Oscar Health, Inc. Announces Enhanced Cost Estimator Tool, Improving Cost Transparency for More Members

(Graphic: Business Wire)
Improved access to this tool comes at a pivotal moment for consumer cost transparency following the new protections available under the No Surprises Act, which aims at ending surprise medical billing for individuals. In a recent survey of Oscar members, more than half stated that they prefer to know potential medical costs upfront, with
“Since day one, Oscar has been focused on building a system of healthcare that is centered around providing a seamless and straightforward member experience,” said
Oscar's Cost Estimator Tool is the first of its kind, generating a real-time, member-plan and deductible-status-aware cost estimate, instead of only using general historical averages. The tool's technology predicts all claims that would typically be submitted after seeing a specific provider for a given procedure. From there, the tool adjudicates those claims and offers a member-personalized price estimate. This deviates from the industry norm of relying on predefined service bundles and using historical claims to generate an average price, which often results in a less precise and out-of-date estimate.
Members can access the Cost Estimator Tool directly from their account. From there, they can estimate costs connected to medical visits that occur in varied settings, such as PCP or specialist offices, ambulatory surgery centers, imaging centers, clinics, or outpatient hospitals. In addition to providing a more streamlined experience, this tool is now available on mobile, allowing members to more easily receive estimates at the point of care. The tool has also been translated into Spanish, broadening access to a wider member base.
With Oscar’s foundational full-stack technology platform, the company is able to build end-to-end experiences for members that can be optimized to meet their individual needs. To learn more about Oscar’s unique technology platform, +Oscar, and how it is empowering others in the provider and payer space, please visit hioscar.com/plus-oscar.
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1 Applies to Individual & Family plans only. Does not apply to Medicare Advantage plans.
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