Oscar Health Insurance Review (2026)

Oscar provides Bronze, Expanded Bronze, Silver and Gold plans across HMO, EPO and PPO network types. HMO plans are available at all four metal levels and have lower premiums but require referrals for specialist care and limit coverage to in-network providers.

EPO plans also include these metal tiers but add Catastrophic options. Members can see specialists without referrals, though EPO plans still require in-network care. PPO plans are available at the Expanded Bronze, Silver and Gold levels only. They add out-of-network access at higher costs.

HMO plans post the highest medical quality score among Oscar plan types at 74.83. All three plan types share Oscar's 95.3 member experience score. EPO plans score 59.23 on medical quality, 15 points below HMO.

Oscar operates in 20 states with 301 total plans, though what's available depends on where you live. Texas is the only state where Oscar sells both HMO and EPO plans in the same market, with 11 HMO and 12 EPO options available. Ohio has the most individual plan options, with 32 HMO plans.

Nine of Oscar's 20 states sell HMO plans only, including Florida, North Carolina and Ohio. Oscar sells EPO plans only in nine states, including Iowa, Missouri and Nebraska. Oklahoma is the only state where Oscar sells PPO plans. Members in all 19 single-network states can't switch network types at renewal without moving to a different insurer.

Ohio's 32 HMO plans are four times the eight plans available in New York or Michigan. Members in high-option states like Ohio and North Carolina can match a plan to a specific provider network or cost structure. Members in Alabama, Kansas or Virginia choose from nine plans or fewer. In low-option states, compare Oscar against other marketplace carriers in your county before enrolling.

Oscar's premiums are $96 to $122 below national averages across all three network types. HMO and EPO plans save $96 per month each. PPO plans save $122.

That $26 difference appears in MoneyGeek's 2026 CMS rate data because its PPO plans save $122 per month against the national average while its EPO saves $96 and the PPO also adds out-of-network access. Oscar PPO averages $603 per month versus $540 for EPO, so it costs more in absolute terms. But members who want out-of-network access pay $63 more per month for it and beat the national PPO average by $122 doing so.

EPO Catastrophic plans start at $350 monthly and carry $10,600 deductibles, a bare-bones option for healthy adults under 30 or those who qualify through a hardship exemption.

Bronze plans average $369 to $458 per month by network type, with deductibles between $5,213 and $8,250. Expanded Bronze plans cost $466 to $484 per month with deductibles of $4,614 to $4,950. Silver plans average $572 to $616 per month with deductibles near $3,400. Gold plans carry the lowest deductibles, $1,389 to $1,695, at monthly premiums of $586 to $598.

Oscar's PPO saves $122 per month against the national PPO average, $26 more than its EPO savings of $96. PPO members in Oklahoma get out-of-network access through plans starting at $466 per month.

Oscar covers all member benefits only through the Oscar app. Members get $0 virtual urgent care 24/7 and $3 prescription home delivery through the app without visiting an office or calling a traditional insurer.

• Dedicated Care Team: Message your Care Team 24/7 through the Oscar app for help finding doctors, understanding bills or sorting out a claim.
• Virtual Urgent Care: Talk to a licensed provider in as little as 15 minutes, 24/7, for $0 with most plans. Providers can diagnose conditions, prescribe medications and refer you to specialists. No office visit needed.
• Oscar Primary Care: Members in Texas, New York, Florida, Arizona, Georgia and Oklahoma get $0 virtual primary care visits for routine checkups and ongoing health management.
• Oscar App: Find in-network providers, access your digital ID card, refill prescriptions, track claims, check your deductible and set up autopay, all from your phone.
• $3 Prescriptions: Many common medications are $3 for a 30-day supply. Order refills through the app with home delivery.
• Oscar Unlocks Rewards: Complete healthy activities, annual wellness visits, daily step goals, chronic condition management, to earn gift cards and grocery credits. Not available in New Jersey and Oklahoma.

The $0 virtual urgent care and $3 prescription program cover the two most common routine care costs for Oscar members. Members in Texas, New York, Florida, Arizona, Georgia and Oklahoma add $0 virtual primary care. For frequent users, these three benefits reduce costs beyond what the below-average premiums alone deliver.

Oscar's 95.3 member experience score holds across all three plan types. Medical care quality scores tell a different story: 74.83 for HMO plans, dropping to 55.03 for PPO. Plan administration scores range from 85.08 to 89.09.

HMO plans earn a medical care quality score of 74.83. EPO and PPO plans score 59.23 and 55.03. HMO plans deny 30% of claims and EPO plans deny 31%. PPO plans do better at 22%, per MoneyGeek's analysis of CMS 2026 exchange data.

A 30% denial rate doesn't mean 30% of claims go unpaid. Many are resolved through appeals. What the rate does signal is a higher volume of claim disputes for members who file regularly, an administrative burden that compounds when medical care quality scores are also below average.

Use the table below to filter Oscar health insurance plans by state, network structure and coverage level to find the best options in your area. Plan availability depends on your county, so not all options shown may be accessible at your location:

We rate the best health insurance providers based on premiums, out-of-pocket expenses, customer experience, claims denial rates and plan selection. 

MoneyGeek health insurance provider scores use these weights:

• Affordability (60%): MoneyGeek measured monthly premiums, deductibles and maximum out-of-pocket (MOOP) costs. Within the affordability score, the weights are: monthly premiums (66.67%), deductible (16.67%) and MOOP (16.67%).
• Customer Experience (30%): Centers for Medicare & Medicaid Services (CMS)’s Quality Rating System (QRS) overall rating for health-insurance plans. This is a 5-star rating system used to help consumers compare health plans on the Health Insurance Marketplace. Ratings are calculated based on three main categories: Medical Care, Member Experience and Plan Administration.
• Denial Rate (10%): Denial rate is the percentage of submitted claims or applications that are rejected instead of approved. Oscar's HMO and EPO plans deny 30% to 31% of claims; its PPO plans deny 22%, per MoneyGeek's 2026 analysis of CMS exchange data.

Data sources

Health insurance plan and provider data was updated with the Centers for Medicare & Medicaid Services (CMS) exchange data released in October for the 2026 enrollment period as well as manual collection of health plan data from state insurance marketplaces for 22 states.

Sample consumer profile

We collected data on all available health plans for consumers ages 18, 26, 40, 50 and 60. Monthly premiums are based on a 40-year-old buyer unless otherwise noted, such as the category for seniors. We analyzed plans for each cited metal tier, which include Catastrophic, Bronze, Expanded Bronze, Silver, Gold and Platinum.