Choosing health insurance shouldn’t feel like decoding a foreign language—but for many people, it does. Between confusing terms, hidden costs, and endless plan options, the process can quickly become frustrating. Oscar Health Insurance was created to solve that exact problem by combining health coverage with modern technology.
Founded in 2012, Oscar Health has grown into one of the most recognizable tech-focused health insurers in the U.S., serving more than 1.6 million members. But is Oscar actually a good choice for your healthcare needs? This in-depth guide breaks down Oscar’s plans, pricing, benefits, drawbacks, and who it’s best for—so you can decide with confidence.
What Is Oscar Health Insurance?
Oscar Health Insurance is a technology-driven health insurance company designed to simplify how people manage their healthcare. Instead of relying on outdated systems and paperwork, Oscar centers its experience around a mobile app, virtual care, and personalized support teams.
Most Oscar plans are offered through the Affordable Care Act (ACA) marketplace, making them available to individuals and families who qualify. While Oscar doesn’t operate nationwide, it has steadily expanded its footprint and continues refining its offerings in profitable markets.
At its core, Oscar’s mission is simple: make health insurance easier to understand and easier to use.
Where Is Oscar Health Available?
Oscar Health’s availability depends on your state and county. As of 2026, Oscar offers plans in 20 states, covering more than 570 counties. However, availability can vary even within the same state, so checking your exact ZIP code is essential.
States Where Oscar Health Operates
- Arizona
- Florida
- Georgia
- Illinois
- Iowa
- Kansas
- Missouri
- New York
- North Carolina
- Ohio
- Oklahoma
- Pennsylvania
- Tennessee
- Texas
- Virginia
- Alabama
- Mississippi
Oscar has exited several markets in recent years, including California and Colorado, to focus on regions where it can operate more sustainably.
Oscar Health Insurance Plan Options
Individual & Family ACA Plans
Oscar’s main offerings are ACA-compliant plans available in standard metal tiers:
Bronze Plans
Lower monthly premiums with higher deductibles and out-of-pocket costs. Best for healthy individuals who rarely need medical care.
Silver Plans
A balanced option with moderate premiums and cost sharing. Silver plans are also the only tier eligible for cost-sharing reductions if you qualify.
Gold Plans
Higher premiums but lower costs when you receive care. Ideal for people with ongoing medical needs or frequent prescriptions.
Specialized Oscar Plans
Oscar stands out by offering targeted programs that many insurers don’t:
HelloMeno Plans
Designed for women navigating perimenopause and menopause. These plans include $0 visits for primary care, gynecology, behavioral health, labs, hormone therapy, and bone density screenings.
Condition-Focused Plans
Tailored for members with chronic conditions such as diabetes, asthma, COPD, or cardiovascular-kidney-metabolic syndrome, offering $0 primary and specialist visits plus preventive screenings.
Buena Salud
A Spanish-first healthcare experience for Hispanic and Latino members, connecting them with culturally aligned providers and bilingual care teams.
Medicare Advantage Plans
Oscar also offers Medicare Advantage plans in select locations. These plans often include extra benefits like dental, vision, hearing coverage, fitness perks, and sometimes $0 monthly premiums.
Small Business Health Plans
Oscar provides coverage for small businesses with fewer than 50 employees and partners with ICHRA programs, allowing employers to reimburse employees for individual health plans.
Key Benefits of Oscar Health Insurance
User-Friendly Mobile App
Oscar’s app is one of its strongest features and consistently ranks among the best in the industry. Members can:
- Find in-network doctors and specialists
- Access 24/7 virtual urgent care
- Track deductibles and spending in real time
- Message their care team
- Refill and deliver prescriptions
- Earn rewards for healthy habits
Oscar’s app satisfaction scores significantly outperform industry averages.
Dedicated Care Teams
Each member gets a personalized care team made up of healthcare guides and nurses who help with appointments, benefits, billing questions, and care decisions—without endless phone menus.
Virtual & Telehealth Services
Oscar offers $0 virtual urgent care visits, often within minutes. In some markets, Oscar Primary Care provides ongoing virtual care with a consistent medical team, making routine care easier and more accessible.
