Oscar Health, Inc. announced that members now have access to its enhanced Cost Estimator Tool as part of an ongoing effort to drive more transparency around medical costs. With this latest product launch, members1 will have access to an improved tool, with better overall performance as well as increased options for engagement. This updated functionality empowers members to better manage their healthcare spending by giving them the ability to proactively plan for medical costs and make informed decisions about their healthcare.

Improved access to this tool comes at a pivotal moment for consumer cost transparency following the new protections available under the No Surprises Act, which aims at ending surprise medical billing for individuals. In a recent survey of Oscar members, more than half stated that they prefer to know potential medical costs upfront, with 20% of members expressing concern around affordability of care. Oscar's Cost Estimator Tool is the first of its kind, generating a real-time, member-plan and deductible-status-aware cost estimate, instead of only using general historical averages.

The tool's technology predicts all claims that would typically be submitted after seeing a specific provider for a given procedure. From there, the tool adjudicates those claims and offers a member-personalized price estimate. This deviates from the industry norm of relying on predefined service bundles and using historical claims to generate an average price, which often results in a less precise and out-of-date estimate.

Members can access the Cost Estimator Tool directly from their account. From there, they can estimate costs connected to medical visits that occur in varied settings, such as PCP or specialist offices, ambulatory surgery centers, imaging centers, clinics, or outpatient hospitals. In addition to providing a more streamlined experience, this tool is now available on mobile, allowing members to more easily receive estimates at the point of care.

The tool has also been translated into Spanish, broadening access to a wider member base.