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Houston is one of two U.S. locations selected to launch Oscar’s new Medicare Advantage program, officials at the technology-driven health insurance start-up announced on Wednesday.
Founded in 2012, the New York company is mostly known for individual plans offered through the Affordable Care Act’s exchanges. The scheduled October launch of its Medicare Advantage plans in Houston and New York City is the first foray into that program for seniors, Dr. Dennis Weaver, chief clinical officer for the company said in an interview Tuesday.
Medicare Advantage plans are a type of health coverage where participants enroll and receive Medicare-covered benefits, but they are administered through private health insurance companies instead of directly from the federal government. They are heavily marketed to seniors as offering more generous benefits than traditional Medicare such as wider prescription drugs coverage, dental and vision coverage.
About a third of the nation’s Medicare recipients were enrolled in Medicare Advantage plans in 2017, according to federal statistics. One criticism of the program, though, is that plans often have narrow networks of providers.
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The Oscar offering of Medicare Parts C and D in Houston will include coverage at HCA Houston Healthcare, Houston Methodist, St. Joseph Medical Center as well as partnerships with several large physician groups such as Village Family Practice, IntegraNet Health and Priva Medical Group, officials said Thursday.
Absent from the current list of covered Houston facilities areÂ Memorial Hermann Health System and University of Texas MD Anderson Cancer Center.
Most other major insurers also offer Medicare Advantage plans in Houston.
WeaverÂ said he was not able to disclose all of the details of the Medicare Advantage plans at this time pending regulatory approval. But he said the company’s expansion into Medicare AdvantageÂ isÂ a logical extension of the company mission to be customer driven. “It’s in our DNA,” he said, adding that its existing customers.
The company was formed seven years ago by three Harvard Business School classmates after they experienced difficulties navigating insurance and medical billing systems. The name Oscar comes from the great-grandfather of Josh Kushner, one of the founders and brother of Jared Kushner, son-in-law of President Donald Trump.
Oscar got its start selling individual plans and has now spread to nine states, with Texas being its largest market with 60,000 members. Oscar individual and small group health plans are offered in Austin, San Antonio, El Paso and Dallas, but are not available in Houston.
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Weaver declined to comment directly on if the company will expand into Houston with individual plans this fall along with its Medicare Advantage program. “Stay tuned,” he said.