Prescription Coverage
Many generic prescriptions cost as little as $3, with easy refills and home delivery directly through the app.
Wellness & Rewards Programs
Step Rewards
Members can earn daily rewards for meeting step goals, redeemable for gift cards.
Oscar Unlocks
A perks program that rewards members for healthy actions and digital engagement, offering priority support and additional benefits.
AI-Powered Health Support
Oscar’s AI assistant, Oswell, helps members understand symptoms, medications, lab results, and benefits using real plan data for personalized guidance.
Oscar Health Insurance Costs
Monthly Premiums
Oscar premiums are often higher than average, especially for Silver and Gold plans. For example, a typical 40-year-old may pay more than comparable plans from other insurers.
That said, many members qualify for ACA subsidies, which can significantly reduce costs—sometimes even to $0 monthly premiums.
Deductibles & Out-of-Pocket Costs
- Bronze plans usually have high deductibles
- Silver plans offer moderate deductibles
- Gold plans feature lower deductibles but higher premiums
All plans include federally regulated out-of-pocket maximums for financial protection.
Cost Sharing
Oscar plans often include:
- $0 primary care visits
- $0 virtual urgent care
- Affordable prescription pricing
These features can lower overall healthcare expenses despite higher premiums.
Provider Networks & Access
Oscar primarily uses EPO networks, meaning:
- No referrals needed for specialists
- No coverage for out-of-network care (except emergencies)
- Smaller provider networks compared to PPO plans
Some members report difficulty finding in-network specialists, making it critical to confirm providers before enrolling.
Customer Reviews: Pros & Cons
What Members Like
- Excellent mobile app experience
- Fast virtual care access
- Clear plan details
- Helpful care teams for routine support
Members using Oscar’s specialized programs often report very positive experiences.
Common Complaints
- Claim denials after initial approvals
- Delays in prior authorizations
- Inaccurate provider directories
- Unexpected medical bills
- Long wait times for phone support
Oscar receives a higher-than-average number of complaints compared to similarly sized insurers, particularly related to claims handling.
Financial Stability & Company Performance
Oscar Health has significantly improved its financial performance. In 2024, the company reported $9.2 billion in revenue and achieved profitability for the first time. Revenue is projected to exceed $11 billion in 2025, signaling improved long-term stability.
How to Enroll in Oscar Health Insurance
You can enroll through:
- Healthcare.gov during Open Enrollment (Nov 1 – Jan 31)
- A Special Enrollment Period after qualifying life events
- Oscar’s website or phone enrollment
- Licensed insurance agents or brokers (no extra cost)
Is Oscar Health Insurance Right for You?
Oscar Is a Good Fit If You:
- Prefer digital tools and virtual care
- Are comfortable with EPO networks
- Qualify for ACA subsidies
- Want condition-specific or culturally focused programs
- Don’t need broad out-of-network access
Oscar May Not Be Ideal If You:
- Want PPO flexibility
- Need frequent specialist care
- Have established doctors outside Oscar’s network
- Prioritize traditional customer service over technology
- Are seeking the lowest possible premiums
Oscar Health Insurance Alternatives
If Oscar isn’t right for you, consider:
- Blue Cross Blue Shield – Large national networks
- Kaiser Permanente – Integrated care model
- Aetna – Competitive pricing in many markets
- UnitedHealthcare – Extensive provider access
Tips to Get the Most Out of Oscar
- Always verify providers before appointments
- Get pre-authorization for procedures
- Keep records of claims and approvals
- Use virtual care whenever possible
- Take advantage of $0 services and rewards
Final Verdict
Oscar Health Insurance offers a fresh, tech-forward approach to healthcare that works exceptionally well for digital-first users who value convenience, virtual care, and personalized support. However, its higher premiums, smaller provider networks, and claims-related complaints mean it’s not the best option for everyone.
If you qualify for subsidies and don’t mind managing your care through an app, Oscar can be a strong choice. Just be sure to compare plans carefully, verify provider access, and understand the total cost—not just the monthly premium—before enrolling.
This guide is for informational purposes only and reflects publicly available information as of late 2025. Plan availability, pricing, and benefits may change. Always confirm details directly with Oscar Health or through Healthcare.gov.