Aetna vs. Oscar Insurance

Which health insurance company is the best option for you and your family? Compare Aetna and Oscar side by side.

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Aetna vs. Oscar: What You Need to Know

In 1850, Aetna Insurance Company created a fund to sell life insurance. In 1953 the life and health divisions of Aetna separated. The company’s first president was Eliphalet A. Bulkeley. The name “Aetna” was taken from an 11,000-foot volcano in Sicily, Italy, which was also the most active volcano in Europe.

In 2012, Oscar Ceo Mario Schlosser and his wife were preparing to have a baby and saw how difficult it was to navigate through the healthcare system. Schlosser’s friend, Josh Kushner, had also had a similar frustration in treating an injury. They founded Oscar Health on a hope to help consumers feel less powerless in managing their health. What makes Oscar different is the Concierge Team that guides members and handles customer service questions and coordination of clinical care.

To learn more about each company, you can check out the Aetna Overview and Oscar Overview.

What is Aetna and Oscar Insurance Rating?

Which health insurance company is better? We've made it easy to compare companies side by side. See how Aetna and Oscar ranked among the industry ratings.

Comparison Aetna Oscar
Year Founded 1853 2012
BBB Rating A+ A+
NAIC Complaint Index 6.27 for individual health insurance 0.12%
Market Share Percentage 4.53%  
Financial Strength Excellent  

Pros & Cons of Aetna or Oscar

Pros

Aetna
  • Aetna is one of the largest insurance carriers and has a vast network of providers.
Oscar
  • Affordable marketplace plans with different tiers of coverage.
  • Health plan concierges who offer guidance and answer questions.
  • Very low complaint ratio, which means they offer great customer service.

Cons

Aetna
  • It’s not very easy to buy Aetna Insurance unless it’s offered by an employer.
Oscar
  • Oscar Health Insurance is only available in New York, California, Texas, New Jersey, Ohio, Tennessee, Arizona, Florida, and Michigan.

Aetna and Oscar Mobile Apps Options

The Aetna Health app allows you to find a doctor in your area and see estimates of what certain procedures may cost. You can also view your benefits, review account balances, and manage your claims. The App is available on ios and Android.

The Oscar app allows you to access your health information anytime you need it. It allows you to search for doctors & drugs and even have virtual visits with a doctor.

Aetna Mobile App
iOS      4.5 29.3K users
Android      3.4 2,316 users
Oscar Mobile App
iOS      4.8 2.5K users
Android      3.3 433 users

Aetna and Oscar Enrollment Process

Aetna

Aetna is available through participating employers. You can also buy an individual or family plan directly from Aetna, the health insurance marketplace or you can get several free quotes here.

At this time, Aetna offers Medicare, Medicaid, student health insurance and international insurance. For individual and family plans, they offer plans through eHealth, which compares rates from several companies for the Affordable Care Act plans, short-term plans, and medical indemnity plans.

Oscar

Oscar Health Insurance offers plans through the health insurance marketplace. You can begin searching plans here or you can get several free health insurance quotes here.

Each state has its own marketplace. If you’re not sure where to begin, visit https://www.healthcare.gov/. You can also schedule a personal appointment with a local Kaiser Permanente Medicare specialist: 1-866-973-4588.

How to File a Claim with Aetna and Oscar Insurance

Aetna

If you use a network doctor or hospital, your claims will be submitted by that provider. If you see an out-of-network provider, you need to submit the claim yourself. You must submit a completed claim form or alternative documentation via fax or mailing address. As an alternative to sending a claim form, supply a description of services, a bill of charges from the provider and any medical documents you received from your provider.

Oscar

Your doctor or care provider should submit a claim to the insurer. You should be covered except for copay. Your insurer will send you an explanation of benefits. If you owe anything, your doctor will send you a bill. If you visit an out-of-network provider, you will not be covered unless it was an emergency. Call 855-672-2755 with any additional questions.

Common Questions About Oscar and Aetna Insurance

Aetna

What type of health plans does Aetna offer?

Aetna offers Aetna Medicare, Aetna Medicaid, student health insurance and international insurance. They offer the Affordable Care Act plans, short-term plans, and medical indemnity plans through e-Health, which compares insurance partners’ rates for you. Or, you can just visit here for free health insurance quotes.

What pharmacy accepts Aetna insurance?

Medicare Part D plans have a network of participating pharmacies you can find here. For all other types of plans, visit here to find a pharmacy.

Does Aetna insurance cover hearing aids?

Most Aetna plans exclude coverage for hearing aids. Any applicable benefit plan exclusions and limitations for coverage of hearing aids would apply to air conduction hearing aids, implantable hearing aids, and semi-implantable hearing aids.

Is Aetna insurance Medicaid?

Aetna offers Medicaid plans, which vary according to individual state Medicaid programs and have a different name in each state.

Oscar

What do Oscar health insurance plans cover?

Oscar health insurance plans cover a wide range of medical services and drugs. You have the option of selecting from different tiers, based on the coverage you anticipate needing. There’s an Oscar health insurance plan for every budget. Oscar also offers Medicare Advantage and Medicare Supplements.

Does CVS take Oscar insurance?

CVS pharmacy is Oscar’s preferred pharmacy in New York.

Is Oscar insurance a PPO?

No, Oscar is an Exclusive Provider Organization plan, or EPO. Consumers receive coverage for in-network providers and they don’t need a primary care physician to refer them to a specialist. Out-of-network providers are only accepted in case of an emergency.

What is Oscar medicare advantage?

Medicare Advantage is the private version of Medicare. It is important to note that it’s not necessarily more expensive. To compare Medicare Advantage plans (Medicare Part C, which replaces Parts A and B), visit here.

Aetna and Oscar Insurance Contact Info

Aetna Contact Info
Address 151 Farmington Ave., Hartford, CT 06156
Phone 1 (800)-872-3862
Website https://www.aetna.com/
Facebook https://www.facebook.com/aetna/
Youtube https://www.youtube.com/aetna
Twitter https://twitter.com/Aetna
Linkedin https://www.linkedin.com/company/aetna/
Oscar Contact Info
Address 75 Varick St. 5th Fl, New York, NY 10013
Phone 1 (844) 392-7589
Website https://www.hioscar.com/
Facebook https://www.facebook.com/OscarHealth/
Youtube https://www.youtube.com/user/OscarHealthInsurance
Twitter https://twitter.com/OscarHealth
Linkedin https://www.linkedin.com/company/oscar-health/

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