Oscar Health Health Insurance Plans

About Oscar Health

Oscar Health offers ACA/Obamacare individual/family plans, small group plans and Medicare supplement plans. 

Oscar has been focused on one mission – to be a health insurance company centered around the patient, engaging members and guiding them to the right care. 

Simple Plans: Although they do offer HSA qualified plans, most of Oscar’s plans have affordable copays for most routine care, so you get immediate value from day one. Plus, you can earn rewards just for walking with Step Tracking.

Concierge service: Oscar reinvented Customer Service with a dedicated Concierge team for every member. You talk to the same people each time, so you get personalized help when you need it. They can help you find a doctor, understand your plan, and save money on care.

Quality care: Oscar’s network of world-class doctors and hospitals are here to take care of you from head to toe. Use their tools to find a great doctor, book an appointment, have a free Virtual Visit using the app, and get prescriptions fast.

Oscar Health Plans State Availability

Individual Plans:

Oscar offers their individual/family plans On and Off the exchanges. On exchange plans are offered on the Federal Marketplace and the state exchanges in states with their own exchange. With expansion for 2022, Oscar will offer Individual & Family plans in 20 total states. Plans are available in select counties in each state. We are currently appointed to sell Oscar plans in 15 states. 

NOTE: The states above that you can click are states where US Insurance Solutions is currently licensed. Clicking a state link will take you to our page for that state where you can see ALL health plan options we offer in that state.

Small Group Plans:

Beginning October 1, 2020, Cigna + Oscar is a new joint venture providing fully-insured small group health insurance. This partnership is a 50/50 risk sharing arrangement between the two companies.

That means your small business will have the best of both worlds:

• Cigna’s robust provider networks: Employers will have the option to choose from Cigna’s most popular networks, LocalPlus® or Open Access Plus. Both networks include Cigna’s Behavioral Health Network and no specialist referrals.
• Oscar’s digital and human support: Oscar provides a differentiated member experience to both employers and employees with features like a personalized Care Team, $0 copay virtual urgent care available 24/7, dedicated support and tools for care navigation, and an easy-to-use app. 

Oscar offers small group plans in the following states:

Oscar Health Plan Benefit Grids by State

Individual Plans:

You can now find downloadable benefit grids/brochures and plan network information for Oscar in each state at this link: https://www.hioscar.com/brokers/plans.
Filter by the state and type of coverage (Individual or Small Group) at the top of the page. The following are the states where U.S. Insurance Solutions is currently licensed:

Small Group Plans:

You can now find downloadable benefit grids/brochures and plan network information for Oscar in each state at this link: https://www.hioscar.com/brokers/plans.
Filter by the state and type of coverage (Individual or Small Group) at the top of the page. The following are the states where U.S. Insurance Solutions is currently licensed:

Oscar Provider Networks

To find a provider in Oscar’s provider network in your area, please go to their doctor search tool link. If you need help using the tool, you can review their network search tutorial or the finding a doctor demo video.
Here are instructions for Choosing a Primary Care Provider with Oscar

Oscar Prescription Coverage and Formulary Information

To find a prescription drug in Oscar’s prescription formulary in your area, you will also use their doctor search tool link. From this link, if you are a member, you can login to your member account to do a custom search. You can also do a general search by clicking the “Select a Network” button under “Just browsing?” After clicking this link fill in the information for the year and your state and click “Continue.” On the next page, click “List of covered drugs.” On the next page you can download the list for your state in a pdf document.  

Oscar is thrilled to introduce their new Preferred prescription list that will only cost you $3 from day one and is available on almost all Individual & Family plans.*** Starting in 2020, 56% of prescriptions can be filled with a drug (or a close equivalent drug) that costs Oscar members $3 or less. In fact, 82% of their members are either already taking a drug on the $3 list, or they may be able to switch to one.

***Available in all states except CA, NJ, and NY. Not applicable for Catastrophic, Small Group, or Medicare Advantage plans.

Oscar Member Tools and Resources

NEW for 2021 Oscar plans to launch its new $0 Virtual Primary Care product in 10 markets in 2021: Miami, FL, Fort Lauderdale, FL, Palm Beach, FL, Houston, TX, Dallas, TX, Austin, TX, Los Angeles, CA, Orange County, CA, Denver, CO, and New York, NY, pending regulatory approval. Virtual Primary Care is the latest addition to the suite of Oscar Care features that provide a personalized experience for Oscar members. 

All Oscar plans come with: 

• Doctor on Call – Free and unlimited telemedicine, available 24/7. Now with over-the-phone prescription renewals!
• No referrals, ever – Our plans never require a referral to see a specialist—that means one less trip to a primary care doctor and one less copay. 
• A dedicated Concierge team – As noted above every Oscar member has a team of care guides and a nurse, who are experts on plan benefits and local care options. 
• $ just for walking – Oscar members can earn up to $100 per year in Amazon® Gift Card rewards when they hit their step goals by syncing the Oscar app with Google Fit or Apple Health. 

Oscar Care, which includes access to Oscar designated virtual primary and urgent providers, offers our members with Individual and Family Plans:

• Virtual Primary Care: $0, unlimited virtual visits with a dedicated team of Oscar primary care providers. Tier 1 prescriptions, DME, labs, diagnostic imaging orders and initial specialist referrals prescribed by an Oscar Primary Care provider are also $0. Oscar Primary Care also will bring some care directly to members in their homes, by offering $0 vitals monitoring kits and in-home lab draws, when ordered by an Oscar Primary Care provider. NOTE: Not all services above are available in all markets and other restrictions/exclusions may apply.
• Virtual Urgent Care: 24/7 access to Oscar Virtual Urgent Care Providers at $0 for whenever a member needs to see a doctor quickly.(7) Tier 1 prescriptions and labs are $0 when prescribed by our virtual urgent care providers, too. NOTE: Not all services above are available in all markets and other restrictions/exclusions may apply.
• Care Teams: Dedicated Care Guides, including a nurse, who know the member’s medical history, help them navigate their plan, and connect them with in-network providers.

Oscar Individual and Family Plan Quotes

Oscar ACA plans are available on the Federal Marketplace and various state exchanges. To see if Oscar individual/family ACA health plans are available in your area and get a free quote, just go to our ACA Quotes page. From there you can run run quotes for Oscar health plans and the other available insurance companies ON the Federal Marketplace and Covered California exchange. 

 U.S. Insurance Solutions is here to help

Remember, you are NOT in this alone…I am here to help! As your Personal Health Insurance Advisor, my goal is to make your life easier by taking the hassle out of finding the right health plan for your situation and needs.

To discuss your health insurance options and make sure you have the best possible health plan for your situation, please go to the link above with the image that says CALL ME and schedule a call with me on a day and time that works for you, and I will call you to review your options.