Oscar Health insurance review 2023
“Verified by an expert” means that this article has been thoroughly reviewed and evaluated for accuracy.
“Verified by an expert” means that this article has been thoroughly reviewed and evaluated for accuracy.
BLUEPRINT
Updated 12:39 p.m. UTC Dec. 7, 2023
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Oscar Health
Pros
- Average plan rates.
- Free virtual doctor appointments.
- Rewards for tracking your steps and making healthy choices.
Cons
- No short-term health insurance option.
- Only available in 20 states in select counties.
- Low National Committee for Quality Assurance (NCQA) rating compared to competitors.
Why trust our health insurance experts
Our team of insurance experts evaluates hundreds of insurance products and analyzes thousands of data points to help you find the best product for your situation. We use a data-driven methodology to determine each rating. Advertisers do not influence our editorial content. You can read more about our methodology below.
- 129 health insurance companies analyzed.
- 864 health insurance plan rates reviewed.
- 5 levels of fact-checking.
About Oscar Health Insurance
Oscar Health, Inc. is a first-of-its-kind tech-based health insurance company headquartered in New York City. Oscar Health was founded in 2012 and reached almost a million members in June 2023.
Oscar Health Insurance only offers individual and family, small group health insurance and Medicare Advantage plans in 20 states.
Our Oscar Health Insurance review can help you decide if this health care company is right for you and your family. We compare rates by metal tier with other health insurance companies and discuss plan types below.
Types of plans and coverage available from Oscar Health
Oscar Health has three health plan options in the health care marketplace. Understanding how each plan differs can help you choose the best plan and coverage. Depending on where you live, the PPO plan is restricted to only small businesses or not offered.
- HMO: A health maintenance organization (HMO) plan is typically the cheapest option of the plan types because you’re restricted to in-network providers who contract with the insurance company. An HMO will only cover out-of-network health care providers if you have a true medical emergency. If you pick an HMO, choose your primary care physician (PCP) carefully, as this doctor will provide care and write referrals for you to see a specialist.
- EPO: An exclusive provider organization (EPO) plan will cover health care services you receive that are part of the plan’s network. You typically don’t need a referral from your primary care doctor to see a specialist like you do with an HMO. You also usually have a more extensive provider network and may have coverage options in multiple states. Premiums may be higher than an HMO but are generally lower than a PPO plan.
- PPO: A preferred provider organization (PPO) health plan is usually the most expensive option but has the most flexibility. You can see any in-network provider without a referral. You’ll also have coverage for out-of-network providers but pay higher out-of-pocket costs.
Here’s how these types of health insurance plans compare at a glance.
Compare Oscar Health plans
Choosing a health insurance plan type can be challenging, but evaluating your medical needs can help you determine which plan type is best for you and your family. You should consider how often you plan to see a doctor and what you’re willing to pay out of pocket.
Consider if you need to see a specialist regularly because of a medical condition. Remember, you’ll have to go through the extra step of getting a referral if you need to see a specialist with an HMO.
If cost is most important, an HMO may be the best fit. But if you don’t want the hassle of getting referrals, you might want to consider a higher-cost PPO. If you travel or want more provider options, an EPO might be the right fit.
When you fill out a health insurance form online with Oscar, the insurer makes it easy to compare health insurance plans side by side to make sure you’re getting the coverage you need at a price you can afford.
Additional benefits offered by Oscar Health
Oscar Health has several unique features, including:
- 24/7 free doctor visits, including virtual primary and urgent care visits.
- Concierge team to provide support, help with claims, run cost estimates for medical care and find doctors and specialists.
- Oscar mobile app available, or sync it to your Apple Health or Google Health and earn up to $75 per year for meeting your step goals. This perk varies by state.
- Some prescriptions cost as little as $3, while some prescriptions may be free.
How much does Oscar Health insurance cost?
For a single adult age 30, the silver tier Oscar plan costs $451 per month. Oscar health insurance costs will vary depending on:
- The plan type.
- The tier of the plan you choose.
- Where you live.
- Your age and the age of anyone the plan will cover.
You can typically get lower premiums by taking on more out-of-pocket costs of your medical bills, as you can see with the price points at different metal tiers.
The following sections include sample rates for different family profiles at all three metal tiers for Oscar health insurance plans.
Cost examples for Oscar Health Bronze plan
Cost examples for Oscar Health Silver plan
Cost examples for Oscar Health Gold plan
How Oscar Health compares to other health insurance companies
Oscar Health earns 3.5 out of 5 stars, according to our rating metric. Although it falls below average, it may still be the right fit for customers looking for a technologically-focused insurer or can benefit from free virtual visits and low-cost prescriptions in the 20 states where its policies are available.
The chart below shows our top picks for best health insurance companies in the United States.
Monthly cost for ACA marketplace Silver plans by company
Methodology
We analyzed insurers that sell individual health insurance plans to determine the best health insurance companies. Each health insurance company was eligible for up to 100 points, based on its performance in the following key categories:
- Cost (30 points). Health insurance companies with the lowest average monthly premium and deductible for Silver tier health insurance plans received the highest score.
- Consumer complaints (25 points). Health insurance companies with the lowest levels of complaints received the highest score. We collected complaint data from the National Association of Insurance Commissioners, which shows the volume of health insurance consumer complaints against each company.
- NCQA quality rating (25 points). Health insurance companies with the highest quality ratings received the highest score. We collected data from the National Committee for Quality Assurance (NCQA), an independent, nonprofit organization that accredits health plans and produces ratings based on specific metrics.
- Variety of health insurance plans (10 points). Health insurance companies with the greatest variety of health insurance plans (HMO, EPO, PPO) received the highest score.
- Metal tier offerings (10 points). Health insurance companies with the most options of metal tier plans received the highest score.
The average cost of an Oscar health insurance policy for an individual adult age 30 is $451 per month, according to our analysis. Your age, ZIP code, dependent and spouse’s ages, metal tier and plan choice will determine how much you will pay for an Oscar health plan.
You can enroll in Oscar Health during open enrollment between November 1 and December 15 each year. This is also when you renew your plan or change to a new policy. If you have a qualifying life event, like losing a job and your health plan or having a child, you can enroll during special enrollment periods throughout the year. You can answer a few questions on Oscar’s website to help you determine which plan best meets your needs.
Oscar didn’t score as high as competitors in its NCQA’s rating, which evaluates health plans based on quality of care, customer satisfaction and efforts for improvement. Although Oscar Health Insurance might not be the right fit for everyone, its free doctor-on-call service, low-cost prescriptions and simple plans may be a good fit if you mostly need coverage for urgent care visits.
Blueprint is an independent publisher and comparison service, not an investment advisor. The information provided is for educational purposes only and we encourage you to seek personalized advice from qualified professionals regarding specific financial decisions. Past performance is not indicative of future results.
Blueprint has an advertiser disclosure policy. The opinions, analyses, reviews or recommendations expressed in this article are those of the Blueprint editorial staff alone. Blueprint adheres to strict editorial integrity standards. The information is accurate as of the publish date, but always check the provider’s website for the most current information.
