Oscar Health Insurance

Oscar Health Insurance is the “new kid on the block.” While they may be new, they bring a powerhouse full of intuitive technology tools that are designed to provide the best health care experience.

They were founded in 2013 as Oscar Health Plan of California.

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Oscar Health Insurance was one of the two new carriers that joined Covered California; the California State Exchange in 2016. Their coverage area included the southwest region of Los Angeles County (pricing region 16) and Orange County (pricing region 18).

For 2018 Oscar will be moving into Northeast Los Angeles which is Region 15.

Take Note

Because Oscar is new to the California market, we will need to see how they rated in New York. The New York Department of Financial Services gave them a quality ranking of second out of 12 New York PPOs and EPOs.

Network

A hybrid of the HMO and PPO model, Oscar will be offering EPOs. EPOs work similar to an HMO in that they only cover in-network services. But unlike an HMO, they do not require members to obtain a referral before visiting a specialist.

Oscar’s Southern California network will include Providence Health & Services, UCLA Health and St. Joseph Hoag Health. This will give members access to 16 hospitals along with more than 5,000 doctors in the area.

In Northern California Oscar’s network will offer UCSF Health, Sequoia Quality Care Network (and Sequoia Hospital), Hill Physicians, Verity Health System and SCCIPA.

To view Oscar’s network of provider’s please click here.

The Future is Here

Oscar Health Insurance is proud to ride the wave of the future to not only offer members a mobile app that is intuitive, but user friendly. Many have said that what sets the Oscar model apart from others is the seamless experience. At any time a member can use the app to list a condition, and then are offered a free phone call from a doctor or a visit with a primary care doctor or a specialist with an estimated price. Oscar has said that in other states approximately 45% of their members use this web based app.

The app also helps members see their plan information, the costs they have spent to date, and how that relates to their deductible and out-of-pocket maximum. A provider directory is accessible that can filter provider results based on language, years of experience, hospital admitting privileges, and distance, etc.

An online health risk assessment is available for members to complete that gives them personalized results and a preventative health care checklist. They can also access personal health records that allow them to see a searchable timeline of past health care services received.

While Oscar may be strong in technology they take pride in providing a measureable human touch. There whenever members need them, live Oscar representatives answer 90% of all calls within 30 seconds.