Frequently Asked Questions

Yes, absolutely. Your Oscar plan includes in-network access to therapists, psychiatrists, and mental health services. Log into the app to find an in-network provider near you, or take advantage of our $0 virtual therapy options. No referral required.

No, they’re not in-network. If you pick up a specialty drug at an Amber Specialty Pharmacy, it’ll be processed as an out-of-network claim. You’ll want to get your prescriptions at in-network pharmacies to keep costs low. You can search for an in-network pharmacy right in your account. Or if you need assistance, just give your Oscar care team a call at (855) 672-2755.

Absolutely. This isn't just an English plan with a translation toggle. Every single signature Oscar benefit — from messaging your dedicated Member Services Team to $0 Oscar Virtual Care visits — is completely in Spanish from day one.

Absolutely. There's no diagnosis required to enroll. While the $0 copays for specialists, labs, and key medications are built with COPD, diabetes, and heart conditions in mind, this plan is open to anyone who wants solid care in those departments.

Absolutely. There's no diagnosis required to enroll. While the $0 perks for oxygen, lung specialists, and inhalers are designed to help folks managing asthma or COPD, anyone looking for solid, reliable respiratory coverage can sign up.

Most likely, yes. We partner with two of the biggest, most widely accepted nationwide networks in the country. Want to be 100% sure before you enroll? Look up adult dental providers here, adult vision providers here, and pediatric vision providers here.

We get it — losing a doctor you trust is a dealbreaker. That’s why RetireEase gives you full access to Oscar’s expansive network of premium doctors, hospitals, and specialists. Want to be 100% sure before you enroll? Look up your providers here. It takes less than 60 seconds to lock in your peace of mind.

Most likely, yes! We know how important it is to keep a doctor who already knows you well. That’s why Oscar’s network includes top-rated doctors and medical groups nationwide. Want to be 100% sure before you enroll? Look up your providers here.

Most likely, yes! We know how important it is to keep a doctor who already knows your history. That’s why Oscar’s network includes top-rated endocrinologists and medical groups nationwide. Want to be 100% sure before you enroll? Look up your providers here.

Most likely, yes! We know how important it is to keep a doctor who already knows your history. That’s why Oscar’s network includes top-rated lung doctors and medical groups nationwide. Want to be 100% sure before you enroll? Look up your providers here.

Most likely, yes! We know how important it is to keep a doctor who already knows your history. That’s why Oscar’s network includes top-rated doctors and medical groups nationwide. Want to be 100% sure before you enroll? Look up your providers here.

Your RetireEase plan features fixed, predictable copays, meaning your costs won't suddenly spike just because you moved money around to fund your retirement. While large retirement accounts or income shifts can affect tax subsidies that could lower your monthly premium, your eligibility for the plan itself is entirely secure.

Absolutely. Your family gets Oscar’s comprehensive coverage with day-one perks like $0 virtual care. Then, if you or anyone else in the house needs extra help with asthma or COPD, those specific people get the bonus respiratory perks tacked on. It’s the best of both worlds.

Yes! Breathe Easy includes the same comprehensive, full-body coverage you'd expect from an Oscar plan, plus extra benefits designed specifically for navigating asthma and COPD. The difference? You don’t have to trade regular health insurance for respiratory support. You get both.

Yes! Chronic Care CKM includes the same comprehensive, full-body coverage you'd expect from an Oscar plan, plus extra benefits designed specifically for navigating COPD, diabetes, and heart conditions. The difference? You don’t have to trade regular health insurance for specialized support. You get both.

Absolutely. Your family gets Oscar’s comprehensive coverage with day-one perks like $0 virtual care. Then, if you or anyone else in the house needs extra help with COPD, diabetes, or a heart condition, those specific people get the bonus perks tacked on. It’s the best of both worlds.

Absolutely. Your family gets Oscar’s comprehensive coverage with day-one perks like $0 virtual care. Then, if you or anyone else in the house needs extra help with diabetes, those specific people get the bonus perks tacked on. It’s the best of both worlds.

Yes! Diabetes Care includes the same comprehensive, full-body coverage you'd expect from an Oscar plan, plus extra benefits designed specifically for navigating type I or II diabetes. The difference? You don’t have to trade regular health insurance for that specialized support. You get both.

Yes! HelloMeno includes the same comprehensive coverage you'd expect from an Oscar plan, plus extra benefits designed for navigating perimenopause and menopause. And here’s what’s cool: You're not trading regular health insurance for menopause support. You're getting both.

Your plan includes vision coverage for the entire household, including built-in pediatric vision benefits for routine eye exams, lenses, and frames. Just note that pediatric dental benefits are not covered under this plan.

