Oscar provides individual and small‑business health insurance plans that combine traditional HMO/EPO coverage with an employed primary‑care network and a built‑in telehealth urgent‑care platform. The plans include $3 30‑day prescription pricing and a digital portal for enrollment, claims, and virtual visit scheduling, enabling coordinated in‑person and virtual care while reducing out‑of‑pocket costs.
Funding
$355M raised to dateRaised to date based on public sources. This may differ from the amount the company actually raised and is based only on what is publicly available on the internet.
+1Founders
Product
Problem
Many consumers face fragmented health coverage that separates insurance benefits from primary and urgent care services, leading to higher out‑of‑pocket costs for prescriptions and limited access to convenient virtual visits. This complexity makes it difficult to obtain affordable, integrated care, especially for individuals in the individual market.
Solution
Oscar delivers health insurance plans that combine traditional coverage with built‑in virtual urgent care and a network of employed primary‑care physicians in selected states. Members benefit from low‑cost prescriptions priced at $3 for a 30‑day supply and can access telehealth visits directly through Oscar’s digital platform, eliminating the need for separate providers. The company’s centralized administration streamlines enrollment, claims processing, and member support, while the integrated care model ensures that covered services are coordinated across in‑person and virtual settings. By aligning insurance benefits with a dedicated care delivery network, Oscar reduces overall healthcare spending for members and improves care continuity.
Target Audience
Oscar’s primary customers are individual and family consumers in the states where the plans are offered who seek affordable health insurance with integrated virtual and primary‑care services, as well as small‑to‑medium employers looking for a bundled health benefits solution.
Features
- $3 prescription pricing for up to a 30‑day supply on eligible plans, with clear eligibility rules per state and plan type
- Integrated virtual urgent care platform offering fee‑free or low‑cost telehealth visits for members in supported markets
- Employed primary‑care physicians (Oscar Medical Group) providing in‑network primary care without the need for external referrals
- Digital member portal that consolidates enrollment, benefits management, claim tracking, and telehealth scheduling in a single interface
- Multi‑state plan availability (e.g., NY, FL, TX, GA, AZ, NC) with HMO and EPO options tailored to local licensing requirements
- Seamless coordination between virtual and in‑person visits, including co‑payment handling for hybrid care episodes
- Compliance with HIPAA and state insurance regulations, with secure data transmission for telehealth and prescription services
- Administrative services managed centrally to simplify billing, eligibility verification, and provider network updates