Oscar, the New York health insurer backed by Google's parent company Alphabet, is officially making its entrance into the Medicare Advantage market through a joint venture with Montefiore Health System.
The duo will begin selling private Medicare plans for 2020 when the open enrollment period runs from Oct. 15 through Dec. 7, pending approval by regulators. It also plans to sell Medicare plans in Houston. Oscar originally announced last summer that it hoped to move into the Medicare Advantage market when it raised $375 million from Alphabet.
Oscar's entrance into the Medicare market comes at a time when private Medicare plans run by insurance companies have become more popular as an alternative to the traditional Medicare program administered by the federal government. They differ from traditional Medicare in that many offer a combined medical and prescription drug benefit and other supplemental benefits such as vision and dental. They also set caps on how much members spend out of pocket unlike traditional Medicare.
But private plans also have more limited networks than traditional Medicare. Oscar's network will be anchored by the 11-hospital Montefiore system which has nearly 200 outpatient sites in the Bronx, Westchester County and the Hudson Valley. The network also will include Bronx doctors outside the Montefiore system, Oscar said.
Enrollment in private Medicare plans in New York increased 77% in 2018 to 1.3 million compared with the number of members in 2008. Of the total Medicare population, 39% are enrolled in private plans.
Oscar said it could not yet disclose more details about its benefits of federal regulations.
But it plans to extend some of the same perks it offers individual and small-business market customers to Medicare members, such as 24/7 telemedicine calls and a care team made up of a nurse and customer service representatives who are assigned to each member.
"We're confident that our approach will ensure long-term, sustainable growth in Medicare Advantage -- unlocking a new opportunity to bring consumers a health insurer that puts them first," CEO Mario Schlosser wrote in a blog post published today.
"Oscar and Montefiore team up on Medicare Advantage plan" originally appeared in Crain's New York Business.