Select $0 generics are available at Hy-Vee Health Exemplar Care clinics only. So, for example, if a doctor sends your RX to a Hy-Vee Pharmacy, it will not cost $0.

If you’re an eligible member, we’ll send you more information on how to enroll. Make sure to check your email or your secure messages in your Oscar account for a WellDia signup link, and simply follow the instructions to enroll. (See terms and conditions below.)

If you have questions, learn more here (opens in new tab) or call (855) 672-2755 to speak with a Care Guide.

The Oscar Diabetes Management Program (WellDia) is available to actively-enrolled IFP Oscar members with Type 1 or 2 diabetes living in: AZ, FL, GA, IA, IL, KS, MI, MO, NC, NE, NY, OH, OK, PA, TX, or VA. Members must have or create an Oscar account, agree to the terms of the program, and actively enroll to participate. For members under the age of 18, a parent or guardian, must call Oscar at (855) 672-2755 to enroll them in the program. Members can become ineligible for the program should they no longer have a diabetes diagnosis, or change to an ineligible plan. A prescription is required by a licensed provider to receive diabetes test supplies included as a benefit of this program.

When you search for a doctor in your Oscar account, you’ll see an icon that says “Hy-Vee Health Exemplar Care” to the left of the doctor’s info. The doctor’s profile will also say “This doctor is a part of Hy-Vee Health Exemplar Care clinics” under the ‘About’ tab.

We make it simple. Our provider search tool specifically highlights local, native Spanish-speaking doctors. You can also ask your Care Team to match you with a trusted provider who understands your language and your roots.

You can schedule your appointment at www.exemplar.care/virtual-telemedicine-appointment. If you need assistance, just call your Oscar team at (855) 672-2755.

You can schedule your appointment at www.exemplar.care/locations. If you need assistance, just call your Oscar team at (855) 672-2755.

The exact cost of Breathe Easy depends on where you live, your household size, and whether you qualify for financial assistance (nearly 90%¹ of people do!).

Since this plan is tailored to your needs, your total annual costs — including premiums and medical care — are typically lower.

The exact cost of Buena Salud depends on where you live, your household size, and whether you qualify for financial assistance (nearly 90%2 of people do!).

The exact cost of Chronic Care depends on where you live, your household size, and whether you qualify for financial assistance (nearly 90%¹ of people do!).

Since this plan is tailored to your health needs, your total annual costs — including premiums and medical care — are typically lower.

The exact cost of Diabetes Care depends on where you live, your household size, and whether you qualify for financial assistance (nearly 90%¹ of people do!).

Since this plan is tailored to your needs, your total annual costs — including premiums and medical care — are typically lower.

The exact cost of HelloMeno depends on where you live, your household size, and whether you qualify for financial assistance (nearly 90%¹ of people do!).

The exact cost of Oscar Vision & Dental depends on where you live, your household size, and whether you qualify for financial assistance (nearly 90%¹ of people do!).

Since this plan is tailored to your needs, your total annual costs — including premiums and medical care — are typically lower.

The exact cost of RetireEase depends on where you live, your household size, and whether you qualify for financial assistance (nearly 90%¹ of people do!).

Since this plan is tailored to your specific needs, your total annual costs are typically lower than with standard plans.

Congrats! Yes, you can enroll today. Leaving a job and losing your employer-sponsored health insurance is what the industry calls a "qualifying life event." This opens up a 60-day special enrollment period just for you, meaning you do not have to wait for the standard fall open enrollment window. That way, there isn't a single gap in your coverage.

No, it’s not $0. If you see a doctor outside of a Hy-Vee Health Exemplar Care clinic, copays and cost shares apply.

No. That is exactly the kind of financial guesswork we built this plan to eliminate. Your insulin out-of-pocket cost is locked in at a hard ceiling of $100 a month, maximum. No matter what.

It’s all included in one plan, and you can choose the right one for you. Many Oscar plans have Vision and Dental as part of the plan, including specialized plans like RetireEase.

That means one single monthly premium, one digital ID card, and one app login. No dealing with three different companies or tracking down random bills in your inbox.

Leaving a corporate safety net can feel daunting. But you're actually trading a rigid employer plan for a local option that works harder for your dollar. This plan outperforms traditional coverage by locking in what matters: $0 routine care, 24/7 virtual doctor visits, and seamless access to local specialists. You get the same employer-grade protection you’re used to — just tailored to your budget and backyard.

