- Health insurance startup Oscar is entering the Medicare Advantage market next year, partnering with health systems in New York and Texas to launch plans in those areas, pending CMS approval.
- For New York residents, Oscar is planning to offer an MA plan co-branded with Bronx-based Montefiore Health System. In Houston, Oscar intends to partner with multiple providers, including HCA Houston Healthcare and St. Joseph Medical Center.
- If the plans are approved, they will be rolled out for the 2020 open enrollment period beginning Oct. 15.
Oscar was founded seven years ago with a tech-focused and user-friendly approach that emphasizes telehealth and provides a concierge team accessed through a mobile app. One of the founding members is Josh Kushner, whose brother Jared Kushner is President Donald Trump's son-in-law.
The company has had some financial struggles over the years as it entered new Affordable Care Act exchange markets. Oscar has raised $1.3 billion over eight funding rounds, with Google parent Alphabet as a lead investor. The startup garnered $375 million in its most recent corporate round in August 2018
Oscar has also attempted to buck the status quo in a legal fight with Florida Blue Cross Blue Shield challenging the Blues plan's exclusive broker policy. In May, the U.S. Department of Justice sided with Oscar in the antitrust suit.
The MA market certainly holds promise for payers, and likely appears more attractive than ever to Oscar as new regulations going into effect boost digital care options. In April, CMS finalized a rule expanding telehealth benefits for MA plans in 2020.
In a blog post announcing the company's entrance into MA, Oscar CEO Mario Schlosser said three-quarters of its members who are 63 or older have digital accounts. "We want to give Medicare Advantage consumers the same opportunity our members on the individual market have: to choose an insurer who will be their advocate," he said.