Oscar Health Insurance is a tech-focused provider aiming to simplify healthcare.
Since its founding in 2012, it has gained attention for its user-friendly app and affordable plans. This article dives into Oscar health insurance reviews to explore its strengths, weaknesses, and customer experiences.
It provides a clear guide for those considering Oscar in 2025.
What Is Oscar Health Insurance?
Oscar Health Insurance, based in New York, offers plans in 18 states. It focuses on technology to make healthcare accessible. The company provides individual, family, and small business plans through the ACA marketplace.
Oscar stands out with its mobile app and virtual care options. Features like 24/7 doctor-on-call and a concierge team aim to streamline the insurance experience. However, availability is limited to select states like Texas, Florida, and New York.
Key Features of Oscar Health Plans
Oscar offers several features that attract customers. These perks are often highlighted in Oscar health insurance reviews. They cater to those seeking convenience and affordability.
- Virtual Urgent Care: Free 24/7 consultations with providers via the Oscar app.
- Concierge Team: Dedicated support for scheduling and billing issues.
- Low-Cost Prescriptions: Many drugs cost as little as $3.
- Step-Tracking Rewards: Earn up to $100 yearly for meeting fitness goals.
These features make Oscar appealing, especially for tech-savvy users. However, not all plans include every perk, depending on the state and plan tier.
Plan Types and Costs
Oscar provides HMO, EPO, and PPO plans, with PPO options limited to small businesses in some states. Plans are divided into ACA metal tiers: Bronze, Silver, and Gold. Bronze plans have the lowest premiums but higher out-of-pocket costs.
In 2025, an Oscar Silver plan averages $582 monthly for a 40-year-old, higher than some competitors like Kaiser Permanente. Bronze plans cost around $488, with deductibles averaging $4,548. Costs vary by age, location, and household size.
Oscar’s Simple, Classic, and Elite plans cater to different needs. Simple plans have lower premiums but higher deductibles, while Elite plans offer more coverage at a higher cost.
Table: Average Monthly Premiums by Oscar Plan Tier (2025)
| Plan Tier | Monthly Premium (40-Year-Old) | Deductible | Notes |
|---|---|---|---|
| Bronze | $488 | $4,548 | Lowest premiums, high out-of-pocket costs |
| Silver | $582 | $4,000 | Balanced costs, subsidy-eligible |
| Gold | $655 | $1,500 | Higher premiums, lower deductibles |
Note: Costs are averages for an individual. Subsidies may apply through HealthCare.gov.
Customer Satisfaction: The Good
Oscar health insurance reviews often praise its technology. The mobile app is a standout, allowing users to manage plans, find doctors, and access virtual care. Many appreciate the app’s intuitive design and quick access to services.
The concierge team earns positive feedback for resolving billing and scheduling issues. Free virtual urgent care and low-cost prescriptions are also highlights. Some users, like Penny from California, report smooth claims and good doctor networks.
Oscar’s Buena Salud program, tailored for Hispanic and Latino members, has an impressive Net Promoter Score of 87. This Spanish-first initiative connects members with culturally aligned providers.
Customer Satisfaction: The Challenges
Despite its strengths, Oscar faces criticism in many reviews. Customer satisfaction lags behind competitors like Kaiser Permanente. HealthCare.gov rates Oscar plans poorly, and the company has a higher-than-average complaint ratio.
Common complaints include denied claims and billing issues. One user reported a $3,003 bill for physical therapy with no prior warning or explanation. Others mention difficulties finding in-network providers, with outdated doctor lists causing frustration.
Customer service is another sore point. Some users describe long hold times, unhelpful staff, and dropped calls. A 2025 BBB review claimed Oscar enrolled someone without consent, calling it “illegal” and “horrible.”
Coverage and Network Issues
Oscar’s network size varies by state, and some areas have limited in-network providers. Reviews often cite challenges finding specialists, with one user unable to locate a urologist after days of searching. Out-of-network care, except in emergencies, costs more, especially with HMO and EPO plans.
