Oscar health medicare review starts with a company that changed how Americans think about health insurance. Oscar Health was founded in 2012 by Joshua Kushner, Mario Schlosser, and Kevin Nazemi. The company is headquartered in New York City. It launched with a simple goal. Oscar wanted to make health coverage simple, transparent, and technology-driven. Today, the company serves over one million members across 18 states. Oscar went public in 2021 and trades on the NYSE under the ticker OSCR.
- Oscar Health Overview and Financial Strength
- Oscar Health Medicare Review: Medicare Plan Options
- Oscar Health Medicare Rates and Enrollment
- Oscar Health Additional Benefits and Perks
- Oscar Health Claims Process and Customer Service
- Pros and Cons of Oscar Health Medicare Plans
- Who Is Oscar Health Best For?
- Frequently Asked Questions
Oscar entered the Medicare Advantage market in 2019. However, its Medicare footprint remains smaller than legacy carriers like UnitedHealthcare or Humana. This oscar health medicare review examines Oscar’s digital-first approach to senior coverage. We cover plan types, financial ratings, benefits, and customer experience. Medicare beneficiaries considering Oscar should understand both its tech-forward strengths and its geographic limitations before enrolling during the Annual Enrollment Period.
Oscar Health Overview and Financial Strength
Oscar Health has grown rapidly since its founding over a decade ago. The company now operates in 18 states for individual and family plans. For Medicare Advantage specifically, Oscar currently offers plans in select markets. These include parts of New York City and the Houston, Texas metro area. As a result, Medicare beneficiaries in most states cannot access Oscar’s MA plans. The company reported over one million total members in recent years across all product lines.
Financial strength ratings tell an important story for any oscar health medicare review. Oscar Health does not currently hold a traditional AM Best financial strength rating. This is notable because AM Best ratings help consumers gauge an insurer’s ability to pay claims. The company’s CMS Star Rating for Medicare Advantage stands at 2.7 out of 5 stars overall. However, Oscar earned a perfect 5-star rating for member experience. The NAIC complaint index for Oscar averages approximately 3.0, which is above the national benchmark of 1.0. A higher number indicates more complaints than expected for a company of its size.
Oscar’s BBB profile shows the company is not BBB accredited. For a newer insurer, these mixed ratings reflect both growing pains and genuine innovation. The table below summarizes Oscar Health’s key ratings from independent sources.
| Rating Source | Score / Grade |
|---|---|
| AM Best Financial Strength | Not Rated |
| CMS Star Rating (Overall) | 2.7 out of 5 Stars |
| CMS Star Rating (Member Experience) | 5 out of 5 Stars |
| NAIC Complaint Index | ~3.0 (Above Average Complaints) |
| J.D. Power Medicare Advantage | Not Individually Ranked |
| BBB Rating | Not Accredited |
Oscar Health Medicare Review: Medicare Plan Options
Oscar Health offers Medicare Advantage HMO plans with built-in Part D prescription drug coverage. These are sometimes called MAPD plans. In most cases, Oscar’s MA plans feature $0 monthly premiums. They also include $0 copays for primary care visits. However, Oscar does not sell Medicare Supplement insurance. Beneficiaries looking for Medigap Plan G, Plan N, or other standardized supplement plans will need to consider a different carrier.
Oscar also does not offer standalone Part D prescription drug plans. Prescription coverage comes bundled with its Medicare Advantage plans only. The company does not currently offer Special Needs Plans for dual-eligible or chronic condition beneficiaries. As a result, this oscar health medicare review finds that Oscar’s Medicare product lineup is narrower than many competitors. Companies like Humana and Aetna offer Medigap, MA, Part D, and SNPs all under one roof.
Oscar’s Medicare Advantage plans use HMO-style networks. This means members typically need referrals to see specialists. They must also use in-network providers for covered services. For beneficiaries who prefer PPO flexibility, Oscar may not be the right fit. You can compare available plans in your area at Medicare.gov Plan Finder.
Oscar Health Medicare Rates and Enrollment
Oscar Health Medicare Advantage plans are competitively priced. Many plans feature $0 monthly premiums in available markets. However, rates vary by county and plan type. Beneficiaries still pay their standard Medicare Part B premium. Copays, coinsurance, and out-of-pocket maximums differ by specific plan. In most cases, Oscar’s cost structure is comparable to other $0-premium MA HMO plans in the same service areas.
Enrollment in Oscar Medicare Advantage follows standard Medicare timelines. The Annual Enrollment Period runs from October 15 through December 7 each year. New Medicare beneficiaries can also enroll during their Initial Enrollment Period. The Medicare Advantage Open Enrollment Period from January 1 to March 31 allows existing MA members to switch plans. This oscar health medicare review notes that Oscar supports online enrollment through its website at hioscar.com. Beneficiaries can also enroll by calling Oscar directly or working with a licensed insurance agent.
Before choosing any plan, beneficiaries should compare Oscar’s offerings against competing MA plans in their county. Rate comparisons are important because benefits and costs can vary significantly. Even $0-premium plans may differ in specialist copays, drug formularies, and out-of-pocket limits. Many retirees also find it wise to compare home insurance rates at Home Insure Guide when reviewing their overall coverage alongside Medicare choices.
Oscar Health Additional Benefits and Perks
Oscar Health Medicare Advantage plans include several supplemental benefits beyond Original Medicare. Dental coverage includes routine cleanings and exams. Vision benefits typically provide an annual allowance of around $200 for eyeglasses or contact lenses. Hearing benefits offer discounted rates on hearing aids and related services. These extras are a key selling point in any oscar health medicare review.
