Oscar Health is a US-based health insurance provider founded on November 1, 2012. It focuses on the health insurance industry through telemedicine, healthcare-focused technological interfaces, and transparent claims pricing systems. Founded by three classmates, Mario Schlosser, John Kushner, and Kevin Nazemi, Oscar Health’s headquarters is in New York City. In 2018, Oscar was listed among CNBC’s top 50 ‘disruptors.’
Bright Health is an American health insurance company situated in Minneapolis, Minnesota. The company was founded in 2016 by Bob Sheehy, Kyle Rolfing, and Tom Valdivia. Bright Health started offering plans in the state of Colorado in collaboration with Centura Health. Gradually it began to roll out plans in Arizona and Alabama. With over 1500 employees in their workplace, Bright Health raised revenue of about $440 million in 2019.
Oscar Health
In 2013, Oscar Health started selling insurance when the Affordable Care Act went into effect for the 2014 plan year. By 2014 Oscar managed to secure 16,000 members, and by the end of 2015, the number raised to 40,000. In 2016, Oscar expanded its coverage to New York, New Jersey, California, Texas, and Arizona. It has raised capital from the funding of Thrive Capital, General Catalyst Partners, Khosla Ventures, CapitalG, and Fidelity Investments.
Types of Insurance Plans
Oscar offers a wide range of health insurance plans for its members. These plans focus mainly on individuals, families, and small group businesses. Here are the types of plans available at Oscar Health:
Individual & Family Health
Oscar Health currently offers health insurance plans in Arizona, Colorado, Florida, Georgia, Kansas, Missouri, Michigan, New York, Pennsylvania, Virginia, Ohio, Texas, New Jersey, Tennessee, and California. The following table will help you understand their plans:
Bronze Tier
- Oscar Secure
- Bronze Classic
- Bronze Classic PCP Copay
- Bronze Classic Next
- Bronze HDHP
Silver Tier
- Silver Classic Next
- Silver Classic
- Silver Classic Copay
- Silver Classic $0 Ded
| The Basics | Bronze Classic Bronze Classic PCP | Bronze Classic Bronze Classic PCP | Bronze Classic Bronze Classic PCP | Bronze Classic Bronze Classic PCP | Bronze Classic Bronze Classic PCP | Bronze Classic Bronze Classic PCP |
| Deductible (Individual / Family) | $8,550 / $17,100 | $7,000 / $14,000 | $6,000 / $12,000 | $0 / $0 | $5,200 / $10,400 | $6,200 / $12,400 |
| Pharmacy Deductible (Individual / Family) | N/A | N/A | N/A | $5,500 / $11,000 | N/A | N/A |
| Out-of-Pocket Max (Individual / Family) | $8,550 / $17,100 | $8,550 / $17,100 | $8,550 / $17,100 | $8,550 / $17,100 | $7,000 / $14,000 | $8,550 / $17,100 |
| $0 Preventive care Dedicated Care Team | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
| Dedicated Care Team | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
| HSA-Compatible? | No | No | No | No | Yes | No |
| The Basics | Silver Classic Next | Silver Classic | Silver Classic Copay | Silver Classic $0 Ded | Gold Classic |
| Deductible (Individual / Family) | $6,000 / $12,000 | $5,000 / $10,000 | $7,000 / $14,000 | $0 / $0 | $2,500 / $5,000 |
| Pharmacy Deductible (Individual / Family) | N/A | N/A | N/A | $4,000 / $8,000 | N/A |
| Out-of-Pocket Max (Individual / Family) | $8,000 / $16,000 | $8,550 / $17,100 | $8,200 / $16,400 | $8,550 / $17,100 | $6,000 / $12,000 |
| $0 Preventive care | ✓ | ✓ | ✓ | ✓ | ✓ |
| Dedicated Care Team | ✓ | ✓ | ✓ | ✓ | ✓ |
| HSA-Compatible? | No | No | No | No | No |
Besides these, Oscar Health also offers some other health insurance plans, which you can find in this PDF.
Medicare Advantage
Oscar Health offers Medicare Advantage plans to New York City and Houston, Texas residents. After enrolment, Oscar assigns each of its members to a “Care Team” consisting of three Care Guides and a registered nurse. They attend to traditional customer service questions as well as coordinate clinical care. The federal government offers Medicare Advantage plans to people older than 65. They may fulfill the eligibility requirements if they are natural residents of the United States or have specific physical or mental disabilities.
Cigna + Oscar
Oscar Health has partnered with Cigna to deliver small-group health insurance to businesses. Their plans feature-
- Affordable health plans
- Nationwide network
- 24/7 virtual urgent care
- Easy administration
- Personalized care team
- Employee care navigation
They have a plan called the $0 plan that helps manage your health care more accessible. The features include–
- Get a refill without an appointment
- Talk to a doctor for a $0 copay 24/7
- Get personalized care
- Find care fast
Business
Oscar Health offers customizable business plans in New York that are affordable and easy to understand. Here you do not need any referrals with any plan. You can book with a specialist without seeing a PCP first. Their features include:
- Access to doctors nearby
- Nationally ranked doctors across 100+ specialties
- No referrals for appointments with specialists – ever
- Top hospitals and urgent care centers
- Top pharmacy partners for prescriptions
- Unlimited Doctor on Call, free and available 24/7
- All essential health benefits, like free annual physicals, most vaccinations, and more
Through Oscar business plans, you will get the following benefits –
- Personal Concierge team with a nurse who knows you by name
- Geo-specialized care Guides and nurses who know your area
- Step tracking that pays members just for walking
- An easy-to-use app with appointment booking
- Online tracking of labs and prescriptions
- Real-time deductible tracking
Bright Health
Bright Health uses smart tools and technologies to simplify health insurance for its members. They provide low rates of health insurance plans so members can stay happy and healthy. Bright Health has achieved recognition of its health plan with URAC accreditation which is recognized in all 50 states and the District of Columbia.
