Business Profile

Health Insurance

Oscar

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Complaints

This profile includes complaints for Oscar's headquarters and its corporate-owned locations. To view all corporate locations, see

Customer Complaints Summary

98 total complaints in the last 3 years.
37 complaints closed in the last 12 months.

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The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

Initial Complaint
Date:07/11/2025
Type:Order Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I received a collections call this morning indicating teh call was an attempt to collect a debt. I explained to the agent I had contacted Oscar in August 2024, and told them I am on ********* and did not apply for Oscar Insurance. At that time, the Oscar agent said she would forward the issue to their fraud department to be corrected. The collection agent advised me to file a police report and file an ID theft report. At this time, I am asking Oscar to correct their records, and confirm in writing they have done so, and nothing should be reported to my credit report, and collection efforts should cease, and they should confirm all of that in writing.
Business Response
Date: 07/24/2025
Dear Better Business Bureau,
Thank you for contacting Oscar regarding the enrollment of our members 2024 policy. Our member
states that they did not request to be enrolled in an Oscar policy for the 2024 plan year.
Furthermore, our member did not request claims to be submitted on this policy.
Upon further review, our members 2024 policy was enrolled through the federal health insurance exchange,
referred to as the Federally Facilitated Marketplace (***). Oscar does not have any ability to make
changes to our members policies if they are enrolled through the ***, without first receiving explicit
instruction from the **** We rely on data sent to us electronically from the **** and when we
receive notification pertaining to a members policy, we make the requested plan adjustment to
reflect any information exactly as relayed in the data transmission. We can confirm that Oscar did not directly enroll our member into the 2024 policy.
We have verified that these concerns were escalated to Oscars Eligibility Team who confirmed that
the members 2024 policy was unable to be terminated due to the submission of claims. Please note,
Oscar is unable to remove claims once they are submitted. This must be performed by the provider.
We have further verified that if our member would like their 2024 policy to be terminated, they may
contact the *** and appeal the past decision by contacting **************.
Please note that due to the public nature of this forum Oscar cannot share specific details such as
HIPAA protected PHI information. This includes specific member accounts and financial information.
If our members would like a more detailed response, we encourage them to contact Oscar directly
for assistance.
We apologize for any inconvenience that this issue may have caused, and appreciate our members
feedback regarding their experience. Oscar strives to maintain a high standard of service, and we
value member feedback to continually help us improve our processes and procedures. If our member has any questions about this information she can contact our ************************** at ************ or *************************************************************.

Thank you,
****** *.
********* *******
***** ********* ***********
Initial Complaint
Date:06/12/2025
Type:Service or Repair Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
We got authorization and gave the drug and for Oscar to say that the drug is inclusive with the administration is obsurd. Oscar needs to pay this claim, it is a breech of contract. And this is not the only thing that they are not doing, they have not paid any labs on any of our patients. We need this resolved as soon as possible. Please have one of your **** in the states call me or come in and see me to have this issue resolved. Please claim ********* * ********, ******** ************* CODE NOT PAID IS *****
Business Response
Date: 06/26/2025
**** *** ****
****** ******** ****** *****
***************************************************
************************
********* *** ********

Dear Better Business Bureau,
Thank you for contacting Oscar with the processing of multiple claims. Our provider states that the claims have not been properly paid by Oscar.
Oscar can confirm that our providers claims, listed in their statement, were processed correctly. The provider may contact Oscar ***************** and submit a complaint directly so that we may provide full details regarding any claim denials. We did not find any evidence that Oscar has failed to pay claims in error. Our ***************** Team can also investigate any contract information and answer any related questions.
We apologize for any inconvenience that this issue may have caused. Oscar strives to maintain a high standard of service, and we value feedback to continually help us improve our processes and procedures.
Please note that due to the public nature of this forum, Oscar cannot share specific details such as HIPAA protected PHI information. This includes specific member accounts and financial information. If our member would like a more detailed response, we encourage them to contact Oscar directly for assistance.
If our provider has any questions about this information she can contact our ***************** Department at ************ or *************************************************************.

