Oscar

Oscar | Simple+ Silver

  • Simple+ Silver is an Obamacare health insurance plan offered by Oscar that is available for individuals and families.

  • This plan is a EPO, meaning you will have some of the flexibility to manage more of your health care without a primary care physician, however, you will need to stay within the provider’s network. (Read more about EPOs.)

  • This plan is a Silver metal level plan, which generally has a mid-level monthly cost and deductible (and co-pay), and provides middle-of-the-road insurance coverage for people who occasionally use their health care benefits (doctors, prescription drugs, etc.).

  • Deductible amount of $5,900. A deductible is the amount of healthcare costs you will pay on your own each year before the insurance company.

  • Max out-of-pocket of $5,900, which is the most you will pay in a plan year outside of premiums, out-of-network providers and non-essential health benefits.


Ways to Enroll or Learn More

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Plan Summary

Monthly Cost

Plan Name:
Simple+ Silver

Plan ID:
20069TX0140001

Plan Type:
EPO

Deductible:
$5,900

Maximum Out-of-Pocket:
$5,900

Summary of Benefits:

Provider Information:

Who is this plan for?

This plan with a moderate monthly cost is great for individuals and families who occasionally visit the doctor or use prescription drugs. The very high deductible on this plan means you will pay a significant amount of money of pocket for medical care and prescriptions before your insurance kicks in. The very high out-of-pocket maximum on this plan means you could be faced with a very expensive medical bill if an emergency happens.

HealthCare.com is a privately-held internet start-up for healthcare consumers. We’re not the government website.

Highlights


Dental Coverage:
Child

Overview


Plan Type:
EPO

Metal Level:
Silver

Health Spending Account:
No

Primary Care Office Visit:
No Charge

Specialist Office Visit:

Out of Network Coverage:
No

Out of Country Coverage:
No

Coverage Details

Inpatient

Hospital Services
In Network:
No Charge after deductible

Out of Network:
Not Covered
Mental Health
In Network:
No Charge after deductible

Out of Network:
Not Covered
Home Healthcare
In Network:
No Charge

Out of Network:
Not Covered

Outpatient

Mental Health
In Network:
No Charge

Out of Network:
Not Covered

Maternity/Pregnancy

Pre & Postnatal Care
In Network:
No Charge

Out of Network:
Not Covered
Labor and Delivery Inpatient Services
In Network:
Not Covered

Out of Network:
Not Covered

Dental

Accidental Care
In Network:
$50 Copay

Out of Network:
Not Covered
Dental Checkup (Child)
In Network:
Not Covered

Out of Network:
Not Covered

Vision

Eye Exam (Child)
In Network:
No Charge

Out of Network:
Not Covered
Glasses (Child)
In Network:
No Charge after deductible

Out of Network:
Not Covered

Additional Coverage

Rehabilitation Services (Speech)
In Network:
No Charge after deductible

Out of Network:
Not Covered
Rehabilitation Services (Occupational Therapy)
In Network:
No Charge after deductible

Out of Network:
Not Covered
Hospice Service
In Network:
No Charge after deductible

Out of Network:
Not Covered
Diabetes Care Management
In Network:
No Charge

Out of Network:
Not Covered
Durable Medical Equipment
In Network:
No Charge after deductible

Out of Network:
Not Covered
Hearing Aids
In Network:
No Charge after deductible

Out of Network:
Not Covered
Nutritional Consuleling
In Network:
Not Covered

Out of Network:
Not Covered
Reconstructive Surgery
In Network:
No Charge after deductible

Out of Network:
Not Covered

Doctor Visits

Primary Care Visit
In Network:
No Charge

Out of Network:
Not Covered

Additional Plan Information

Summary Of Benefits:

Provider Information:

HealthCare.com is a privately owned website, and monthly costs shown above are estimates only. Your monthly premium may change based on the data provided, outside fees, optional benefits or if other factors take effect before your coverage start date. Note that insurance companies reserve the right to change your premium rate and the policy terms at any time. Effective date, benefit amounts and other conditions may apply at the discretion of the insurance carrier you select. Depending on your state of residence, this website may not display all plans available by state. The Obamacare Tax Subsidy Calculator amounts are estimates only and the actual amount of subsidy eligibility may differ. Access to your physician depends on network selected, and networks can change without notice. Contact your health insurance company to confirm your healthcare provider is still available in the network you select.

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