About
Oscar Health Insurance was founded in 2013 and designed as a tech-savvy, consumer focused health insurance company. Oscar provides an alternative to traditional health insurance companies in New York, New Jersey, California, Texas, Ohio, Tennessee, Arizona, Michigan, and Florida.
See our comprehensive review here
Special features
All Oscar plans offer free primary care visits, free generic drugs, and free laboratory tests. Oscar also aims to simplify plans by presenting them to consumers in plain English. Oscar also has some of the best designed apps in the health insurance market, with easy to use doctor search tools and a free Doctor On Call service that helps you with common illnesses without ever leaving your house.
Prescriptions & drugs
Oscar covers generic and brand name drugs that are on their formulary (also known as a drug list). All generic drugs are free for Oscar plan members. You can see if Oscar covers a specific drug by using their search tool.
Learn more about prescription drug coverage.
Enrollment process
You can browse all plans on the Obamacare health insurance marketplace on healthcare.gov, and sort and filter those plans based on your preferences and budget.
Once you’ve selected a health insurance plan, enrolling in that plan is easy. You fill out a short online form, then complete the final step with a quick enrollment phone call with a licensed agent. On that call, the licensed agent will verify your identity, double-check eligibility and answer any questions you may have. For certain insurers, who don’t permit private brokers to enroll customers, you’ll have to enroll directly with the insurer or on your state’s marketplace (these plans will be noted).
After you enroll in a health insurance plan, you will get your membership materials (including your member ID card) and the first premium bill directly from the health insurance company. You are responsible for paying the bill to ensure that your coverage goes into effect, and to keep current on those payments.
Claims process
Your health services provider should make a claim directly to Oscar for you. However, if that doesn’t happen or you visited a non-Oscar affiliated provider, you may need to make a claim yourself. To do so, print out the appropriate claim form (listed on the Oscar form page; choose your state in the top right) and follow the instructions on the form.
Oscar review
Although Oscar is still too new to have the ratings history of other more established health insurance companies, its plan offerings and perks are often hard to beat. From free benefits (primary care visits, lab tests and generic drugs) to a doctor-on-call service to a best-in-class website and mobile app, Oscar’s offering exceeds a lot of traditional plans. It’s generally among the more affordable plans at a given benefit level; however, its provider network is generally smaller than that of the larger, brand name insurers.
Basics & ratings
Founded | JD Power Rating | # of Policyholders | A.M. Best Rating |
|---|---|---|---|
2013 | NA | 257,000 | NA |
Overall score
We evaluated this health insurance company using publicly available data on patient care & satisfaction, customer service and costs (premiums) versus similar plans on the market.
Quality & Satisfaction | Affordability |
|---|---|
NA | 5 out of 5 |