Thank you,
****** *.
Grievance Liaison
Oscar Insurance Corporation

Customer Answer
Date: 07/16/2025
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me and the matter has been resolved.
Claim got paid Thank you

Sincerely,

******* ********
Initial Complaint
Date:05/12/2025
Type:Sales and Advertising Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
They keep sending mail and correspondence but I didn't sign up for Oscar and I don't know how I got signed up.
Business Response
Date: 05/19/2025
*** *** ****

****** ******** ****** *****
***************************************************
************************

********* *** ********

Dear Better Business Bureau,

Thank you for contacting Oscar regarding the enrollment in a 2025 Oscar policy. In our members complaint, they state that they did not request enrollment in a 2025 Oscar policy and were unaware of the enrollment.

Upon investigation, we confirm that our members policy was enrolled through the federal health insurance exchange, referred to as the Federally Facilitated Marketplace (***). Oscar does not have any ability to make changes to our members policies if they are enrolled through the ***, without first receiving explicit instruction from the **** We rely on data sent to us electronically from the **** and when we receive notification pertaining to a members policy, we make the requested plan adjustment to reflect any information exactly as relayed in the data transmission.

As of the date of this response, Oscar has not received any information from the *** to terminate the policy. Our member may contact the *** directly at ************** to discuss the enrollment and termination of the policy.

Please note that due to the public nature of this forum, Oscar cannot share specific details such as HIPAA protected PHI information. This includes specific member accounts and financial information. If our member would like a more detailed response, we encourage them to contact Oscar directly for assistance.

We apologize for any inconvenience that this issue may have caused, and appreciate the feedback regarding our members experience. If our member has any questions about this information, they can contact our ************************** at ************ or *************************************************************.

Thank you,
****** **
Grievance Liaison
Oscar Insurance Corporation
Initial Complaint
Date:03/20/2025
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
March 18, 2025 Oscar Health Insurance ATTN: Grievances/Complaints **** ******************************** ****** **** **************************************************************** ************ *************** RE: Grievance complaint, Member Number: ************* To Whom it May Concern:I am writing this letter as a grievance to showcase the unfortunate delay in my medical care due to the misinformation and disinformation as the result of Oscars careless and problematic communication between Oscar and my providers office. Because of the lack of care on Oscars behalf, this has caused an increase in pain and suffering. This was caused by a denial of pre-authorization for my upcoming epidural of the lumbar region. I will now highlight how Oscar has failed me as the insured. I have spent, in total, over 7 hours speaking with various departments within Oscars interweb of lines of communication. During these 7 hours, I have been hung up on, dropped calls, told different stories, transferred to incorrect departments, and received misinformation/disinformation. Oscar wants to blame the providers office for not following the correct process in the allotted timeframe, but I witnessed just the opposite. Sections that are in blue and italicized are notes from the providers office:2/05 at 11:29AM: Called Oscar Health@************ S/w JACK A said member is active from 01/01/2025 with no termination date, has a EPO PLAN, Provider is in network, In network benefits are covered 100% after COPAY$75.00, No DED, IND OP $1,100.00 MET$227.25. Also, *** stated for CPT *****, ***** / member authorization handled by OSCAR EVICORE @************ Ref#SERVICE-*********
Business Response
Date: 04/01/2025
***** ** ****

****** ******** ****** *****
***************************************************
************************

Complaint ID: ********

Dear Better Business Bureau,

Thank you for contacting Oscar regarding the denial of our members authorization requests. In our members complaint, they state dissatisfaction regarding the denial of their authorization requests for services. They further explain that this has caused pain and suffering as a result of their experience with Oscar Member Services.

Upon investigation, we have verified that an authorization request was submitted to Oscars clinical review partner, *******, on February 5, 2025. ******* denied the request based on a clinical review for medical necessity on February 7, 2025. The provider then submitted an appeal on February 7, 2025. ******* also denied this request on February 7, 2025, based on a clinical review for medical necessity. Please note, an external review was submitted to Oscar. As a result of the external review with further information submitted, the services were approved on March 21, 2025.

We sincerely apologize for any inconvenience this may have caused, and appreciate our members feedback regarding their experience. We want to ensure that we meet our members needs and we regret that their experience did not reflect that expectation. Oscar strives to maintain a high standard of service, and we value member feedback to continually help us improve our processes and procedures.

Please note that due to the public nature of this forum, Oscar cannot share specific details such as HIPAA protected PHI information. This includes specific member accounts and financial information. If our member would like a more detailed response, we encourage them to contact Oscar directly for assistance.

