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Oscar Health – The Health Insurance Startup That Wants To Revolutionise Healthcare


In View Summary

Oscar is simplifying user experience, giving policy holders the power to lower their premiums through wearable devices and allowing consumers to consult directly with physicians in order to reduce the quantity of in-patient claimants

Oscar is simplifying the user experience, giving policy holders the power to lower their premiums through wearable devices and allowing them to consult directly with physicians in order to reduce the quantity of in-patient claimants

Oscar Health was founded in 2012 with the vision of “changing the user interface of health insurance”. This means health care plans and benefits that are easy to understand, tools such as smart watches and fitness monitors that save you time and discounted health insurance premiums.

At its core, Oscar is using technology to simplify the entire health insurance experience in a way that legacy health insurers have been unable to do. For example, customers can use Oscar’s app to consult with a doctor at any time and get prescriptions without ever leaving home. Another example is the use of Geofencing and geo-locational data to enable Oscar members to choose from a list of available and relevant doctors based on their location. They can also keep track of their health history with a timeline and earn financial discounts for staying active with a free Misfit step tracker.

Oscar charges its customers a yearly fee that varies according to the risk profile of each customer. The company uses a risk assessment algorithm to set its price. The amount each customer pay is directly related to age, income, geography and range of coverage.

How Oscar Works:

  1. Using a computer or the smart phone app, Oscar Health members can describe their symptoms or health concerns in order to identify a range of possible underlying health conditions.
  2. Users are then shown a list of primary care physicians or specialists they can consult with free of charge. If there is a diagnosis, Oscar’s insurance plan covers the associated expenses in accordance with the individual policy.
  3. The app and website also present users with other helpful information, including how often a physician treats patients of your age, gender and whether your Oscar health plan covers the full extent of your health issue.
  4. Other features on the app and website include free fitness trackers. Users can earn Amazon gift cards for reaching daily exercise goals.

Oscar currently offer plans to individuals, couples, and families living in New York, New Jersey, California and Texas who don’t already receive employee health insurance. Oscar is notable because it is a rare example of an insurance startup that has scaled to a multi-billion dollar valuation amidst heavy regulation. With more than 40,000 members across New York and New Jersey, the company recently expanded its coverage to select cities in California and Texas.

Ultimately, Oscar has already proven much of what it set out to do, simplify the user experience of health insurance, give policy holders the power to lower their premiums through fitness trackers / wearable devices and allow consumers to consult directly with physicians in order to reduce the quantity of in-patient claimants.

Reported Benefits

Benefit to Customers

  • Better User Experience – Access to professional help 24/7
  • Real time diagnosis
  • Instantly view and manage your entire health history
  • Rewards for being active
  • On call support from In house Healthcare experts

Benefit to the Insurer

  • Transformation the value proposition from a health insurance company to heath service provider
  • Became a national insurer able to compete with established players in very short span of time
  • Short claim processing time due to digitisation saves cost and increases customer retention
  • Competitive differentiation through customer centric approach
  • Command on huge amount of customer data which can be leveraged for future business benefits

The Digital Insurer's View

Oscar is disrupting the US health care market by making something that is ordinarily unpleasant be more engaging and palatable through the use of digital technology. Oscar exemplifies the process of integrating technology with a tech-enabled operating model to win the loyalty of digital customers. Having said that, it remains to be seen how big traditional players like United Health Group and Aetna will respond to the Oscar challenge.



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