Oscar’s Health Insurance focuses centers around the Internet and mobile applications. Another click and appointment options — a free doctor’s call or a visit to a primary care physician or specialist — are splashed on the screen with estimated costs. A consumer could expect to shell out a total of $200 in co-pays and typical prescriptions or tests for a visit to a specialist. Oscar offers an Exclusive Provider Organization plan, or EPO — a hybrid of the HMO and PPO models. Consumers, for example, receive no coverage out of network, but unlike an HMO they don’t need a primary care physician or a referral to see a specialist. Providence Health & Services, UCLA Health, St Joseph, HOAG, Huntington Memorial and USC Keck have signed on to Oscar’s network, giving it 19 hospitals and 11,000 MD’s in Los Angeles. Orange County has 9 hospitals and 5,000 providers.
All plans are EPOs with Doctor on Call, Concierge, and Step Rewards for staying active. Even better, Oscar never requires referrals to see a specialist. This means you don’t need to book an appointment with a primary care provider just to get a permission slip, saving you time and money.
Classic plans have higher monthly premiums and lower annual deductibles than Simple plans. Most plans provide pre-deductible copays for routine care and drugs. All plans have either coinsurance or affordable copays after you hit your deductible.
Saver plans are low premium, high deductible plans. In California, these are plans that work alongside a Health Savings Account (HSA). With HSA compatible Saver plans, you pay the full negotiated rate for care out of your HSA until your reach your deductible. After that, Oscar pays 100% for any covered care.
Oscar’s Simple Plans
offer something different, they combine the deductible and Out of Pocket Maximum as one number. The kicker, you still get pre-deductible benefits. For example, you have a $4,500 deductible and MOOP on the Gold Simple plan, however you can go to the doctor, get your labs and x-rays all at a flat co-pay prior to meeting your deductible. Simple!
All plans are EPOs Exclusive Provider Organization with Doctor on Call, Concierge, and Step Rewards for staying active. Even better, Oscar never requires referrals to see a specialist. This means you don’t need to book an appointment with a primary care provider just to get a permission slip, saving you time and money.
Oscar Coverage Matrix
Coverage Areas –
We have been approved by the DMHC to expand our network into East Los Angeles County. We now have a coverage area from Santa Clarita north to San Juan Capristano south Malibu west to Pomona east. The only area we do not have in Los Angeles County is Palmdale/Lancaster –