Current Oscar members in Florida who are seeking plan renewal for 2023 will not be impacted. They can renew their plan for 2023 throughout the remainder of Open Enrollment through the exchange or their broker. Any new Oscar member in Florida that has enrolled in Oscar for 2023 prior to December 13 at 12:00 a.m. EST will not be impacted. Oscar remains steadfast in the Florida market and intends to continue to provide coverage throughout 2023 and beyond.

As disclosed in Oscar’s Q3 2022 Form 10-Q, the company proactively engaged regulators, as a result of the changing market dynamics following market exits by certain carriers, regarding options to manage its membership growth. Prior to Open Enrollment, the company requested that regulators limit its membership growth in Florida so that total membership across all markets would be within its previously announced target range of 1M members, +/-10%. This limit will allow the company’s projected membership not to exceed the company’s targets for 2023 and maintain its strong financial position.

About Oscar Health

Oscar Health, Inc. (“Oscar”) is the first health insurance company built around a full stack technology platform and a relentless focus on serving its members. At Oscar, our mission is to make a healthier life accessible and affordable for all. Headquartered in New York City, Oscar has been challenging the health care system’s status quo since our founding in 2012. The company’s member-first philosophy and innovative approach to care has earned us the trust of over one million members as of September 30, 2022. We offer Individual & Family, Small Group and Medicare Advantage plans, and +Oscar, our full stack technology platform, to others within the provider and payor space. Our vision is to refactor health care to make good care cost less. Refactor is a term used in software engineering that means to improve the design, structure, and implementation of the software, while preserving its functionality. At Oscar, we take this definition a step further. We improve our members’ experience by building trust through deep engagement, personalized guidance, and rapid iteration.

Cautionary Note Regarding Forward-Looking Statements

This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. All statements other than statements of historical fact contained herein are forward-looking statements. These statements include, but are not limited to, statements about our plans to stop enrollment in Florida; enrollment expectations for 2023; business and financial prospects, and our management’s plans and objectives for future operations, expectations and business strategy. In some cases, you can identify forward-looking statements by terms such as “may,” “will,” “should,” “expects,” “plans,” “anticipates,” “could,” “intends,” “targets,” “projects,” “contemplates,” “believes,” “estimates,” “predicts,” “potential,” or “continue” or the negative of these terms or other similar expressions. Accordingly, we caution you that any such forward-looking statements are not guarantees of future performance and are subject to risks, assumptions, and uncertainties that are difficult to predict and generally beyond our control. Although we believe that the expectations reflected in these forward-looking statements are reasonable as of the date made, there are or will be important factors that could cause our actual results to differ materially from those indicated in these forward-looking statements, including, but not limited to, the following: the impact of COVID-19 on global markets, economic conditions, the healthcare industry and our results of operations, and the response by governments and other third parties; our ability to retain and expand our member base; our ability to execute our growth strategy and scale our operations; our ability to meet increased capital requirements as a result of expanding membership; our ability to maintain or enter into new partnerships, service arrangements or collaborations with healthcare industry participants; negative publicity, unfavorable shifts in perception of our digital platform or other member service channels; our ability to achieve and/or maintain profitability in the future; changes in federal or state laws or regulations, including changes with respect to the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended (collectively, the “ACA”) and any regulations enacted thereunder; our ability to accurately estimate our incurred claims expenses or effectively manage our claims costs or related administrative costs, including as a result of fluctuations in medical utilization rates due to the impact of COVID-19; our ability to comply with ongoing regulatory requirements and applicable performance standards, including as a result of our participation in government-sponsored programs, such as Medicare, and as a result of changing regulatory requirements; changes or developments in the health insurance markets in the United States, including the passage and implementation of a law to create a single-payer or government-run health insurance program; our ability to comply with applicable privacy, security, and data laws, regulations, and standards; our ability to maintain key in-network providers and good relations with the physicians, hospitals, and other providers within and outside our provider networks, or to arrange for the delivery of quality care; unfavorable or otherwise costly outcomes of lawsuits, regulatory investigations and audits and claims that arise from the extensive laws and regulations to which we are subject; unanticipated results of risk adjustment programs; delays in our receipt of premiums; disruptions or challenges to our relationship with the Oscar Medical Group; cyber-security breaches of our and our partners’ information and technology systems; unanticipated changes in population morbidity and large-scale changes in health care utilization; and the other factors set forth under the caption “Risk Factors” in our Quarterly Report on Form 10-Q for the quarterly period ended September 30, 2022, filed with the Securities and Exchange Commission (“SEC”), and our other filings with the SEC.

You are cautioned not to place undue reliance on any forward-looking statements made in this press release. Any forward-looking statement speaks only as of the date as of which it is made, and, except as otherwise required by law, we do not undertake any obligation to publicly update or review any forward-looking statement, whether as a result of new information, future developments or otherwise. New factors emerge from time to time, and it is not possible for us to predict which will arise.

Source: Oscar Health, Inc.

De acuerdo con las autoridades, las personas inscritas en el sistema de salud podrían romper un récord durante 2023, en comparación con el presente año y los beneficiarios tendrán al menos tres opciones para escoger una compañía de seguro.

Over 2.7 million Americans insured through the COVID-19 emergency Medicaid expansion will qualify for Marketplace tax credits and will need professional assistance, such as New Health Partners agents, to transition into an Affordable Care Act plan carrier once the Medicaid expires.

