-network plan was available then you would have needed to obtain a written exception to the plan policy from Oscar before the procedure was done. Oscar offers EPO plans and virtually every EPO and HMO insurance plan, regardless of the insurance company, have this same restriction unless it is a medical emergency situation. It’s one way they use to try to keep their costs and premiums lower. It cannot be emphasized enough: Always, always, always, verify that the provider you plan to use (including labs) is in the network or you will get unpleasantly surprised like this.

      BTW, every insurance company plan places time limits for making appeals. In most cases that is 180 days. 2 yrs far exceeded that. Again, that is a contractual thing that is very clearly documented in the insurance contract and in the Explanation of Benefits (EOB) you should have received.

      Reply
    • I also have OSCAR and also want to get a Cologard test, which at this point they have refused to cover. They keep trying to push me to get a “sedation” colonoscopy, where you are not fully under.

      I have told them I react badly to sedatives (hives, nausea, persistent dizziness for days after) but they don’t care. They told me cologard is from an out of network company, so that’s that. But, they don’t have any other provider in-network that offers a similar test. Also, cologard is definitely cheaper than standard colonoscopy.

      I am not having an invasive medical test procedure that will take me out of commission for 2-3 days (if I’m lucky), and can have risks (I have a friend who got a perforated colon from a colonoscopy; he almost died).

      Oscar likes to throw roadblocks in your way for almost any procedure or treatment. Their default is to refuse to pay, and you always have to fight them. They are basically a fraudulent company, taking your premiums and making it nearly impossible to get any care paid for.

      We need SINGLE PAYER health insurance in this country. Then there would be no question of in network or out of network. And for anyone who thinks the government can’t do a good job with anything, I have a hard time believing that anything could POSSIBLY be worse than these GREEDY, FRAUDULENT, EVIL private health insurance companies.

      Reply
  4. I am a Psychiatrist practicing in New York City. Oscar through a company called Ciox requested a chart of a patient for review. The entire chart. The crazy part is that I am not an Oscar provider and my patient sees me “out of network” because his Oscar plan does not actually provide adequate mental health benefits for his needs. So, Oscar requested extremely sensitive information regarding a patient I treat for Bipolar Disorder.

    Might I add that this is a company founded by a [redacted] brother.

    Reply
    • Ha-ha: I am dealing or rather not with Ciox for over a year: that is a 3rd party company, collecting patients info, documents, etc.

      I am an Oscar provider, still, I do not have to provide sensitive info to a 3rd party.

      They are pushing, even threatening me, they are really-REALLY bad.

      But I do know what I am doing: Ciox just called me today, again.

      Do not have to do if you do not want to.

      Oscar can contact you directly if they want something: still, the patient has to give consent to provide information!

      Reply
  5. I am SO frustrated by my dealings with the OSCAR and the company who provides their Physical Therapy services, eviCore. Below is a statement that I just sent them…..
    I and my physical therapist office have talked to them (eviCore) on MULTIPLE occasions to try to get the services that my Therapist, my doctor and myself, feel I need. EVERY time I call their representative to try to get some clarity, I am given information that does not match what I have been previously been told or that my therapist has been told. So, one complaint is that they do not keep good notes and are unclear about what they are doing. My second complaint is that they are disregarding my best interest. I have been in pain for over a year and am finally feeling better and seeing a light at the end of the tunnel. My therapist has said to them on multiple occasions that she feels like if she were able to work with me for 4 more weeks then I should be good to go but they are not allowing that. She has now requested 2 more visits to set up a home plan because they told her they would not give anymore and she was able to get them to consider the 2–even though this is not what she thinks I need. (btw, I am already doing LOTS of exercises she has given me at home, I am still having trouble sleeping due to hip pain and am not able to walk or sit for any amount of time without discomfort, not to mention get any kind of exercise) I am so frustrated as is my provider.

    Additionally, I drive 30 minutes to go to a therapist because you guys had only ONE of the many physical therapy groups that my Doctor (who is in your plan) recommended. I think this is unacceptable.

    Reply
  6. Do not use this company! I canceled my insurance with them last month, and the Oscar rep verified the cancellation. Yet, I just found out that I’m still being billed, and that they have no record of the cancellation. Each time I call, I can’t get anyone to help resolve the situation.
    And… the reason for canceling, is because there are very few doctors in their network. So, I would hope these two issues will be enough to keep people away.

