A Better Way to do Health Insurance?

Common Sense and Usability

For example, according to this, a flu shot ranges from $14-$63 (my cost), yet elsewhere on the site it says that flu shots are a covered as preventative care.

For example, according to this, a flu shot ranges from $14-$63 (my cost), yet elsewhere on the site it says that flu shots are fully covered under our plan as preventive care.

I hate our health insurance. Before get excited thinking that this is a rant about the Affordable Care Act and how healthcare for all is ruining America, I can assure you that this is not that kind of post.

What I hate is that the system of this Major Health Insurance Company (MHIC) is completely incomprehensible. After a doctor’s appointment, I get an envelope in the mail. The included form lists a whole series of numbers — what the doctor charges, negotiated rates, discounts, coverage percentages, remainder which may or may not be due because it’s unclear whether negotiated rates have been accepted, and the amount applied to our massive deductible — which are laid out in a way that takes a whole lot of time and patience to understand. Naturally, they recently changed the format, and I once again no longer understand what I’m seeing.

And does my health insurance give us any credit for being reasonably healthy, fairly active people who rarely go to the doctor? Nope.

Plus, the website for our MHIC is mind-numbingly counterintuitive. And don’t even get me started on the pain and heartache and hours lost trying to get a prescription set up on their mail-order delivery system; this required six months, countless phone calls, hours on hold, and ultimately the intervention of the broker who sold the MHIC package to my husband’s company.

There has to be a better way. As Ben Franklin said, an ounce of prevention is worth a pound of cure. Let’s reward healthy behaviors. Let’s make good health and good healthcare understandable to the average individual. Let’s give all of us intuitive, easy-to-use tools to meet our goals.

That’s when I discovered Oscar.

Sometimes you just have a question and don't want to spend $300 to make an appointment and ask it.

Sometimes you just have a question and don’t want to spend $300 out of pocket to make an appointment and ask it.

While I haven’t personally used the service — currently only available in New York and New Jersey — I love the logic behind it. Did you meet your step goal on your fitness tracker? Congratulations, you earned $1, up to $240 per year. Need to find a doctor or track your appointments or prescriptions? There’s an app for that. Need to ask a doctor a question that isn’t appointment-worthy? They have docs on call. Preventive care? Covered.

And the best part: they’re a digital-first company, putting data and information at your fingertips. Technology isn’t some kludgy afterthought from a legacy phone-and-paper company.

While the reviews for Oscar have been mixed, I don’t see that their overall satisfaction is any worse than those of us with MHICs. I’m actually quite excited to see how the lessons learned from Oscar trickle up to larger, national-scale health insurance providers to improve healthcare for all of us.

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