Fitness benefits are a standout feature. Oscar’s MA plans include access to the Silver&Fit fitness program. Some plans have also offered Fitbit fitness kits to encourage physical activity. Over-the-counter allowances give members quarterly credits for items like pain relievers, vitamins, and first aid supplies. These can be redeemed at major pharmacies including CVS, Walmart, and Walgreens.
Telehealth services are central to Oscar’s model. Members can access virtual doctor visits at $0 cost for many plan types. This is especially valuable for seniors with mobility challenges. However, transportation benefits and meal delivery services are not consistently available across all Oscar MA plans. Beneficiaries should check their specific plan’s Summary of Benefits for details. Many Medicare beneficiaries also carry a life insurance policy to protect their family, and they can compare life insurance rates at Life Insure Guide while reviewing their coverage options.
Oscar Health Claims Process and Customer Service
Oscar Health built its reputation on a user-friendly digital experience. The Oscar mobile app allows members to manage claims, find doctors, and access telehealth services. Both iOS and Android versions are available. Members can view their health history, check benefits, and message their care team directly through the app. For a company focused on Medicare, this digital-first approach is a key differentiator in any oscar health medicare review.
Every Oscar Medicare Advantage member receives a dedicated Concierge Care Team. This team includes care guides and a registered nurse. They help members find doctors, understand benefits, and navigate the healthcare system. According to Oscar, 83 percent of members have contacted their Concierge team. Customer service is available by phone at 1-855-672-2788. Hours are Monday through Friday, 8 AM to 8 PM ET. Weekend hours run Saturday through Sunday, 9 AM to 8 PM ET.
Claims can be submitted by mail, fax, or email. However, Oscar’s NAIC complaint ratio of approximately 3.0 suggests room for improvement. The company has faced criticism for higher-than-average claim denial rates. J.D. Power does not individually rank Oscar in its Medicare Advantage satisfaction study due to smaller market share. Typically, beneficiaries who are comfortable with technology report positive experiences. Those who prefer traditional phone-based service may find Oscar’s app-first approach less intuitive.
Pros and Cons of Oscar Health Medicare Plans
Every oscar health medicare review should weigh the advantages against the drawbacks. Here is a balanced summary based on current plan offerings and independent ratings.
Pros:
- Industry-leading mobile app and digital tools for managing health coverage
- Dedicated Concierge Care Team with a nurse assigned to each member
- $0-premium Medicare Advantage plans with $0 primary care copays in available markets
- Strong supplemental benefits including dental, vision, hearing, fitness, and OTC allowances
Cons:
- Medicare Advantage plans available in very limited geographic markets only
- No Medigap supplement, standalone Part D, or Special Needs Plans offered
- Above-average NAIC complaint ratio and below-average overall CMS Star Rating of 2.7
Who Is Oscar Health Best For?
This oscar health medicare review finds that Oscar is best suited for a specific type of Medicare beneficiary. Tech-savvy seniors who prefer managing their health coverage through a mobile app will appreciate Oscar’s platform. The Concierge Care Team model works well for members who want personalized guidance. Beneficiaries in Oscar’s available service areas who want $0-premium MA plans with strong supplemental benefits should consider Oscar seriously.
However, Oscar is not the best choice for everyone. Beneficiaries who want Medigap supplement coverage must look elsewhere. Those who need PPO network flexibility will find Oscar’s HMO-only structure limiting. Seniors in most states simply cannot access Oscar Medicare plans due to geographic restrictions. For example, beneficiaries in states like California, Illinois, or Ohio will not find Oscar MA plans available locally.
In most cases, an oscar health medicare review concludes that Oscar works best for digitally engaged Medicare beneficiaries in New York City or Houston. These members value app-based healthcare management and personalized care teams. For broader Medicare coverage options across more states and plan types, traditional carriers may be a better fit. Beneficiaries should always compare multiple plans during the Annual Enrollment Period to find the right coverage for their needs and budget.
Frequently Asked Questions
Does Oscar Health offer Medigap or Medicare Supplement plans?
No, Oscar Health does not sell Medigap plans. The company only offers Medicare Advantage HMO plans with Part D coverage included. As a result, beneficiaries who want standardized supplement plans like Plan G or Plan N must choose a different insurer.
What states offer Oscar Health Medicare Advantage plans?
Oscar Health currently offers Medicare Advantage plans in limited markets. These primarily include parts of New York City and the Houston, Texas metro area. However, availability changes each plan year, so beneficiaries should check Medicare.gov Plan Finder for current options in their county.
Is Oscar Health a good Medicare Advantage plan based on this oscar health medicare review?
Oscar Health earns a perfect 5-star CMS rating for member experience. However, its overall Star Rating is 2.7 out of 5. Typically, Oscar works best for tech-savvy seniors who value app-based care management and live in Oscar’s limited service areas.
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Official Sources & Resources
For verified information on Medicare plans, ratings, and enrollment:
- Medicare.gov (Official): medicare.gov
- CMS.gov (Centers for Medicare & Medicaid): cms.gov
- AM Best (Financial Strength Ratings): ambest.com
- NAIC (Complaint Ratios): naic.org
- State Health Insurance Assistance Program (SHIP): shiphelp.org
- Kaiser Family Foundation (KFF): kff.org
Content last reviewed April 2026. If you notice any outdated information, please contact us.