    Reply
  7. This insurance (Oscar) is fraudulent. Yes they do insure but their online payment is messed up and they don’t even bother to refund you.

    I got charged 3x for a 1 month payment. They said it didn’t go through the first two times for a bad zip code. But the truth is, it did go through. I brought this to their attention and they didn’t bother to refund me.

    Now I have 32 cents in my account. Thanks to them. I’ll be reporting fraud!

    Reply
  8. They are horrible and absolutely unhelpful. I would encourage anyone to go elsewhere for coverage.

    Reply
  9. Oscar is by far the worst insurance company EVER! I had a UTI and could not find a doctor that would fit me in until 3 weeks out. The doctors not only have terrible reviews, but they are non-existent. Good luck finding any doctor that takes this insurance. If you do find any, they are booked out at least 3-4 weeks out and they won’t take you in earlier even if you have a serious health issue. I’m dumping this garbage insurance and going back to my old plan which is a bit more monthly but at least I can get in to see a doctor.

    Reply
  10. HELP: How Do You You Get an Estimate of Health Care Costs? Oscar has Denied Me in Every Attempt.
    I called Oscar with instructions from my doctor to call my insurance company and give them billing codes to estimate a long-term treatment plan for my son’s allergy shots. When I called Oscar, a supervisor [Redacted] told me that you cannot estimate cost until AFTER you receive treatment. My physician said the cost could be as much as $8,000! Doesn’t a patient have a right to know what they will be billed? AT LEAST AN ESTIMATE! [Redacted] has strongly denied my request for a simple estimate.

    Reply
  11. I had them for 2 years and other than for basic GP visits or emergency care, they question everything and try to make YOU pay as often as they can. Read the fine print. I switched to Blue Shield. A bit more expensive but in the long run much cheaper. Haven’t been with them for a few months and still receiving bills from basic things they didn’t cover, but is covered by my new insurance. Please don’t sign up with them.

    Reply
  12. Seeing the number of bad reviews here kind of scared me at first but then I started reading them and almost all of the bad reviews were from people who really should have been blaming themselves, not Oscar, for things like getting their policy canceled for failing to pay their premiums, for not informing their doctor that they need to make sure the lab they will use for blood tests needs to be part of the plan network, for not bothering before signing up to see if the provider(s) they want to work with are in the plan network, for not bothering to understand what the deductibles and co-pays are would be before they bother to sign up and for not bothering to ask which blood tests are covered per the ACA’s criteria for essential care.

    Last year I saw a bunch of bad reviews about Ambetter and noticed the same thing about most of those bad reviews. So, I took a chance with them because they had the lowest premium plans. Best decision I could have made since they turned out to be really good at complying with the plan’s benefits, customer service has been very friendly and helpful, prompt claims processing and prompt payments to providers.

    For 2018 Oscar has entered my area offering the lowest premiums. Since I’ve seen nothing in the negative reviews that indicates any significant problem with Oscar whatsoever I think I’ll be signing up with them.

    Reply
    • Just make sure you put yourself on autopay or a note on your calendar. Because at least in NY, they did mail or email a notice for the monthly premium being due. My first month with them was March. I received absolutely no communication for April. I remembered a few days into the month and it was too late — they’d already canceled my policy. They did this to thousands of others in my state — I know because our Attorney General’s office has a health insurance department. The state government said this was unethical of the company. So go ahead and blame the people, but what company that you know doesn’t send you a billing notice? And if it happens the first time at least you know so that you set a reminder for yourself. But when they immediately cancel you — you don’t even get the chance. And before you say “autopay” — some of us have experience with companies overdrawing more money than they were supposed to and are cautious about auto bill pay.

      Reply
      • I said that most, not everyone’s, complaints about Oscar were due to their own fault. For instance, the person you had originally replied to was a MONTH past due on the premium payment. Sorry, there is absolutely no excuse for that and that person bears full responsibility for the consequence of non-payment. Others complained about how bad Oscar’s benefits are but the insurance companies make it very clear in their benefits summary and detail documents what they cover and don’t cover, what the co-pays, deductibles, coinsurance and max out of pocket levels are. Still others complained about Oscar not paying benefits for service provided by non-plan providers or for not confirming with their doctors that they would be participating in the plan. It is very clear from what they posted that they did not take the time to understand the benefits/coverages were that Oscar provided before they signed up. That is their fault, not Oscar’s. If they wanted better coverage benefits they should have signed up for a different plan (and paid the higher premium for that coverage).