Medication coverage is another concern. Some users report that prescribed drugs, like insulin or Ozempic, were denied or not covered, forcing them to pay out of pocket. One reviewer paid over $300 monthly for two people, only to find half their medications uncovered.
These issues highlight the importance of checking provider networks and formularies before enrolling. Oscar’s website offers tools to search doctors and drugs, but accuracy can be inconsistent.
Oscar’s Technology and Innovation
Oscar’s tech-driven approach sets it apart. The +Oscar platform integrates care delivery, member engagement, and administrative tasks. It powers features like virtual visits and prescription refills through the app.
In 2025, Oscar expanded its culturally specific solutions. The Buena Salud initiative now serves nearly one-third of its 2 million members. Guided Care HMO plans offer $0 specialist visits and medications for cost-conscious consumers.
However, the app has glitches. Users report broken links, outdated provider lists, and step-tracking issues. One reviewer called it “insanely frustrating,” citing frequent crashes and no bug-reporting feature.
Financial Performance and Stability
Oscar’s financial growth is notable. In Q1 2025, revenue surged 42% to $3 billion, with membership exceeding 2 million. Its SG&A ratio hit a record-low 15.8%, showing improved efficiency.
Despite this, some reviews express concern about Oscar’s stability. The company has exited markets like California and scaled back Medicare Advantage plans. Posts on X and Reddit suggest Oscar may face solvency issues, though recent profits counter these claims.
For consumers, this mixed outlook underscores the need to research Oscar’s long-term reliability. Its 2025 expansion into 504 counties across 18 states signals confidence, but past market withdrawals raise caution.
How Oscar Compares to Competitors
Oscar competes with giants like Blue Cross Blue Shield and Kaiser Permanente. Its Bronze plan premiums ($488) are lower than the industry average ($495), but Silver plans ($582) are pricier than Kaiser’s ($481).
Kaiser Permanente outranks Oscar in customer satisfaction and plan quality. Blue Cross Blue Shield has higher average prices but broader networks. Oscar’s tech focus and free virtual care give it an edge for some, but limited state availability is a drawback.
For those prioritizing affordability and digital tools, Oscar is a strong contender. However, if network size or customer service is key, other providers may be better.
Tips for Choosing Oscar Health Insurance
Considering Oscar? Here are practical tips to ensure it meets your needs.
- Check Provider Networks: Use Oscar’s website to confirm in-network doctors and specialists.
- Review Drug Coverage: Verify your medications are on the formulary to avoid surprises.
- Compare Plans: Look at premiums, deductibles, and copays on HealthCare.gov.
- Test the App: Download the Oscar app to explore its features before enrolling.
These steps can help you avoid common pitfalls mentioned in Oscar health insurance reviews.
Summary
Oscar Health Insurance offers tech-driven plans with appealing features like free virtual care and low-cost prescriptions. Its mobile app and concierge team earn praise, but customer satisfaction lags due to billing issues, denied claims, and limited networks.
In 2025, Oscar’s Silver plans average $582 monthly, with Bronze plans at $488. While innovative, the company faces criticism for poor customer service and outdated provider lists.
Checking networks and formularies is crucial before enrolling. Oscar suits tech-savvy, healthy individuals but may frustrate those needing extensive care or reliable support.
FAQ
What makes Oscar Health Insurance unique?
Oscar focuses on technology, offering a user-friendly app, free virtual urgent care, and a concierge team. Its Buena Salud program supports Hispanic members with Spanish-first services. However, availability is limited to 18 states.
Are Oscar’s plans affordable?
Oscar’s Bronze plans average $488 monthly, below the industry average. Silver plans cost $582, higher than some competitors. Subsidies through HealthCare.gov can lower costs for eligible households.
Why do some reviews criticize Oscar?
Common complaints include denied claims, billing errors, and limited in-network providers. Customer service issues, like long hold times, also frustrate users. Outdated doctor lists add to the challenges.
Is Oscar’s app reliable?
The app offers virtual care, prescription refills, and plan management, but some users report glitches. Issues include broken links and inaccurate provider lists. Oscar is working to improve its technology.