The OE Brief: An Open Enrollment Q&A with Oscar

Oscar has been focused on delivering a better member experience since day one. Employees can expect responsive, hands-on support paired with technology that makes choosing and using their health plan easier.
That commitment shows up in our results: Oscar’s Net Promoter Score, a measure of how likely members are to recommend their health plan, is 54 points higher than the industry average.

Employees also receive a dedicated customer service line with support teams who understand their specific plan and the details of ICHRA enrollment, payments, and the role of the benefits administrator. The result is a more personalized experience, from enrollment through everyday care.

Oscar is expanding its offerings this year with new ways to simplify coverage and make care more affordable from day one.
For the first time, employees in eight states—Arizona, Florida, Georgia, North Carolina, South Carolina, Ohio, Tennessee, and Texas—can choose Oscar plans with embedded dental and vision coverage.

We’re also launching RetireEase in Florida and Texas, designed for employees approaching Medicare eligibility. The plan offers fixed copays for specialist visits, routine lab work, and chronic condition management.
In Iowa, as well as select counties in Missouri, Nebraska, and Kansas, we’re expanding Hy-Vee Health with Oscar. Through its direct primary care membership, employees can access $0 benefits on day one without first meeting a deductible.

Across our markets, we’re also introducing richer plan options, including platinum plans in select markets, more competitive gold and silver plans, lower out-of-pocket maximums, and $0 deductible options.

Oscar believes high-quality care should be easier to afford and easier to access. This year, we have plans with lowered copays for frequently used services such as urgent care and continue to curate regional networks that give members access to the providers and facilities they need without paying for unnecessary breadth.

Prescription costs are another important part of affordability. Oscar’s affordable drug list includes many of the most commonly used medications priced between $3 and $6 across all markets, regardless of plan type.

We know the cost to manage many chronic conditions can be overwhelming. Our CKM, Diabetes Care and COPD plans include $0 routine and specialist services, along with personalized support. HelloMeno, designed for women 45 and older, includes $0 specialist visits, labs, scans, and prescriptions—including hormone replacement therapy—to help make perimenopause and menopause care more manageable. 

Oscar continues to strengthen its local networks by adding providers and facilities across our markets. We’re also expanding access across state lines: this year, members in New Jersey will have access to Oscar’s New York network.

Our approach combines strong local access with convenient virtual care. Oscar Virtual Care gives members 24/7 access to real providers at no cost. Members can use it for urgent care, preventive exams, prescription refills, and lab orders—without leaving home or work.

Virtual care providers can also coordinate with a member’s regular doctors, helping keep care connected and reducing the need for members to repeat their history every time they seek care.

Employees with ICHRA have to navigate their benefit administrator and their insurance plan once they enroll. Oscar collaborates closely with administrators like Take Command to help make enrollment, payments, and ongoing plan administration as smooth as possible.

Our technical integrations are designed to support timely payments and help prevent disruptions in coverage. Just as importantly, our service teams maintain close working relationships with benefits administrators so issues can be identified and resolved quickly.

The member-facing experience is equally intuitive. Through Oscar’s member portal and mobile app, employees can review their coverage, search for doctors and medications, and get personalized support through Oswell, our private AI health guide.

Oswell uses a member’s health history and plan details to make its guidance more relevant, whether they need help managing symptoms, refilling a prescription, or understanding what to do next. With the member’s permission, Oswell can also share relevant information with their care team to help support more connected care.

Oscar’s support extends beyond paying claims or covering visits. We help members stay engaged with their health through practical tools, rewards, and everyday resources.
Our member rewards program gives members points for completing healthy activities such as routine checkups, preventive screenings, and everyday care. Those points can be added to an Oscar Unlocks Debit Card and used toward eligible everyday purchases at many national and local retailers.

Members also receive free access to Calm™, which offers guided meditations, sleep support, mental health tools, and evidence-based programs for managing stress, anxiety, and chronic conditions.

On top of that, Oscar members can access exclusive discounts on gym and fitness programs, dining, travel, shopping, and more at thousands of brands. Together, these resources help make healthy choices more accessible and support members well beyond the traditional health plan experience.