Two big names in the health insurance industry, with very different backgrounds, have formed a partnership and are now working together to provide medical insurance to employers in select regions.

The crux of this partnership is Oscar’s technology and member focus built on top of Cigna’s strong provider network. Cigna brings its affordable and large network to Oscar’s renowned member experience for employees and employers.

Oscar is a health insurance startup that recently went public and is backed by Google parent Alphabet. Oscar has been steadily growing since it launched it’s first plans in 2014, with 529,000 members over 18 states and 2020 year-over-year growth of 75% in customers and 60% in premium.

Cigna is one of the largest health insurance carriers in the industry, with over 20 million insured members. Not only that, but Cigna’s Open Access Plus is one of the largest and most popular networks in the industry. Many level-funded and self-funded groups contract with Cigna to give their members access to the OAP network.

What to Know About Oscar’s Member Experience

Oscar emphasizes a digital-first front door for employee’s healthcare needs by offering a $0 and unlimited telemedicine service that is available 24/7. As an EPO, Oscar’s plans sit somewhere between an HMO and a PPO. Members have a primary care physician but can self refer to any specialist in the network, however, they have no out-of-network benefits. Key benefits include:

• Two networks: LocalPlus and Open Access Plus to find the right mix of providers and cost for your team.
• EPO design saves costs yet specialists can be seen without referrals.
• 24/7 Virtual Urgent Care: Hundreds of doctors are on call and available any time of the day for a $0 copay via the app.
• Personalized care team: Your team includes care guides, a nurse, and a physician to answer your questions and manage your care.
• Care navigation: Your care team helps you find the right doctor and care for your needs and in your area. You can also use tools to find care on your own.
• Prescriptions filled with Express Scripts from your phone
• Healthy minds, healthy bodies: behavioral health network for mental health care and resources, plus step-tracking rewards that can pay you up to $100 per year

To make the best use out of Oscar health insurance, members should take Oscar’s lead on the digital front. Download the app, connect with your care team, and get familiar with the platform.

If you need non-emergent care, start with a telemedicine visit through Oscar’s app. You can indicate ahead of time if it’s for prescriptions, skin conditions, cold/flu/allergies, or other common reasons for interacting with your physician. By providing information and symptoms about your condition and even pictures, your doctor can hit the ground running before you even speak to them.

And your care team doesn’t stop at your doctor.

Each employee gets a dedicated Care Team to help navigate their care and understand their health plan. Rather than offering an automated 800 number, Oscar members get a hands-touch that has led Oscar to boast a member satisfaction rate that is twice the industry average.

This care team includes a pair of care guides and a nurse so members can get answers to questions and save money with affordable, high-quality care. Those questions don’t stop at visits and physician information but also can include plan benefits and how to get the most out of their plan.

Cigna’s Networks Expand Access

The Cigna + Oscar partnership first launched in Northern California and now boasts nearly 30,000 providers, 71 urgent care centers, and 78 hospitals, not to mention nationwide access. Key Bay Area hospital systems in the network include Sutter, UCSF, Stanford Health, El Camino, John Muir, HCA, and Dignity.

Recently launched in Southern California, Cigna + Oscar offers the Local Plus network, a more curated network than Open Access Plus, but still includes key providers such as HealthCare Partners, Scripps, St. Joseph, High Desert Medical Group, and others. For access to UCLA, USC, and Hoag, Oscar’s existing network provides members access to these excellent institutions.

What’s Next?

If you are interested in learning more about Cigna and Oscar’s partnership for your team, please schedule time with one of our benefits consultants. We love the combination of technology and access for members via this partnership and we’re happy to discuss your goals with you.

Posted by John Hansbrough in Behavioral Health, Digital Health, Healthcare Innovation, News, Telehealth