If our member has any questions about this information, they can contact our ************************** at ************ or *************************************************************.

Thank you,
****** **
********* *******
***** ********* ***********

Customer Answer
Date: 04/08/2025
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:

[At no point in time did my grievance get mentioned. I know all the facts,but nothing in the explanation gives reason as to why I wrote this complaint to start! I want to know what Oscar is doing about the misinformation that was provided to myself and the doctors office several times within Oscar **** as well as ******* ****. Furthermore, what has transpired with the **** involved will prevent this from happening again. Will those agents be coached? I mean they do not acknowledge there was an error on their end, when clearly there were several in fact! They cant even say "We are so sorry this happened So yes, I was harmed, physically and mentally!]

In order for the BBB to appropriately process your response, you MUST answer the question above.

Sincerely,

****** ****

Business Response
Date: 05/29/2025
*** *** ****

****** ******** ****** *****
***************************************************
************************

********* *** ********

Dear Better Business Bureau,

Thank you for contacting Oscar regarding the denial of our members authorization requests. In our members complaint, they state dissatisfaction regarding the denial of their authorization requests for services. They further explain that this has caused pain and suffering as a result of their experience with Oscar ***************.

We sincerely apologize for any inconvenience that our members interaction with *************** may have caused, and appreciate their feedback regarding their experience. We want to ensure that our representatives properly address our members needs, and we regret that their experience did not reflect that expectation. Oscar strives to maintain a high standard of service, and we value member feedback to continually help us improve our processes and procedures. Please note, authorization requests must be submitted by the provider and Oscar is unable to review or create requests without the provider first submitting the request.

Upon further investigation, we have verified that our member submitted a direct complaint with Oscar regarding these concerns. These complaints provide more detail about the concerns the member mentions as they disclose personal information.

Please note that due to the public nature of this forum, Oscar cannot share specific details such as HIPAA protected PHI information. This includes specific member accounts and financial information. If our member would like a more detailed response, we encourage them to contact Oscar directly for assistance.

If our member has any questions about this information, they can contact our *************** Department at ************ or *************************************************************.

Thank you,
****** **
********* *******
***** ********* ***********
Initial Complaint
Date:03/06/2025
Type:Customer Service Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Oscar has been sending me and my provider in circles for over a year now. I chose this plan from the marketplace sole because they should be covering my 2 providers and a life saving eye injections. They have yet to pay for any of the injection since beginning of 2024. I have been on the phone with them more than 30+ times and every time they are not able to provide efficient answers as to why this claim is not being paid. There has been countless efforts from the *************** on receiving prior auth and nothing! they keep withdrawing the auth that is sent by the doctor and refer me to different departments. I am working with a supervisor that has not done anything. My doctor herself has called the insurance several times herself and she was given verbal authorization by medical director ***** **** and that is also not being honored. I NEED these injection to be able to SEE and nothing has moved forward since Jan 2024!!!!
Business Response
Date: 03/27/2025
***** *** ****
****** ******** ****** *****
***************************************************
************************
********* *** ********

Dear Better Business Bureau,
Thank you for contacting Oscar with the denial of multiple claims. The member states that they have been attempting to correct the claims issues related to prior authorizations but have failed due to lack of proper assistance from Oscar.
We can confirm that certain services require a review of the services medical necessity through authorization processes. If a members provider is considering or provides a service requiring authorization, the members provider is responsible for contacting Oscar to share relevant clinical information so that a determination of the services medical necessity can be made. Authorization determinations consider multiple factors, including the circumstances of the service, medical policy, clinical guidelines, pharmacy and therapeutics guidelines and the setting of the service.
Oscar can confirm that the members claims were denied correctly. Our member can reach out to Oscar *************** and submit a complaint directly so that we may provide full details regarding the claim denials. We did not find any evidence that our representatives failed to provide quality service.
We apologize for any inconvenience that this issue may have caused, and appreciate your feedback regarding your experience. Oscar strives to maintain a high standard of service, and we value member feedback to continually help us improve our processes and procedures.
Please note that due to the public nature of this forum Oscar cannot share specific details such as HIPAA protected PHI information. This includes specific member accounts and financial information. If our member would like a more detailed response we encourage them to contact Oscar directly for assistance.
If our member has any questions about this information she can contact our *************** Department at ************ or *************************************************************.

