Both UnitedHealthcare Choice Plus and Oscar Health Simple Plan offer comprehensive coverage with telehealth options, but they cater to different needs. UnitedHealthcare Choice Plus provides a larger network with out-of-network benefits, while Oscar Health Simple Plan focuses on simplicity and affordable generic prescriptions. Customer satisfaction is a concern for both, so consider individual needs and priorities when choosing.
| Attribute | UnitedHealthcare Choice Plus | Oscar Health Simple Plan |
|---|---|---|
| Monthly premium cost | Not available | Not available |
| Deductible amount (individual/family) | Network: $0 individual; $200 individual / $400 family; $750 individual / $1,500 family; $1,500 individual / $3,000 family; $2,800 individual / $5,600 family; $6,350 individual / $12,700 family. Non-Network: $500 individual / $1,000 family; $800 individual / $1,600 family; $1,500 individual / $3,000 family; $4,500 individual / $9,000 family; $5,000 individual / $10,000 family; $15,000 individual / $30,000 family. | $1,500 individual / $3,000 family, $5,000 individual / $10,000 family, $7,150 individual / $14,300 family, $7,300 individual / $14,600 family, $7,900 per person, $8,150 per person |
| Out-of-pocket maximum (individual/family) | Network: $1,000 individual / $2,000 family; $1,500 individual / $3,000 family; $2,000 individual / $4,000 family; $4,000 individual / $8,000 family; $5,000 individual / $10,000 family; $7,200 individual / $14,400 family; $7,400 individual / $14,800 family. Non-Network: $3,000 individual / $6,000 family; $4,000 individual / $8,000 family; $6,000 individual / $12,000 family; $10,000 individual / $20,000 family; $15,000 individual / $30,000 family; $30,000 individual / $60,000 family. | $1,500 individual / $3,000 family, $7,150 individual / $14,300 family, $8,150 per person/family, $8,550 individual / $17,100 family, $9,050 individual / $18,100 family |
| Copay for primary care physician visit | $10 copay per visit, deductible does not apply; $15 copay per visit, deductible does not apply; $20 copay per visit, deductible does not apply; $30 copay per visit; No copay. | $5, $10, $15, $20, $25, No charge, No charge after deductible |
| Copay for specialist visit | $15 copay per visit, deductible does not apply; $20 copay per visit, deductible does not apply; $30 copay per visit, deductible does not apply; $60 copay per visit; No copay. | $35 (for cardiology, pulmonology, and endocrinology under specific "Chronic Care" plans), $40, $50, $70, $75 |
| Prescription drug coverage (formulary tiers and costs) | Coverage to help pay for prescription drugs and medications. Formulary tiers and costs vary. Specialty drugs must be filled through CVS Specialty Pharmacy. | Generic drugs: $0, $3, $5 copay; Preferred brand drugs: $75 copay after deductible; Non-preferred brand drugs: No charge after deductible; Specialty drugs: 40% or 50% coinsurance after deductible; $3 prescriptions are available for many commonly prescribed drugs. |
| Coverage for preventive care services | Covered at 100% in network. Certain preventive care services are provided as specified by the Affordable Care Act (ACA) with no cost-sharing. | Generally covered at no charge. Includes services with an "A" or "B" rating from the United States Preventive Services Task Force (USPSTF) and immunizations. |
| Availability of telehealth services | Yes. Telehealth is covered at the same cost share as in the office. $20 copay per visit by a Designated Virtual Network Provider, deductible does not apply. No virtual coverage non-network. | Yes, virtual urgent care is often covered in full, sometimes through Oscar-designated providers. Some plans offer $0 virtual primary care. Oscar offers 24/7 telemedicine services. |
| Network size and coverage area | Large network, offering access to providers locally and nationwide. Over 1.5 million physicians and 5,897 hospitals nationwide. More than 67,000 retail pharmacies nationwide. | Individual and family plans in 18 states. Most plans are EPOs, meaning coverage is limited to in-network providers except in emergencies. Oscar uses "curated" networks in some cities. |
| Coverage for emergency room visits | $75 copay per visit, deductible does not apply. Non-emergent use of ER paid at applicable In and Out of Network deductible/coinsurance. | 40% or 50% coinsurance after deductible. Some plans may have no charge after the deductible. |
| Coverage for mental health services | Yes. The plan provides inpatient, intermediate, and outpatient care. Coverage for both in-network and out-of-network therapists. Mental health services are covered at the same level as covered health services for any other sickness or injury. | Yes, includes therapy (individual and group), inpatient mental health treatment, and outpatient substance abuse rehabilitation. Some plans may require preauthorization. |
| Customer satisfaction ratings | American Customer Satisfaction Index score dropped to 76 in 2024. | Sometimes poorly rated by HealthCare.gov. May receive a high number of customer complaints. |