Oscar is expanding their health plan availability into San Francisco County for 2017. They will continue to serve part of Los Angeles and all of Orange counties. They have notified members enrolled in some of their 2016 off-exchange plans that they will no longer be offered. The Simple Silver, Simple Gold, Simple Platinum, and Simple+ Platinum will not be offered in 2017. Individuals and families in these health plans must select a new health plan no later than December 31, with Oscar to maintain coverage. If consumers in these plans want to switch to another carrier, they need to enroll by December 15th in a new health plan in order for it to be effective January 1, 2017.
Oscar Health Plan Changes for 2017
Oscar announced that they are making changes to their behavioral health network in 2017. Consequently, some doctors members are currently receiving services from may no longer be in-network in 2017. Oscar health plans are all EPOs (Exclusive Provider Organization) and have no out-of-network coverage.
Oscar will offer 3 non-standard off-exchange plans for 2017
- Simple Bronze
- Simple Silver
- Simple Gold
Off-Exchange Plans
The Bronze and Silver plans each have a $7,150 individual medical deductible which is also the maximum annual out-of-pocket amount. The Simple Gold has a $3,000 deductible which is also the maximum annual out-of-pocket amount. The only item not subject to the Bronze deductible are generic drug prescriptions at $5. The Simple Silver and Gold plans have set copayment amounts for a variety of services not subject to the deductible such as office visits, therapy, labs and preferred brand drugs.
Extra Benefits
Oscar will offer the complete menu of standard benefit design health plans through Covered California and off-exchange. All plans include unlimited telemedicine calls to a board-certified doctor 24/7 at no cost. They also have concierge service that can be contacted for a variety of health concerns. The concierge team includes nurses and healthcare experts. Oscar members can opt into a rewards program that tracks their physical activity. Members who meet daily activity and sleep goals are rewarded with up to $100 in a gift card.
For more information on Oscar, visit Oscar California Health Plans
Oscar 2017 Health Plans
Oscar Hospitals in Los Angeles, Orange, & San Francisco Counties
Oscar Concierge Program