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Oscar Health Insurance Reviews: Is It Legit Or Scam | How It Works

Being the “new kids on the block” has not prevented this company from making a name for itself. In their nearly eight years of existence, they have achieved great strides in the health insurance industry. A review of Oscar’s health insurance company will reveal if they are a scam or legit and keeping their promises.

Though the health insurance company is young and still new to the market, it’s evident that they are striving to carve a spot for itself in the health insurance industry.

They promise great user-friendliness for their app and website and transparency and convenience with their unique features.

This Oscar health insurance review will reveal how it works and answer the question of its legitimacy.

What Is Oscar Health Insurance?

Oscar Insurance was founded in 2012 by three friends and classmates who attended Harvard Business School together. The current CEO, Mario Schlosser, was one of the founders, with Josh Kushner and Kevin Nazemi.

In their few years of inception, they have managed to carve a spot for themselves in the health insurance market. Oscar received some negative reviews for an unclear pricing structure two years after they were established.

However, they continued to work towards being one of the top dogs in the health insurance market. They employed technologically based systems to limit their coverage areas, networks, and paper trails to combat the unclear pricing structure.

This way, they fulfilled their promise of becoming one of the easiest-to-follow health insurance plans by simplifying the sign-up process.   

Although, in trying to achieve this feat, they lost out on providing the best insurance. While other insurance companies built global networks over the years, Oscar focused on delivering a great user experience.

This was the bedrock of most of Oscar’s bad reviews.

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How Does It Work?

Understanding how Oscar works is not so challenging, so we would treat it extensively by considering the costs, unique features, and medical coverages they offer.

How Much Does Oscar Health Insurance Cost?

This is one of the most critical concerns, so we’d address it first. There is no denying that they offer some attractive benefits about the price. However, you’d have to decide if these benefits justify the costs. 

Now, as soon as you attain your deductible mark, there’s only one set price for it, and that’s $0. There’s no out-of-pocket payment once you reach your deductible, regardless of the circumstance or treatment. 

However, there are some challenges with this arrangement. Firstly, before that deductible is met, you must consider other copays and prices for various conditions. Oscar isn’t simplifying everything since you need to consider different costs before reaching your deductible.

This can be pretty prolonged, depending on your deductible and your medical needs at that moment.

Regarding this, you should know that the costs of Oscar health insurance are reviewed by the different plans they offer. They offer four programs – classic, simple, saver, and backup. These plans also have different tiers – Secure, Bronze, Silver, Gold, and Platinum; and different pricings.

What Are The Member Resources and Unique Features?

The Oscar smartphone app or online website would allow you to review some of their unique benefits.

As soon as you buy an Oscar health insurance plan, you get a welcome kit that would include your plan ID cards, a summary of the policy benefits, and other free perks and benefits, like a $400 repayment for a gym membership and about $200 for every covered spouse.

You can track your steps on the app and website and stand a chance to win about $100 for every year you reach your step goal. Also, you can view and read crucial mental health topics and track your progress in the desired direction.

Oscar Concierge Team

Oscar offers a concierge team to help you review your health insurance plans. They usually consist of a specific set of healthcare guides and nurses to provide 24/7 healthcare advice.

This way, they familiarize themselves with your health conditions and your health insurance policy to help them proffer the best advice and suggestions to matters concerning billing issues, finding the best urgent care clinic or emergency room, checking the availability of doctors, as well as answering any policy questions you may have.

You can also access the concierge service through the Oscar app for video conferences with healthcare providers.

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Doctor On-Call

This is another unique feature Oscar offers its members – Telemedicine. This doctor-on-call service lets you have face-to-face conversations with Oscar’s internal doctors.

If you’re wondering how it works, this is:

You request a call from the app anytime in the day with a picture of your symptoms. You’d then get to talk to a doctor to discuss your medical history and symptoms. The doctor would then give you a diagnosis and proceed to send a prescription to a pharmacy if need be.

Both services provide personalized customer service. So, if you do not want to go through the stress of booking an appointment or visiting a health provider, an on-demand health evaluation would be perfect for you, and that’s what Oscar offers.

What States Have Oscar Health Insurance?

Coverage has been a challenge for Oscar’s health insurance. Their services are not available in all the states in the United States. As such, members have to be located in any of the following 18 states – Arizona, California, Colorado, Florida, Georgia, Michigan, Iowa, Kansas, Missouri, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, and Virginia.

Oscar promises to provide solid user-friendliness in their app and website and also with the quality of their doctors and healthcare providers. However, the lack of coverage challenge is still a source of the not-so-great Oscar reviews.

Think about it; you’d be dissatisfied if you had a health insurance plan not accessible in states you sometimes travel to.

However, if you do not travel often, you may not have a problem with this shortcoming, and Oscar would be a fine option.

Does Oscar Cover Vision And Dental?

Oscar does not cover certain medical conditions like vision and dental. They may offer these services to children below 18 years of age. This isn’t necessarily a significant accomplishment since most health insurance companies provide the service for all ages.

This will be a severe disadvantage if you seek comprehensive medical insurance. So, ensure you look at the health insurance details and if they provide coverage for therapy before you sign up.

If you intend to sign up with Oscar, check for all the plan details to know what you’re signing up for.

Also, some users have complained about receiving medical bills after treatment. The insurance didn’t entirely cover their procedures. Try to find out precisely what your plan accommodates so you don’t get surprises.

This could be attributed to the fact that irrespective of how well they are doing in so little time, they are still new to the market and may need time to fix these challenges to match the older, more experienced insurance companies.

However, people still want their money’s worth and continuously demand that they become more transparent. Nobody would like to be denied the help of their insurance when the need arises.

Know your pre-existing conditions and determine if your Oscar insurance covers them.

What Are The Pros And Cons Of Oscar Health Insurance?

There are certain benefits as well as downsides to using Oscar health insurance. This Oscar’s review of the pros and cons would reveal if it’s legit or a scam.

More than one plan option is availableLimited availability
Some unique features for membersLimited coverage
Superior customer service
Some member resources are available.

Is Oscar Health Insurance Legit Or A Scam?

They have a corporate office in New York City where Oscar health insurance company operates their legit business.

They have been well-rated by some of the largest-ranking companies, like the Better Business Bureau (BBB) where Oscar has an A+ ranking with 25 customer reviews.

Furthermore, it has an NAIC complaint ratio of 0.12, showing that it receives fewer complaints than the median company when considering its size.

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Final Thoughts

Since its inception in 2012, Oscar’s health insurance has strived to make a legit name in the market. They have grown their numbers to about  420,000 and still trying to make more improvements.

Though Oscar has hit some bumps with bad reviews, it is unarguable that they are legit and provides some uniqueness in their services. However, this company may not be the best choice if you’re in the market for a comprehensive health insurance plan with full coverage.

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