Thank you,
****** *.
********* *******
***** ********* ***********

Customer Answer
Date: 03/31/2025
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:

The response from Oscar is absolutely incorrect. The doctors office has sent countless records for prior authorization and appeals regarding the original 2024 claim denial. There is also an authorization from 1/9/25 that is still under review today is 4/1/25 that is almost 3 months!
the doctors office was given a day for discussion with Oscar and no one gave them a call. They even had the doctor in the conference room to talk this case through and no one called them.
** ****** herself has talked to the clinical director ** ***** **** and gotten a verbal approval several times. This too has not been honored.
just to simply say doctors office has not done anything is very untrue. My actual doctor herself has been involved with this when I am there. I dont know that many physicians *** would this.
After attempting to call customer service more than 5 times and not getting an answer I finally got escalated to a lead named *****. He was responding for a while but has been unreachable.
It also has been impossible to get a number or a response on how to file a complaint with Oscar.
I have had a treating eye condition where this injection helps my vision for 5 years now. Without this medication I cannot SEE!
several insurances prior to this has paid without an issue. I cannot imagine how this would not be medically necessary.
The doctors office that is prescribing this is a top US doctor and professor for uveitis. You cannot say the provider *** reviewed this simply knows better than a doctor *** has been working with mt impossible diagnosis.
please reconsider reviewing the evidence before responding.
thanks

In order for the BBB to appropriately process your response, you MUST answer the question above.

Sincerely,

******** *******

Customer Answer
Date: 06/09/2025
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:

I as the member and the Oscar advocate that has been helping me have filled several complaints with no resolution. My current authorization for my eye injection this year is also denying. Please have you medical review team and customer service team communicate to resolve this issue.

In order for the BBB to appropriately process your response, you MUST answer the question above.

Sincerely,

******** *******

Business Response
Date: 06/23/2025
**** *** ****
****** ******** ****** *****
***************************************************
************************
********* *** ********

Dear Better Business Bureau,
Thank you for contacting Oscar with the denial of multiple claims. Our member states that they have been attempting to correct the claims issues related to prior authorizations but have failed due to lack of proper assistance from Oscar.
We can confirm that certain services require a review of the services medical necessity through authorization processes. If a members provider is considering or provides a service requiring authorization, the members provider is responsible for contacting Oscar to share relevant clinical information so that a determination of the services medical necessity can be made. Authorization determinations consider multiple factors, including the circumstances of the service, medical policy, clinical guidelines, pharmacy and therapeutics guidelines and the setting of the service.
Oscar can confirm that our members claims were denied correctly. Our member can contact Oscar *************** and submit a complaint directly so that we may provide full details regarding the claim denials. We did not find any evidence that our representatives failed to provide quality service.
We apologize for any inconvenience that this issue may have caused, and appreciate our members feedback regarding their experience. Oscar strives to maintain a high standard of service, and we value member feedback to continually help us improve our processes and procedures.
Please note that due to the public nature of this forum, Oscar cannot share specific details such as HIPAA protected PHI information. This includes specific member accounts and financial information. If our member would like a more detailed response, we encourage them to contact Oscar directly for assistance.
If our member has any questions about this information, they can contact our *************** Department at ************ or *************************************************************.

Thank you,
****** *.
********* *******
***** ********* ***********
Initial Complaint
Date:03/06/2025
Type:Billing Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I received a voice mail from Oscar welcoming me to their HMO plan. I have never before heard of Oscar and I certainly did not sign up for their plan. Ive had insurance through my employer for 44 years.Hopefully this is just a mistake , maybe they misdialed and got me. But if they did start an account or policy in my name, it is clearly FRAUD.. I have been unable to reach any Oscar agents thru there phone menu. Please have them contact me again by phone.
Business Response
Date: 03/07/2025
***** ** ****

****** ******** ****** *****
***************************************************
************************

Complaint ID: ********

Dear Better Business Bureau,

Thank you for contacting Oscar regarding a non-member receiving a voicemail from Oscar.

In the complaint, the non-member expresses dissatisfaction regarding receiving a voicemail from Oscar welcoming them when they do not have a policy.

Upon investigation, Oscar confirms that this non-member is not found in Oscars system. At this time, the non-member does not have any active enrollment or policy with Oscar.

Please note that due to the public nature of this forum Oscar cannot share specific details such as HIPAA protected PHI information. This includes specific member accounts and financial information. If our non-member would like a more detailed response we encourage them to contact Oscar directly for assistance.