Type of Plans
Bright Health offers health insurance plans to 13 states. Their plans include Medicare Advantage, Individual & Family, and Small Business. All over, it offers two main types of plans, namely –
- Bright Advantage (HMO) H8280-001
- Bright Advantage Plus (HMO) H8280-002
Bright Advantage (HMO)
Monthly Premium – $0
Annual Medical Deductible – $0
Maximum Out-of-Pocket Amount – $5,200
Here are some benefits of this plan –
Doctor visits
Primary Care Providers (PCP) – $0 copay
Specialists – $25 copay
Annual Routine Physical Exam – $0 copay
Preventive Care – $0 copay
Diagnostic Services/Labs/Imaging
Diagnostic Tests and Procedures – 20% coinsurance
Lab Services – $0 copay
Diagnostic Radiology Services (e.g., MRI, CAT Scan) – $75 copay
Outpatient X-rays – $15 copay
Bright Advantage Plus (HMO)
Monthly Premium – $39
Annual Medical Deductible – $0
Maximum Out-of-Pocket Amount – $3,200
Here are some benefits of this plan –
Doctor visits
Primary Care Providers (PCP) – $0 copay
Specialists – $20 copay
Annual Routine Physical Exam – $0 copay
Preventive Care – $0 copay
Diagnostic Services/Labs/Imaging
Diagnostic Tests and Procedures – 20% coinsurance
Lab Services – $0 copay
Diagnostic Radiology Services (e.g., MRI, CAT Scan) – $50 copay
Outpatient X-rays – $0 copay
Bright Health Benefits
| Bright Advantage (HMO) | Bright Advantage Plus (HMO) | |
| Inpatient Hospital Coverage | $250 per day for days 1-6 and $0 per day for days 7+ | $185 per day for days 1-5 and $0 per day for days 6+ |
| Outpatient Hospital Services and Observation | $250 copay | $215 copay |
Hearing Services
| Bright Advantage (HMO) | Bright Advantage Plus (HMO) | |
| Exam to Diagnose and Treat Hearing and Balance Issues | $0 copay | $0 copay |
| Routine Hearing Exam | $0 copay Limited to 1 visit every year | $0 copay Limited to 1 visit every year |
| Hearing Aids | Up to a $2,000 allowance for both ears combined every three years for hearing aids. | Up to a $2,000 allowance for both ears combined every three years for hearing aids. |
| Fitting-Evaluation(s) for Hearing Aids | $0 copay Limited to 1 visit every year | $0 copay Limited to 1 visit every year |
Dental Services
| Bright Advantage (HMO) | Bright Advantage Plus (HMO) | |
| Medicare-covered Dental Services | $0 copay | $0 copay |
| Annual Dental Benefit Maximum | No benefit maximum for preventive dental services | No benefit maximum for preventive dental services |
| Oral Exams | $0 copay Limited to 1 cleaning every year | $0 copay Limited to 1 cleaning every year |
| Prophylaxis (Cleaning) | $0 copay Limited to 1 oral exam every year | $0 copay Limited to 1 oral exam every year |
| Dental X-rays | $0 copay Limited to 2 x-rays every year | $0 copay Limited to 2 x-rays every year |
| Optional Comprehensive Dental Services | Available for an additional $21 monthly premium. Up to a $1,500 benefit maximum for all plans covered dental services not covered by Medicare every year. Please see Evidence of Coverage for details. | Available for an additional $21 monthly premium. Up to a $1,500 benefit maximum for all plan-covered dental services not covered by Medicare annually. Please see Evidence of Coverage for details. |
Vision Services
| Bright Advantage (HMO) | Bright Advantage Plus (HMO) | |
| Exam to Diagnose and Treat Diseases and Conditions of the Eye | $0 copay | $0 copay |
| Eyewear After Cataract Surgery | $0 copay | $0 copay |
| Routine Eye Exam | $0 copay Limited to 1 visit every year | $0 copay Limited to 1 visit every year |
| Contact Lenses | $0-$60 copay Up to a $130 allowance every two years for contact lenses or eyeglasses. | $0-$60 copay Up to a $130 allowance every two years for contact lenses or eyeglasses. |
| Eyeglasses (Lenses and Frames) | $25 copay Up to a $130 allowance every two years for contact lenses or eyeglasses. | $25 copay Up to a $130 allowance every two years for contact lenses or eyeglasses. |
Besides these, Bright Health also offers other important healthcare services such as mental health, ambulance, foot care, medical supplies, and much more. You can find the details in this PDF.
Is Oscar an HMO or PPO?
Oscar Health is an EPO (Exclusive Provider Organization) that allows members to access a full network of first-class hospitals and physicians. An EPO offers you more flexibility than a PPO at the price of an HMO.
What kind of insurance does Bright Health offer?
Bright Health offers HMO (Home Maintenance Organization), and PPO (Preferred Provider Organization) plans with a Medicare contract. It also offers SNP plans that are connected with State Medicaid Programs. These plans are issued through Bright Health Insurance Company or one of its affiliates.
Oscar Health and Bright Health are two of the most popular healthcare insurance providers in the United States. They offer various healthcare services and programs at very low cost that helps people to live healthy and happy life. For more information, you can visit www.hioscar.com and brighthealthcare.com.
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