Phillip P.
I went to the orthopedic for knee pain
I went to the orthopedic for knee pain. He recommended PT first to see if that would help, it did not. MRI showed torn meniscus and other worn areas. I was given the choice of cortisone shot or arthroscopic surgery. I decided to start with shot. Got relief for a few weeks but then nothing, Decision to do arthroscopic surgery was made. Now comes the fun part. My doctor talked to insurance stating I needed surgery. They denied. Now going through appeal process. Then I called Oscar for reason for denial and was told doctor did not supply supporting info/results. Called my doctor and explained what insurance said. Doctor's office assured everything in my chart had been submitted. The insurance company is lying. Will wait to hear appeal decision. I had a feeling this may happen because I have met out of pocket maximum and insurance would pay all. Now I feel the pain of what I have heard people say in the media, insurance companies are worried more about the bottom line than their customers, I pay over 1000.00 monthly for my premium and this is how I get treated. Was going to renew with Oscar but I think my best bet is to jump ship.
Response from Oscar HealthDec 20, 2024
Hi, thank you for reaching out. We’re very sorry about this experience and we’d like to help. We have escalated this issue to our team, and someone will be contacting you to provide support.


