Oscar Health Insurance Review

Oscar Health is a technology-forward health insurer known for its consumer-first design and robust digital tools. Since its founding in 2012, it has carved out a substantial presence in the ACA marketplace. As of 2026, Oscar offers individual, small group, and Medicare Advantage plans in select markets across 18 states, with continued focus on virtual care, cost transparency, and chronic disease support.

Pros & Cons

Pros

• Excellent mobile app and virtual care.
• $0 urgent care and $3 generics.
• Strong support for chronic conditions.
• Fitness perks in Medicare Advantage.
• Competitive ACA pricing.

Cons

• Only in 18 states.
• No Medigap or short-term plans.
• EPO-only network limits flexibility.
• Higher complaint rates in some areas.
• Subsidy changes may raise 2026 costs.

Coverage Area (2026)

United States

Oscar Health offers ACA-compliant individual and family plans in 18 states: Arizona, Arkansas, California, Florida, Georgia, Illinois, Iowa, Kansas, Michigan, Missouri, North Carolina, Nebraska, New Jersey, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, and Virginia.

International

No routine global coverage; emergency care abroad is included.

Provider Network

Uses an EPO model—coverage is limited to in-network providers except during emergencies. Access to Cigna’s national network is available for small group plans through the Cigna + Oscar partnership.

Plan Types Offered (2026)

Under-65 (Individual & Family)

• ACA Marketplace Plans
  Oscar offers Bronze, Silver, Gold, and Platinum plans in various markets using an EPO structure. All plans meet ACA essential health benefit standards.
• Employer-Sponsored Plans
  Available via the Cigna + Oscar partnership, offering virtual care, $3 prescriptions, and Cigna network access for small businesses.
• Short-Term Medical, Student Health Plans, Medicaid
  Not offered.

Medicare (65+)

• Medicare Advantage (MA)
  Available in limited markets. Benefits include $0 premiums, $0 PCP copays, and bundled dental, vision, and fitness perks (Silver & Fit, Fitbit kits).
• Medigap, Part D, Retiree Group Medicare
  Not available as standalone plans.

Recent Changes in Cost and Options (2026)

Premiums and Rate Changes

While Oscar remains competitively priced, the lapse of enhanced ACA subsidies after 2025 may increase 2026 out-of-pocket costs for some consumers.

Out-of-Pocket Costs

Oscar offers $0 virtual urgent care, preventive services, and $3 generics. Chronic care plans cap costs with $0 visits and meds.

Medicare Advantage Updates

Oscar’s MA plans added new fitness benefits and maintained low-cost care and bundled services.

Plan Enhancements

Oscar continues to expand chronic condition support (e.g., Diabetes Care, Breathe Easy) and offers strong virtual care and wellness integration via their mobile app.

Network Agreements

No major network changes reported, but the Cigna + Oscar group network remains a key strength. Oscar also renewed its agreement with CVS Caremark.

Consumer Experience Snapshot

Complaint Index

Oscar’s NAIC complaint index averages 2.987—above the national benchmark. While some states show low complaint rates, others are more mixed.

Satisfaction Scores

Oscar does not report an ACSI score, but user satisfaction is generally strong where digital services and chronic care plans are available.

Methodology

Our Health Insurance Rating Methodology scores insurers across five main categories, each rated on a scale of 1 to 10. The overall score is the average of: Coverage Breadth and Accessibility, Plan Variety and Customization, Affordability and Value, Innovation and Care Quality, and Consumer Experience and Transparency. Categories assess provider reach, plan diversity, cost structure, care delivery, and member service experiences based on public data, filings, and expert analysis.

Bottom Line

Oscar Health remains a standout option for tech-savvy consumers seeking ACA coverage with strong digital support and chronic care benefits. Its 2026 offerings are well-suited for individuals and families in participating states, especially those who value app-driven care and wellness tools. However, lack of national reach, Medigap, and short-term options, as well as uncertain subsidy effects, may limit appeal for some.

Best for

App-friendly ACA shoppers with chronic conditions or small business employers in Oscar’s footprint.

Not ideal for

Travelers, retirees needing Medigap, or consumers outside Oscar’s regional markets.

Disclaimer

The views and opinions expressed are those of the authors and do not necessarily reflect the official policy or position of HealthCareInsider.com or HealthCare, Inc.