        Your complaint does appear to be different than most of them. If Oscar canceled your policy for being only a few days late on the payment then Oscar was not compliant with ACA policy cancellation requirements. Your state gov’t then simply saying it was “unethical” of Oscar and not taking action to enforce the law (i.e., re-implementing canceled policies), especially when thousands of people were affected, is mind-numbing and speaks of gov’t incompetence.

        I do agree that perhaps the best and most fool-proof method of payment is to set up autopay. Mailed bills sometimes get misdelivered or lost in the mail or get hidden in some flyer that gets thrown out. Emailed bills are sometimes filtered into spam/junk email folders which many people do not check very often or at all. Most of the people I know who have had autopay issues had them because they made a mistake in when and/or how they set it up or they failed to ensure they had sufficient funds in their account to pay for it when the autopay transaction occurred. Those who don’t want to use autopay or can’t budget themselves properly to use it should do as you suggested…enter payment reminders in their calendars.

        Reply
        • How are you liking them? I’m thinking of going with them because they charge a $600 copay for giving birth and up to 5 days in the hospital which seems too good to be true. I’m scared after reading all these reviews though! Help!

          Reply
          • Sorry about the late reply. I liked them so much in 2018 that I signed up with them, again, in 2019. Most of my doctor visits and prescriptions in 2018 were rather routine and nothing unusual and there were no issues encountered with Oscar. I also had one ER visit which also was managed well by Oscar. Just make sure no matter who you take out insurance with that you clearly understand which doctors, pharmacies, hospitals, urgent care facilities, and labs are in their network. Failure to do so (especially in EPO plans like Oscar’s and with HMOs) will often result in unexpected and unpleasant surprises.

      • Also, be sure to have them send you an email if you cancel your policy. Don’t allow them to just give you a confirmation number. Make sure you get a confirmation email before you get off of the phone. I’m still trying to get my policy canceled with them, almost two months later. In the meantime, they are still charging me.

        Reply
  13. By far [Redacted] has the WORST customer service! Try missing your payment for a month (for any important reason) and they terminate your membership policy WITHOUT GIVING YOU A NOTICE. They don’t have a system of fines, neither do they re-instate your membership. I don’t have any doctors bills with them either. Never again.

    Reply
    • Same thing happened to me. Absolutely ridiculous! Car insurance companies don’t behave this way. These insurance companies are B.S.

      Reply
  14. Just saw an interview CEO Mario Schlosser gave at a CB Insights conference and the headline should be changed to “The User Experience Sucks with Oscar.” I just learned that the health plan I had in 2016 and renewed, because they said it was the same plan, in fact has two key elements MISSING. No notification that we were losing parts of the SAME plan, which now even increased in price in 2017. If I hadn’t looked at the two cards side by side i wouldn’t have noticed. Does Oscar just expect to omit things, not say anything and hope that members won’t notice? Their claim of Health Care that’s Simple to Understand is deceptive and almost fraudulent if you don’t tell members they will be losing things by renewing the same plan.

    Reply
  15. This is by far the worst company! Horrible plan services and bad costumer service!

    Reply
    • I was just told that my gym reimbursement was not on time. sent it in december for the full year. their form does not say that it has to be submitted within 120 days ever 6 months. happy to contribute to a class action suit.

      Reply
      • Yes, they’re really stingy about reimbursing the gym membership. I was with Oscar for two years – and you’re allowed to apply for reimbursement twice a year (once every six months). Since I go to the gym every day, it was easy for me to quickly collect the visits that I needed. But if you dare to submit the application before the full six months are up, they throw it away. I discovered this after many many hours on the phone being transferred from one person to another when I was trying to find out where my reimbursement check was. If you submit even one day before the six months are up, it’s discarded and you have to resend it again. And then when you do resend it, it constantly gets “lost.” I had to send each application at least FOUR times – AND follow it up constantly by phone to make sure they received it and it was being “processed.” I went through this nonsense every single time I submitted my claim for gym reimbursement over the two year period. I can’t tell you how many hours and days I wasted on the phone trying to get paid. I eventually got the check -but not before countless phone calls and re-faxing, re-emailing and re-sending by snail mail at least four times.

