Oscar Health Insurance Review (2026)

Oscar sells Bronze, Expanded Bronze, Silver and Gold plans across HMO, EPO and PPO network types. HMO plans are available at all four metal levels. They have the lowest premiums of Oscar's three network types but require a primary care referral before seeing a specialist and cover only in-network providers.   

EPO plans add a Catastrophic tier and drop the referral requirement. Members see specialists without a referral, though coverage stays limited to in-network providers. PPO plans are available at Expanded Bronze, Silver and Gold levels only. They add out-of-network access at higher costs and are sold only in Oklahoma.

HMO plans score 74.83 on medical care quality on the CMS 0-to-100 scale, the highest of Oscar's three network types. EPO plans score 59.23, 15 points lower, but don't require a referral to see a specialist. All three plan types share a member experience score of 95.3.

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 EPO plans average $540 per month against a national EPO average of $636. PPO plans average $603 per month against a national PPO average of $725. The PPO saves $122 against its benchmark, more than EPO's $96 savings, because national PPO plans price higher. Members who need out-of-network access pay $63 more per month than EPO for that option and still beat the national PPO average by $122. 

Gold plans ($586 to $598 per month) carry deductibles of $1,389 to $1,695. Silver plans ($572 to $616 per month) carry deductibles near $3,400. Monthly premiums between the two differ by $14 to $26. Members who reach their deductible at least once a year usually pay less overall on Gold.   

Bronze plans ($369 to $458 per month) carry deductibles of $5,213 to $8,250. Catastrophic EPO plans start at $350 per month with $10,600 deductibles. Catastrophic plans are open to adults under 30 or those who qualify through a hardship exemption.

All Oscar member benefits are available through its app. Members get $0 virtual urgent care 24/7 and $3 prescription home delivery without an office visit.   

• 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 prescriptions cover the most common routine care costs without a copay or office visit. Members in Texas, New York, Florida, Arizona, Georgia and Oklahoma get $0 virtual primary care on top of that. In those six states, most routine care through the app runs $0.

Oscar's member experience score is 95.3 across all three plan types. Plan administration scores range from 85.08 to 89.09. Both measure how members rate access, communication and administrative handling. For members who mainly use the app for urgent care and prescriptions, these are the scores that reflect their day-to-day experience.   

Oscar's medical quality and denial rates are lower. HMO plans lead at 74.83 on medical quality with a 30% denial rate. EPO plans score 59.23 on medical quality and carry the highest denial rate at 31%. At 22%, PPO plans have the lowest denial rate, but medical quality falls to 55.03.

A 30% to 31% HMO and EPO denial rate doesn't mean that share of claims goes permanently unpaid. Many resolve through appeals. The rate shows how often a first submission comes back denied. For members who file regularly, that adds up to more administrative follow-up. EPO and PPO plans score below 60 on medical quality, so both issues apply at once.

Use the table 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.