Yes, absolutely. In fact, it’s specifically designed to replicate the corporate-grade, all-in-one experience you’re used to. You get the high-end coverage and broad doctor choices you expect, packed seamlessly into a single card and app. It’s corporate-level perks, minus the corporate bureaucracy.

Absolutely. While Buena Salud automatically defaults to Spanish to ensure you never have to ask for a translation, you can toggle your language preference in your account, chat with English-speaking Care Guides on request, and visit English-speaking doctors when you prefer.

A lot. You get $0 primary care, $0 urgent care, $0 routine labs, and $0 select generic drugs at Hy-Vee Health Exemplar Care clinics. You also get access to 24/7 virtual care appointments when you go to Hy-Vee Health Exemplar Care clinics.

It boils down to real-world value. Healthcare costs are skyrocketing by up to 15%2 this year, meaning most plans are charging you more just to get less. So we’re changing the game by giving you $0 care options on day one (no need to meet your deductible first) and hassle-free access to top local specialists. It’s total peace of mind for your health and a serious break for your wallet at the grocery register.

RetireEase is designed to be your permanent bridge to Medicare, not a trap. The exact month you turn 65 and your Medicare coverage kicks in, you can cancel your RetireEase plan instantly. No penalties, no hidden exit fees, and no messy paperwork.

COBRA is usually the default recommendation because it’s easy for HR to hand you the paperwork on your way out the door. But here’s the catch: COBRA forces you to pay up to 102%2 of the premium for standard corporate insurance out of your own pocket. Translation: It can be really expensive.

RetireEase is built specifically for a retirement budget with features like fixed copays and $0 prescriptions (without the bloated, employer-sized premium).

Yes, these plans can help people living with asthma or COPD save money and manage the condition.

Very likely! This plan is anchored by the MercyOne health network and Hy-Vee Health Exemplar Care, which include many of the region’s top-tier primary care doctors, specialists, and hospitals. On top of that, you have access to all the doctors and specialists in Oscar’s network.

Want to be 100% sure before you enroll? Look up your providers here.

Absolutely. HelloMeno rewards are in addition to any other Oscar incentive programs. Visit the Perks page to learn more.

No. HelloMeno is designed for people who are navigating either perimenopause or menopause.

Perimenopause is the transition leading up to menopause. It’s when hormone levels begin to fluctuate and symptoms like hot flashes, sleep changes, brain fog, and mood shifts can start to appear. This transition can last for several years before menopause officially drops. So whether you're in perimenopause, menopause, or somewhere in between, HelloMeno is here to get you the support and care you need.

Not at all! While the plan comes packed with exclusive rewards only Hy-Vee members are eligible for, prepaid debit cards, and $0 care at Hy-Vee Health Exemplar Care clinics, your core coverage works across the entire Oscar health network. Whether you step foot in a supermarket or not.

Please refer to any applicable expiration details provided at the time you receive a reward.

Whenever you get a reward, check out your reward details for any expiration details.

Yes. HelloMeno is built around menopause support, but the coverage keeps on giving. Our Silver Simple Women's Health plan also includes benefits for eligible family members (like your spouse or dependent children). So you're covered, and they're covered.

Call your Care Team at (855) 672-2755. They’ll help make sure your rewards find their way to you. (You deserve them).

The exact cost of Hy-Vee Health with Oscar depends on where you live, your household size, and whether you qualify for financial assistance (nearly 90%1 of people do!).

We’ll get a claim from your visit or prescription refill. That’s our cue to send you a gift card!

Once you complete an activity, the claim from your visit (or prescription refill) will serve as verification of completion and you will be sent your gift card.

If you have not received your rewards, you can call your Care Team at (855) 672-2755.

No, it does not exclude you from other rewards and incentives programs. Check our Perks page for additional rewards and incentives that may be available to you.

The Breathe Easy COPD Plan includes:

• $0 Primary doctor visits
• $0 Pulmonologist visits
• $0 Behavioral health visits
• $0 Pulmonary rehab and pulmonary function test
• $0 Oxygen
• $0 Generic Chantix, nicotine replacement, and inhalers

• $0 primary doctor, gynecologist, and behavioral health visits
• $0 labs (including metabolic panel, lipids, vitamin D, calcium, and parathyroid hormones which can be affected by menopause)
• $0 prescriptions including hormone replacement therapy, SSRIs (depression/anxiety), and autoimmune
• $0 bone density scan
• Access to menopause experts through Elektra Health or Atrium Health (depending on where you live) at no additional cost

HelloMeno members in NC can earn:

• $15 each: cervical cancer screening (pap smear), mammogram
• $25 each: bone density (DEXA) scan, colonoscopy
• $25 for visiting an Atrium Menopause Clinic doctor or advanced practice professional
• $15 for getting nutritional counseling anywhere
• HelloMeno members in AZ, FL, GA, IA, MO, NE, OH-B (Buckeye), OH-C (Cleveland), TN, TX can earn:
• $15 each: cervical cancer screening (pap smear), mammogram
• $25 each: bone density (DEXA) scan, colonoscopy
• $15 for using Elektra virtual support services (coaching sessions, education, or virtual events)
• $25 for meeting with an Elektra doctor or advanced practice professional

Members in Oklahoma are not eligible for rewards.