        Reply
    • Your lawsuit against Oscar for misleading people about in-network providers – unfortunately – could be filed against almost any of the insurers. United Healthcare, Fidelis – all of them – do the exact same thing. They all claim to have thousands and thousands of doctors in their network, but when you call the doctor’s office, they don’t take the insurance. OR the doctor doesn’t exist at the number they list – and when you track down the doctor, he’s listed 50 miles away and also doesn’t take the insurance. It’s extremely frustrating.
      And I agree about Oscar not being quick to resolve issues. When I went for my annual physical – which was supposed to be covered 100% and not subject to a deductible – they started charging me bills for the needle that was used to take the blood and for tests they didn’t think were routine (even though the lab confirmed they were routine tests). It was ridiculous. I asked them how the doctor was supposed to take blood to do tests involved in an annual physical without using a needle? It took over six months to get this resolved. …. Then in 2016, they improved things a bit by allowing ALL labs to be covered 100% if they go through Quest – and that helped alot. But now they’ve dropped that plan for 2017.

      I also found it extremely difficult to find doctors that took Oscar. And now for 2017, they’ve chopped that number in half!!! Ridiculous.

      Reply
  16. My experience has been very similar to other commenters here. I became pregnant immediately after signing up for insurance through them and it has been nothing but a HUGE pain since. Oscar is evasive, they go back on their word, they give you the run-around so that is takes weeks/months to get an issue resolved (if ever), and I feel like all I’ve done for the past 6 months is spend time on the phone trying to do their work for them. Not to mention, I’ve run around to get medical necessity forms they require (that don’t change the cost of outrageous bills AT ALL) and hospital Tax ID information for them, with my own time and energy. It’s much too much work, money, and time, and not remotely what they promise – “Simple.”

    Reply
  17. Having moved from California, which embraced the ACA, to Texas, which has fought it tooth and nail, I was pretty disappointed with the premiums prices and what was offered. I chose Oscar with no knowledge about them. Needless to say, I was apprehensive and expected the worst. I have been pleasantly surprised. I’ll start with Oscar’s big downfall – it’s not we’ll known and not accepted by a lot of doctors, clinics, etc. That said, I was very pleased with their customer service. Being new to the area, I was having a difficult time finding a doctor. I called customer service and was quickly connected to someone who took his time explaining things, helping me find a doctor, and offered suggestions and information that could save me time and money. I thought this was a flock, but have called on two other occasions and have dealt each time with someone who seemed to care, and listen. I like their website, and like the documentation I receive from them when I have a doctor’s visit. I will admit I chose a higher quality policy, but once I met my deduction, it’s been smooth sailing! I would definitely recommend Oscar.

    Reply
  18. 1. The person doing the intake stated we had a discount we could get. She never said it was medicare. She set us up on medicare even though our company was paying for the insurance.

    2. She never reversed our medicare enrollment

    3. She got the spelling of our names wrong despite repeating the spelling twice

    4. She told us they would send an invoice.

    5. Never got an invoice.

    6. Called and was informed of the premium and the address where to send it (in NYC).

    7. I was also told to send it by the end of the month

    8. Sent it. I called and they said all of our introduction packets would be sent once the payment was processed.

    9. Never happened. Sent second payment. It cleared.

    10. Called to ask about our packets, we were told that we were cancelled due to non-payment. I repeated everything that happened and the person who was helping me said she would get to the bottom of it. In our conversations, we discovered a few thins:

    a. NYC address was incorrect. That was the corporate office they gave me. I should’ve been sending to CA address.

    b. NYC address does process payments but slower than CA

    c. The first check was never found though I had proof of it being sent.

    11. By this time, two months checks had cleared, but the first check was not found. I said, “Well then let me send you a check to replace the lost one.” I was told that unless we can show the first check clearing our account, they will not reinstate the account. “So you admit there was an error made on Oscar Health’s part and you have left me unprotected for two and half months now and your answer is we are not reinstating you” – SHE SAID YES.