If our member has any questions about this information she can contact our ************************** at ************ or *************************************************************.

Thank you,
****** *.
********* *******
***** ********* ***********
Initial Complaint
Date:03/05/2025
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I was never informed about this insurance company and the address on the insurance is not a valid address. I was informed medicine was charged through them when all my prescriptions was with my current healthcare insurance. They have no remorse for customers that unaware of things that they never where informed of a switch and confirming information before running anything through their company. How can you run prescription if you have no confirmation or contact with a person. I called in to get this situation rectified to the marketplace and the said they contacted the Oscar health and it is valid when I never lived at the address on file in over 2 years. I was unaware of the insurance. They are not giving customers no remorse or help to fix situations that they are unaware of and not trying to find a solution. All they can continue telling me to go to the market place when I continue fighting between both companies that I was never aware of this insurance due to me not living at the address on file so I don't know how they can run prescriptions when I never knew about the company until I filed my taxes. This is causing a burden on me. I have no receipts with their names on it at all.
Business Response
Date: 03/05/2025
***** ** ****

****** ******** ****** *****
***************************************************
************************

********* *** ********

Dear Better Business Bureau,

Thank you for contacting Oscar regarding the enrollment in a 2025 Oscar policy.

In the complaint, our member expresses dissatisfaction regarding their involuntary enrollment in a 2025 Oscar policy when they were previously enrolled with a different insurer.

Kindly note, the members policy was enrolled through the federal health insurance exchange, referred to as the Federally Facilitated Marketplace (FFM). Oscar does not have any ability to make changes to our members policies if they are enrolled through the ***, without first receiving explicit instruction from the **** We rely on data sent to us electronically from the ***, and when we receive notification pertaining to a members policy, we make the requested plan adjustment to reflect any information exactly as relayed in the data transmission. Oscar has confirmed that information was received enrolling the member in a 2025 Oscar policy.

However, upon further investigation, further information has been received terminating the members policy to have not been enrolled. At this time, the member does not have any active enrollment with Oscar.

Please note that due to the public nature of this forum Oscar cannot share specific details such as HIPAA protected PHI information. This includes specific member accounts and financial information. If our members would like a more detailed response we encourage them to contact Oscar directly for assistance.

If our member has any questions about this information she can contact our ************************** at ************ or *************************************************************.

Thank you,
****** **
********* *******
***** ********* ***********

Customer Answer
Date: 03/24/2025
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:

[Your Answer Here]
In 2024 I was unaware of your insurance and therefore I so called had claims that I never knew about due to my insurance was another provider. Therefore I have been told I used insurance for prescriptions that I never had acknowledged about when all my insurance was through United healthcare for medical insurance.

In order for the BBB to appropriately process your response, you MUST answer the question above.

Sincerely,

***** *******

Customer Answer
Date: 05/20/2025
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:

[Your Answer Here]

I have called in and talked to multiple people and nobody been able to explain how they allowed claims for medication go through on someone who never accepted or access their medical insurance

In order for the BBB to appropriately process your response, you MUST answer the question above.

Sincerely,

***** *******

Business Response
Date: 05/29/2025
*** *** ****

****** ******** ****** *****
***************************************************
************************

********* *** ********

Dear Better Business Bureau,

Thank you for contacting Oscar regarding the enrollment of our members ************************************************************************** an Oscar policy for the 2024 plan year. Furthermore, our member did not request claims to be submitted. They state that they are unsure why Oscar allowed claims to be submitted under the policy.

Kindly note, Oscar must process claims when they are submitted and is unable to refuse claim submission from a provider or pharmacy, even if a policy is terminated or not active. We have verified that at the time the claims were submitted, the 2024 policy was active as it was enrolled through the Federally Facilitated Marketplace (FFM). As stated in previous responses, Oscar is unable to remove these claims as that request has to be made by the provider.

Please note that due to the public nature of this forum, Oscar cannot share specific details such as HIPAA protected PHI information. This includes specific member accounts and financial information. If our member would like a more detailed response, we encourage them to contact Oscar directly for assistance.

We apologize for any inconvenience that this issue may have caused, and appreciate our members feedback regarding their experience. Oscar strives to maintain a high standard of service, and we value member feedback to continually help us improve our processes and procedures. If our member has any questions about this information, they can contact our ************************** at ************ or *************************************************************.

