What Is Oscar Health and What Sets It Apart

Oscar Health is a health insurance company that offers affordable and personalized plans to individuals and families. Founded in 2012 by Kevin Nazarian and Mario Schlosser, Oscar Health has grown to become one of the largest health insurance companies in the US.

Oscar Health is known for its innovative approach to healthcare, which includes a mobile app that allows members to manage their health and benefits on the go. With Oscar Health, members can access their medical records, communicate with their doctors, and even schedule appointments online.

One of the key features that sets Oscar Health apart is its focus on personalized care. By using data and analytics, Oscar Health can provide members with tailored recommendations and support to help them manage their health and wellness. This approach has been shown to lead to better health outcomes and lower costs for members.

Oscar Health offers a range of benefits and coverage options. Each of the 11 Oscar Health plans covers therapy sessions, but the amount of coverage varies by plan, so it's essential to check the details.

Oscar Health has a network of in-network therapists, and none of the plans cover out-of-network therapy sessions. This means that if you want to see an out-of-network therapist, you'll have to pay for it yourself.

Oscar's plans are designed to provide immediate value, with affordable copays for routine care. They also offer rewards for staying active with their Step Tracking program.

Here are the types of plans Oscar Health offers:

Oscar's small group plans are offered through a joint venture with Cigna, providing a combination of Cigna's robust provider networks and Oscar's digital and human support.

Oscar has received significant funding from top investors, including Thrive Capital and General Catalyst Partners.

By 2015, the company had raised $300 million, valuing Oscar at $1.5 billion.

Oscar's valuation continued to rise, reaching $1.75 billion in 2015 after a funding round with Google Ventures and Google Capital.

In 2016, Oscar raised $400 million, led by Fidelity Investments, and was valued at $2.7 billion.

By 2019, Oscar had raised $1.3 billion and was valued at $3.2 billion.

In 2020, Oscar raised an additional $225 million in funding, with participation from new investors Baillie Gifford and Coatue.

Oscar Health's revenue growth has been significant since its inception. In 2014, the company had 16,000 subscribers producing an estimated $72 million in revenue.

By 2015, Oscar Health had expanded to 40,000 subscribers, with each paying an average of $4,500 per year, resulting in estimated revenue of $180 million.

Unfortunately, the company's early success was followed by significant losses. In 2015, Oscar Health lost $92.4 million in New York due to inaccurate forecasting of subscriber health.

Despite these losses, Oscar Health continued to grow. By 2016, the company had 135,000 subscribers, with roughly half residing in New York State.

However, the company's financial struggles persisted. In 2016, Oscar Health lost $204.9 million, and in the first half of 2017, the company posted a $57.6 million loss.

But Oscar Health was making progress in controlling its medical costs. By the second half of 2017, the company's losses had narrowed by nearly half.

The company's revenue growth continued in the following years. By 2018, Oscar Health expected to generate $1 billion in revenue and enroll 250,000 members.

By 2020, Oscar Health had grown significantly, serving 400,000 members and expecting to bring in $2 billion in revenue by the end of the year.

Oscar Health Care has a strong reputation for making their members happy. 97% of Oscar insurance members said they were satisfied with their plan, compared to 86% who were satisfied with competitors.

Their tools and resources are user-friendly, with 87% of account holders having a web login and 52% having the health plan's app.

A significant number of members, 33%, log in to their mobile app weekly, showing they're actively engaged with their health care.

Oscar's rewards program has been a hit, with $235,000 in Misfit rewards given out to members who achieve certain health goals.

Interestingly, 70% of their members believe that care starts not with their doctor, but with Oscar, highlighting their commitment to proactive health care.

Oscar Health covers therapy, with each of its 11 plans offering some level of coverage. However, the amount of coverage varies between plans, so it's essential to check how much of the cost you'll be responsible for.

Oscar Health has a pre-selected list of in-network therapists, which will be the cheapest option for you. Unfortunately, out-of-network therapy sessions are not covered.

To check if your Oscar Health plan covers therapy, you'll need to review your Summary and Benefits sheet. This document will outline the details of your coverage, including any deductibles you may need to pay before the insurance kicks in.

Some types of therapy that Oscar Health covers include Cognitive Behavioral Therapy, Psychodynamic Therapy, and Acceptance and Commitment Therapy. These are just a few examples of the evidence-based therapies that are typically covered by health insurance.

Oscar Health also covers inpatient mental health treatment and outpatient substance abuse rehabilitation. This can be a huge relief for those who need these types of services.

If you're looking for online therapy, the good news is that Oscar Health covers online therapy sessions. They even incentivize online visits with providers, making it a convenient option for those who prefer virtual care.

Here are some examples of therapy types covered by Oscar Health:

Let's take a closer look at how Oscar Health compares to its competitors. Oscar Health offers a more comprehensive range of services, including virtual care and a member portal, compared to some other insurance providers.

Oscar Health has a more streamlined and user-friendly online platform, making it easier for members to manage their accounts and access their benefits.

Compared to some other insurance companies, Oscar Health has a more extensive network of healthcare providers, including primary care physicians and specialists.

Oscar Health's virtual care services allow members to access medical consultations and advice remotely, which can be a convenient option for those with busy schedules or living in rural areas.

Oscar Health's member portal allows members to access their medical records, track their health metrics, and communicate with their healthcare providers, giving them more control over their healthcare.