    11. I asked that they send me back my premiums. The first arrived in 3 weeks. The second in 6 weeks. So returning my money can take as along as they want!!!

    This was a gross display of the degeneration of health care in this country and I am disgusted! PLEASE DO YOURSELF A FAVOR AND GO ELSEWHERE FOR YOUR HEALTH CARE.

    Reply
  19. I signed up with Oscar insurance. 8 mos after signing up I was diagnosed with uterine cancer. The gynecologist was in Network, but 3 weeks after the test were done, I was told that the lab that was used was out of network and the $900, of the lab work was not covered, leaving me to pay it. I was told by Oscar that when I pay OOP, these payments can not go toward my deductible since the providers were Out of Network.. What a crock. I have paid more than $1,300 in payments that are not going toward my deductible and still have $900.00 of lab work to pay that will not be applied toward my deductible. I am really considering filing a complaint with the Department of Insurance Regulations.

    I went on the Oscar website to find a gynecologist- oncologist because the doctors that I was referred to is not in the network. Every doctor I called was either not in the network, or the hospitals they are affiliated with are not in the network. The list of these specialist on the website was more than 20. But now there is only 3, and 2 of those said they do not accept Oscar. That leaves only one specialist in a 70 mile area, that was a graduate of Chiropractic school until 3 yrs ago. In other words, not much experience.

    It has been a month, I have not had any treatment for my condition because the hospitals they claim are in the Network, (Baylor Hospitals), tells me they do not accept Oscar Insurance. So now I am stuck between a rock and a hard place. No hospitals which are suppose to be in network, will accept Oscar. There is only one specialist in network, which is 70 miles away. I guess I will have to have a hysterectomy in the doctors office before it will be covered by Oscar, And you know that these procedures need to be in a hospital. I have a hospital right across the street from me, but I will have to drive myself 70 miles there and back to see the only specialist in the network.

    I have called Oscar so many times and no one does anything. When they call me back, it is to give me the info for a doctor that is on the Oscar Website that has already told me that they are not in the Network. You have to do all the leg work yourself. when you go to your doctors office and have lab work, you have to make sure they are using Quest labs, and not the labs they are used to using. You have to manage every single thing, to make sure it will be paid by Oscar. This is exhausting. Do not take for granted that if the provider is in Network, any lab work that they perform is in Network.

    I think the Insurance commissioner should look into these tactics. As a matter of fact, if nothing is resolved within the next week, I will be filing a complaint with the Insurance Commission myself. There should be a law against Stating that hospitals and doctors are in the Oscar Network, when they are not.

    Reply
    • These reviews are terrible. Misleading & fraudulent, while people try to get decent health coverage (which shouldn’t be such an issue in this “land of the free”, but that’s another story.) I am looking for health insurance, and Oscar is definitely not one of them.

      Reply
  20. Oscar insurance is more like a financial institution, where you invest lots of money a month and never get dividends in return. I have heart problems and Oscar insurance could care less until I pay the 5900.00 deductible. Worst insurance ever. In fact my doctor is not accepting patients with Oscar insurance. Pure crap!!!

    Reply
  21. I signed up with Oscar in Jan. 2016. In May of 2016 my son was denied service by our pediatrician’s clinic even though she was supposedly in-network. Over a month later, and Oscar is still giving me the run-around. Half of the pediatricians that they claim to cover as associated with this clinic that says it does not accept Oscar. Every time I call customer service, I am treated nicely, but nothing is resolved. Now I am either stuck with Oscar until open enrollment or cancel now and pay penalties for not being insured.

    Reply
  22. Oscar is the worst insurance company. They pulled the bait and switch on me of my doctors not being in network–that was a key point for why I chose them. Once it’s too late to change, oops! My doctors are out. Then I go see a doctor that Oscar recommended, in network, and they paid less than $20 of the office visit. That’s insane! I have a doctor’s bill that’s now the same as what I pay for insurance! They gave me the same b.s. about negotiated rates. I’ve never had an insurance company be so [Redacted] before.

    I canceled and would rather pay out of pocket at urgent care centers than give Oscar one more dime.

    Reply
  23. The worst insurance company I’ve ever dealt with. They pay $17 for a chiropractic vist and unfortunately the patient is responsible for the rest over $80. I quickly dropped out of network and instructed patients to choose another plan when offered.