Thank you,
****** **
********* *******
***** ********* ***********
Initial Complaint
Date:02/27/2025
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I cancelled my Oscar plan 1.3.2025 I was told I would not be charged for the month of January because of this. They charged me for the month of January, February, and are now trying to charge me for March. And this new charge is OVER 10x what I paid for my plan initially (with less money made by me annually). When I try to call the line (3 separate occasions, Im playing keypad merry go round where the menu lists number associated with options, I click said options, and after 5-6, Im brought back to main menu, causing me to continuing going for minutes on end. My last attempt was 20 mins of trying any number to get someone on the line to no avail. This is insane. Ive cancelled almost 2 months ago, Im getting charged, and I cant even call someone about it?? And I can only CALL because my account was CANCELLED and I cant get into the app anymore because my account was cancelled.
Business Response
Date: 02/27/2025
******** *** ****

****** ******** ****** *****
***************************************************
************************

Complaint ID: ********

Dear Better Business Bureau,

Thank you for contacting Oscar regarding a member's experience with being charged for a premium on a cancelled policy.

During our investigation, Oscar has confirmed that the member was enrolled in a 2025 policy through the federal health insurance exchange, referred to as the Federally Facilitated Marketplace (***). Oscar does not have any ability to make changes to our members policies if they are enrolled through the ***, without first receiving explicit instruction from the **** We rely on data sent to us electronically from the ***, and when we receive notification pertaining to a members policy, we make the requested plan adjustment to reflect any information exactly as relayed in the data transmission.

Upon investigation, the member was enrolled in a policy starting January 1, 2025, which was then terminated by the *** for an end date of January 31, 2025. A premium payment was initially charged for the month of January but has since been returned. At this time, Oscar can confirm that a premium payment is not on file for the month of January.

However, the *** has not yet directed Oscar to retroactively terminate the January enrollment and as a result, there is an outstanding premium balance. If the member disagrees with their enrollment with Oscar and would like a refund of the January premium, we suggest contacting the *** directly to request any enrollment changes as we are unable to refund any premiums payments for the time that a policy is enrolled or active.

We apologize for any inconvenience that this issue may have caused, and appreciate you bringing this matter forward for our review. If our member has any questions about this information she can contact our ************************** at ************ or *************************************************************.

Thank you,
****** **
********* *******
***** ********* ***********
Initial Complaint
Date:02/25/2025
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
i keeping getting letters from oscar health care even after explaining to them that i have never heard or singed up for health care insurance. when i spoke to them last month i was assured the policy would be cancelled and they had me speak to someone named ******** in the marketplace. during our conversation she told me that she sent this to be investigated. meanwhile i have been getting denied coverage from my actual insurance company. i called oscar back last week and they kept saying i needed to provide my bank account info in order to proceed, to which i replied i had already spoken to them and my policy was cancelled. they replied and said according to your account, based on my phone number only, they showed an active policy. i told them again i never signed up for them, they said they had a glitch in their system and to cancel id have to call back in 30 minutes and hung up. i notified my insurance company and they are investigating. i am receiving multiple letters of money owed and EOBs to which is a direct violation of my hippa rights.
Business Response
Date: 02/27/2025
******** *** ****

****** ******** ****** *****
***************************************************
************************

********* *** ********

Dear Better Business Bureau,

Thank you for contacting Oscar regarding the members enrollment in a 2025 Oscar policy.

Upon investigation, Oscar confirms the members policy was enrolled through the federal health insurance exchange, referred to as the Federally Facilitated Marketplace (***). Oscar does not have any ability to make changes to our members policies if they are enrolled through the ***, without first receiving explicit instruction from the **** We rely on data sent to us electronically from the **** and when we receive notification pertaining to a members policy, we make the requested plan adjustment to reflect any information exactly as relayed in the data transmission.

Oscar confirms that the *** has sent Oscar updated information terminating the members policy for no coverage for the 2025 plan year. Furthermore, Oscar confirms that the member is not responsible for any premium payment amount due.

We apologize for any inconvenience that this issue may have caused, and appreciate you bringing this matter forward for our review. If our member has any questions about this information she can contact our ************************** at ************ or *************************************************************.