MIAMI, Sept. 29, 2022 /PRNewswire/ — New Health Partners, a national FMO based in Miami, FL, specializing in Medicare Advantage and Affordable Care Act carriers, is putting a heavy emphasis on agent recruitment to continue positioning the company to deliver the anticipated post-COVID-19 health insurance demand. Once the federal government’s COVID-19 public health emergency expires, there will be millions of Americans in need of uninterrupted care, and health insurance agents will play a vital role in providing affordable insurance options.

To encourage agents, New Health Partners is running a sweepstakes this upcoming selling season for one licensed health insurance agent to win a Tesla Model 3*. The lucky winner will be chosen at random by a third-party (Alliance) in April 2023. New Health Partners is making it easy for agents to enter the sweepstakes through a simple onboarding process where an agent gains one entry into the sweepstakes with just one carrier appointment.

New Health Partners’ CEO, Tony Feijoo, explains, “Most of us at one time or another have been without health insurance, and we know first-hand the anxiety it can create in households across the country.” He continues, “The Tesla sweepstakes is an ‘out-of-the-box’ strategy to prepare for the upcoming demand for health care while having fun. We know how hard health insurance agents around the country work and wanted to create excitement while giving agents the opportunity to increase their book of business.”

The Affordable Care Act is in its twelfth year and continues to lower the rate of uninsured Americans. With the expansion of health insurance carriers and additional coverage, there will be hundreds of options for consumers nationwide post-COVID-19.

*The New Health Partners Sweepstakes is in no way sponsored, endorsed, or administered by or associated with Tesla or our partner carriers.

We love visiting with our local seniors and providing important information from our partner carriers about the best health insurance plans for them, and we look forward to seeing more in the future!

The Centers for Medicare and Medicaid Services is looking for ways to make Medicare Advantage better. The agency has released a Request for Information seeking public comment on the popular offering, and is seeking input on ways to make it more equitable, affordable and sustainable.

CMS Administrator Chiquita Brooks-LaSure framed the request as part of the agency’s push to advance health equity and expand care access, calling Medicare Advantage plans “essential partners in this work.”

The agency made the request as part of its Strategic Pillars, which prioritize increased engagement with various partners and communities during policy development and implementation.

CMS Deputy Administrator and Director of the Center for Medicare Dr. Meena Seshamani said via statement, “It’s important that CMS engage as many stakeholders as possible to achieve our collective vision of equity, access, quality and affordability.”

Feedback from plans, providers, beneficiary advocates, states, employers and unions, and others will help inform policy development, CMS said.

WHAT’S THE IMPACT

In the Medicare Advantage program – also known as Medicare Part C – Medicare contracts with private insurers that must offer all traditional Medicare services to people with Medicare, and may offer added supplemental benefits, such as vision or dental benefits. Most Medicare Advantage Plans also include prescription drug coverage (Part D).

While the program has proven to be hugely popular among consumers, and insurers are increasingly muscling into the space, there have been criticisms. Some industry experts, for instance, point out that while premiums are lower and sometimes free in MA plans, some beneficiaries with health issues end up paying more over time; as they age and health problems accumulate, care costs them more out of pocket.

Another criticism hinges on prior authorizations. A report published this year by the Office of the Inspector General found that Medicare Advantage Organizations (MAOs) sometimes delayed or denied Medicare Advantage beneficiaries’ access to services, even though the prior authorization requests met Medicare coverage rules.

Examples of healthcare services involved in denials that met Medicare coverage rules included advanced imaging services such as MRIs and stays in postacute facilities such as inpatient rehabilitation facilities.

A separate survey conducted by eHealth in June found that 13% of Medicare Advantage enrollees had a claim or pre-authorization request denied. Those who experienced a self-reported denial of coverage included many who were declined for benefits, such as dental and vision care, which Medicare usually doesn’t cover.

However, 15% of those who had a claim or pre-authorization request initially denied said it was eventually paid by their insurer

THE LARGER TREND

As enrollment in the Medicare Advantage program grows, so do concerns and uncertainty over the profits providers are reaping and whether “overpayment” is an issue. A report from the Brookings Institution indicates the five major insurers – UnitedHealthcare, Humana, Aetna, Kaiser Permanente and Elevance Health (formerly Anthem) – are padding their bottom lines by disguising profits as costs.

The report points out that insurers are able to do this because profits accrued through related businesses are not regulated by medical loss ratio requirements.

Still, insurers are expanding their Medicare Advantage offerings at a decent clip, with Humana announcing last fall it would debut a new Medicare Advantage preferred provider organization (PPO) plan in 37 rural counties in North Carolina in response to market demand in the eastern part of the state.

Around the same time, UnitedHealthcare, which already has significant market control with its MA plans, said it will strengthen its foothold in the space by expanding its MA plans in 2022, adding a potential 3.1 million members and reaching 94% of Medicare-eligible consumers in the U.S.

Medicare Advantage plan payments are expected to get an 8.5% revenue increase for 2023. This is an increase over the 7.98% proposed in the February advance notice. The 2023 growth rate is set at 4.88%.

Win a Tesla Model 3 with the New Health Partners easy-to-enter sweepstakes.

One appointment with any of our partner carriers gets you into the sweepstakes.

Fill out the form at mytesla.newhealthpartner.com/microsite and enter for your chance to win.

If you’re an existing agent with us, you are already entered! Be on the lookout for additional sweepstakes information coming your way, or contact your agency principal to learn more.

*Rules and regulations apply

1. Focus on what you can control

2. Consider converting to Roth IRA accounts

3. Keep an eye on capital gains