    Reply
  24. very disappointed in the coverage, I took a fall recently and done some damage, only to find out that Oscar doesn’t want to assist me in my care nor my recovery.

    They also gave me nothing but problems and grief over my children’s Pediatric Doctor, then they had the hide to suggest i move my kids to another pediatrician after being with the one we are with for the past 2 years, their systems said they covered patients but their reps said something different

    This company seems only interested in lining its own pockets that looking after its members, happy to say it would pay better to go insurance-less than with this company.

    I will be finding a better company next time.

    Reply
  25. Oscar is a criminal. Oscar informed its members soon after open enrollment closed that they have cancelled 2 major providers from their plan. They’re suggestion is to fill out an extension form so you can keep on seeing your doctor(s), but obviously none of the former providers will be open to this because they will not get paid in the end.

    Shame on you Oscar for behaving like a petty thief! Taking members money then canceling major providers.

    Reply
  26. I have had the most infuriating outrageous customer service experience of any company ever I have dealt with.. the agents who answer the phone are for the most part ( there has been 1 or 2 exceptions) very nice, well mannered and try to help. The problem is they lack the ability or authority to actually facilitate the help if the problem is not the norm, like a claim amount in dispute etc.

    I had some biopsies done at a very well known lab that Oscar partners with, asks you to use and I did. The claim was paid, that is not the issue. The issue is that in the explanation of claim, the full view of the claim, they have down an illness and diagnosis that does NOT apply to the procedure I had done. They have mis characterized my health, what was performed and what was found after the biopsy. I have tried for EIGHT LONG and frustrating days to actually get a manager to call, NOT A ONE accept one person days ago who was useless and said he could not promise it could be resolved.. unreal… the scarey thing is THERE IS NOBODY in corporate, no phone number list of managers, no one to contact other than routine member services who write a ticket and nobody ever follows up on it/ I tried finding information on corporate in NY though I am in NJ, and found one informal phone number on line, the gentlemen said he was corporate, and he could see it would get resolved.. I had to repeat the situation so many times it was exhausting, and then he did not seem to understand where to find the incorrect diagnosis though I explained it repeatably.. Then I copied and pasted it all and he actually said, WHY DOES IT MATTER if it does not get taken care of right away, what is the difference! I was dumbfounded… IT IS WRONG IN MY MEDICAL CLAIM HISTORY and it does matter.. would they not care if they did not get paid one month or two or three, would we get to say WHY DOES IT MATTER if you do not get paid!!! today I got an email from him, I find out he is in finance, not even anyone with authority to deal with this, and he sent me an email he passed along saying the customer is upset this is not right. it was a meager attempt to pass it along, not comprehensive enough to explain the situation. Nobody gives a [Redacted] EIGHT DAYS of my time on phone.. one agent after another promising to personally call me back, OR have a manager and NEVER EVER does that happen.

    To have a health insurance company who tauts technology screw up my claim history and nobody can manage to delete the incorrect stuff and re phrase it correctly UNREAL!!!!!!!!!!!!!! Further the diagnosis codes and other codes are ALL correct, having spent my personal time calling my doctor, St Barnabas billing and the laboratory and still OSCAR does not bother to fix this.. high tech company who is not capable of deleting incorrect information off of my history.

    I am going to make a formal complaint to the state if not fixed by monday.. NEVER had a worse experience,, it is shameful . I am told well the doctor has the right history even if we don’t ARE YOU KIDDING ME!!!!!!!!!!!!!!!! it is in my opinion fraudulent to put down things I have NOT had done and refuse to correct it. i am tired of hearing it had to go to another dept, that dept, NEVER contacts me. this is not rocket science this is blatant NOT CARING about the customer.. I have had it. It is always going to be accelerated to a manager but NO MANAGER EVER CALLS and when I call there is NEVER a manager that can come to the phone. NO WAY TO RUN A COMPANY in my opinion. I had aetna for over a decade, and all the others and NEVER had a single problem in my life with health insurance until now… NEVER AGAIN

    Reply
    • Since I have posted my complaint/comment about incorrect language on my history of medical procedures, Oscar has taken action to resolve this issue and amend it which I appreciated. It took too much effort to get to that point, but in the end they did something to resolve it, so i felt it only fair to say that they did make an effort to correct their mistake.. thanks

      Reply
  27. Well i signed up on the marketplace with Oscar….5 days in and i am already furious. I live in the 16th largest city in US. We have 3 top quality hospitals within 10 minutes of me and Oscar is telling me i have to travel 40 -45 minutes to Dallas to go to a covered hospital…..WTF? Tomorrow i am seeing if i can get out of this insurance and get into another marketplace plan.