Thank you,
****** **
********* *******
***** ********* ***********
Initial Complaint
Date:02/21/2025
Type:Service or Repair Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
We are healthcare providers without access to a dedicated provider relations representative. Instead, we are forced to rely on offshore representatives who provide no clear answers or resolutions, leaving us stuck in an endless loop of misinformation. Our claims continue to be denied in error, yet we have no access to a U.S.-based representative who can properly investigate and resolve these issues. Despite these challenges, we remain committed to our patients, but the ongoing claim denials create unnecessary obstacles to delivering care.
Business Response
Date: 02/21/2025
******** *** ****

****** ******** ****** *****
***************************************************
************************

********* *** ********

Dear Better Business Bureau,

Thank you for contacting Oscar regarding the concerns expressed on behalf of our provider. We have researched this case and determined the following:

An Oscar contracted provider expresses dissatisfaction regarding Oscars Provider Relations representatives. The provider stated that their office is forced to rely on offshore representatives who provide no clear answers or resolutions. Furthermore, the provider advised that their claims continue to be denied in error and they have no access to a U.S.-based representative who can properly investigate and resolve their issues which creates unnecessary obstacles to delivering care.

We appreciate our provider for bringing this matter to our attention. Their feedback has been shared with the appropriate team for potential future improvements. Oscar has taken note of our providers concerns and forwarded their feedback so that coaching may be provided to the representatives involved. We want to ensure that our representatives appropriately and promptly address our providers needs, and we regret that their experience did not reflect that expectation. Oscar strives to maintain a high standard of service, and we value feedback to continually help us improve our processes and procedures.

Due to the public nature of the BBB forum and the sensitive nature of this matter as it pertains to claims the Plan cannot provide details in this response. This is not an appropriate or secure forum to discuss claims issues in detail with the provider. Kindly note, we are responding in good faith with the limited information we can provide on a public forum. If our provider would like a more detailed response we would encourage them to contact Oscar directly for assistance so that we might disclose more detailed response in a non-public forum.

If our provider has any questions about this information or specific , we ask that they please contact our ***************** at *************

Respectfully,

****** *
Customer Answer
Date: 02/26/2025
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because: This is not an acceptable response. I still dont have access to a US represetnative. The phone number you list is the same number i call and get the claims representatives that dont help . The response saying that they will better train their **** does not help with anything since that was my first point of contact. I will open a complaint with the insurance commissioner and see if they can help.

[Your Answer Here]

In order for the BBB to appropriately process your response, you MUST answer the question above.

Sincerely,

**** ******

Business Response
Date: 03/19/2025
***** *** ****
****** ******** ****** *****
***************************************************
************************
********* *** ********

Dear Better Business Bureau,
Thank you for contacting Oscar regarding a providers experience with Oscars Provider Relations Team. We have researched this case and determined the following:
An Oscar contracted provider expresses dissatisfaction regarding Oscars Provider Relations Team representatives. The provider stated that their office is forced to rely on offshore representatives who provide no clear answers or resolutions. Additionally, the provider advised that their claims continue to be denied in error and they have no access to a U.S.-based representative who can properly investigate and resolve their issues, which creates unnecessary obstacles to delivering care.
As stated in the previous response, the providers feedback has been shared with the appropriate team for quality improvement. We want to ensure that our representatives properly address our providers needs, and we regret that this experience did not reflect that expectation. Oscar strives to maintain a high standard of service, and we value provider feedback to continually help us improve our processes and procedures.
Furthermore, as stated in the previous response, if the provider is in need with a higher level of support, they may contact our Provider Relations Team and request a supervisor. Our supervisors are U.S.-based and can assist with complicated issues. The provider may also request disputes for any claims in question. At this time, we have verified that the provider's concerns are being investigated further by Oscar representatives.
Please note that due to the public nature of this forum, Oscar cannot share specific details such as HIPAA protected PHI information. This includes specific member accounts and financial information. If our provider would like a more detailed response, we encourage them to contact Oscar Provider Relations directly for assistance.

If the provider has any questions about this information, we ask that they contact our ************************** at ************ or *************************************************************.

Thank you,
****** *.
********* *******
***** ********* ***********

Customer Answer
Date: 03/19/2025
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and feel we are just going in circles. I was never able to speak to a US representative but will continue to appeal my claims and hope for the best.

Sincerely,

**** ******

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