    Reply
  28. It’s disturbing to read the negative comments about Oscar – however in the course of my due diligence I’ve heard horror stories about pretty much every insurance company out there. Also, I think most people don’t go to the trouble of leaving comments when they’ve had a positive or normal experience – it’s more common when they’ve had a terrible one.

    Personally, I’ve had Oscar for the last 2 years. In that time I had a severe neck injury in late 2014 that ultimately necessitated a trip to the emergency room (NYU), visits to 2 specialists at NYU Langone Sport Medicine Center, appointments for various X-Rays and MRIs, several prescriptions for different pain medication, and a lot of physiotherapy. Happy to say that my neck is fine now. My family doctor in Brooklyn is also part of NYU Langone (although I didn’t know that when I found her through a friend’s recommendation) and my medical history from the last few years has been at her finger tips through NYU’s system (through which I also have access to my records), so she’s been able to monitor my neck during general check ups – which I now schedule regularly since they’re free.

    Through this all, I’ve had to do a little work finding recommended specialists whom are affiliated to Oscar (or Magnacare) but have had no problems or headaches – it’s all been straightforward and as advertised. My hospital stay in 2014 took me up to my deductible and thereafter everything was covered and prescriptions have been free. in 2015, a couple of doctor visits were free as were my prescriptions. I did have a few copays for tests in 2014 and 2015, maybe added up to around $30.

    All in all, I’m comfortable knowing that when disaster strikes (and my primary motivation for health insurance (besides it’s legal requirement) was catastrophic cover plus some bells and whistles), I had no problems quickly and easily getting good care without any nasty surprises and problems with vile officialdom.

    Perhaps there are better insurance companies out there but the ones I spoke to completely alienated me with labyrinthine websites, indecipherable paperwork, extremely poor phone menus and manners – if the up front process is that off putting, mind numbing and time consuming, god forbid what the back end experience might be.

    I can only speak for myself but Oscar was easy to digest up front, chose a plan and when I actually had a medical emergency, the process was simple and straightforward. I’m now in the process of choosing a new plan because Silver Edge Plus was discontinued – however, the plan I’m migrating to (Silver Simple Plus) seems to offer a few additional benefits for around $20 more – in general the prices appear relatively stable.

    Reply
  29. Oscar is not transparent! I called to make sure lab were covered at a particular site and was told “yes” only to get a $300.00 bill as they were just covered for “Oscar’s negotiated rate” and I had to pay the difference! This is a typical bait and switch strategy. I will not trust Oscar in the future and demand everything in writing.

    Reply
    • I absolutely hate this company. They are thieves and liars. They increase the premium the minute the ink dries (literally) and their prescription plan is a blatant lie. Then when you try to get them on the phone they send you from one department to the other and they basically cover NOTHING, even though they say they do. Sure, they’re great when you sign up but they are absolutely not there for you when you need them. At all. I hate them SO much and would never let anyone I care about join their program. They’re despicable.

      Reply
      • i signed up in dec. for jan. this year …made sure that my wifes m.s. medication was on list (TECFIDERA). the market place documented that the medication was on the 2016 list . after two weeks of being transferred around i found out the drug was removed from the covered list. actually picked the more expensive plan for the lower drug copay… double [Redacted] the consumer…i am leaving going to care connect..

        Reply
    • Hi julia, i just enrolled with this health insurance, it was so fast to do so, i did it at a walmart, but now reading this negative commens, makes me worry, any orher health insurance you know about which is good? Let me know, thanks

      Reply
      • I have had a bad experience with Oscar. Never again. I went with Freedom Life and PHCS and have had a great experience so far. And you get assigned an agent who takes care of you and deals with issues if they arise. My agent is [Redacted]. He has great customer service and tells you how it is.

        Reply

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