Our Breathe Easy COPD Plan is available in Arizona, Florida, Georgia, Iowa, North Carolina, Ohio (Buckeye), Ohio (Cleveland), Oklahoma, Tennessee, and Texas.

HelloMeno is available in Arizona, Florida, Georgia, Iowa, Missouri, North Carolina, Nebraska, Ohio (Buckeye), Ohio (Cleveland), Oklahoma, Tennessee, and Texas.

Members in Arizona, Florida, Georgia, Iowa, North Carolina, Ohio (Buckeye), Ohio (Cleveland), Oklahoma, Tennessee, and Texas are eligible. Enrollment into these plans are not limited to members with asthma or COPD and the lower cost shares for non-asthma or COPD related services are not conditioned on a member having a specific chronic condition.

Anyone eligible for health insurance can enroll in HelloMeno. It’s designed for women experiencing (or who have experienced) natural or forced menopause. And it covers benefits for the whole family.

Plan names to join the program vary by state: Silver Simple Women's Health with Menopause Benefits and Silver Simple Women's Health with Menopause Benefits Guided Care.

HelloMeno plan members in NC.

HelloMeno Plan members in AZ, FL, GA, IA, MO, NE, OH, OK, TN, and TX.

Please refer to any applicable expiration details provided at the time you receive a reward.

Once you complete an activity, the claim from your visit (or prescription refill) will serve as verification of completion and you will be sent your gift card.

If you have not received your rewards, you can call your Care Team at (855) 672-2755.

No, it does not exclude you from other rewards and incentives programs. Check our Perks page for additional rewards and incentives that may be available to you.

Yes, this plan is especially designed to help members with cardiovascular-kidney-metabolic (CKM) syndrome save money and manage their condition.

The Chronic Care CKM Plan includes:

• $0 Primary doctor visits
• $0 Behavioral health visits
• $0 Cardiologist, endocrinologist, and pulmonologist visits
• $0 Pulmonary and cardiac rehab
• $0 Labs (HbA1C screening, urinalysis, metabolic panel, lipid panel)
• $0 Diabetic eye and foot exams
• $0 Oxygen
• $0 Generic Chantix, nicotine replacement, and inhalers
• $100 out-of-pocket monthly maximum on insulin

Cardiovascular-kidney-metabolic (CKM) syndrome is a complex condition that includes cardiovascular disease, kidney disease, obesity and type 2 diabetes.

Our plans reward you for treating yourself right. And, we’ll cheer you on along the way.

Oscar Members are eligible for rewards upon completion of qualifying activities.

Members enrolled in the Chronic Care CKM Plan can earn:

• $25 for getting flu and pneumonia vaccines
• $30 for switching a qualifying brand name drug from 30-day to 90-day refill, including inhalers
• $50 toward healthy groceries when you complete an annual wellness exam
• Access to gyms and on-demand fitness by the American Specialty Health Fitness' Active&Fit program by completing any two routine services (like labs and a diabetic eye exam)

You can also check our Perks page for additional rewards and incentives that may be available to you.

This plan is available in Alabama, Arizona, Florida, Georgia, Iowa, Kansas, Missouri, Mississippi, North Carolina, New Jersey, Ohio (Buckeye), Ohio (Cleveland), Oklahoma, Tennessee, and Texas.

This plan is available in Alabama, Arizona, Florida, Georgia, Iowa, Kansas, Missouri, Mississippi, North Carolina, New Jersey, Ohio (Buckeye), Ohio (Cleveland), Oklahoma, Tennessee, and Texas.

Enrollment into the plan is not limited to members with cardiovascular disease, kidney disease, obesity, and type 2 diabetes. The lower cost shares for CKM related services are not conditioned on a member having a specific chronic condition.

Here’s how you create your Oscar online account:

• Visit hioscar.com/register (opens in new tab). Enter your email address and create a password. Then, hit ‘Create account’
• Verify your email, and fill out a few details.
• Set up autopay. (You’ll just need your account holder name, routing number, and account number).
• Sign up for paperless communications.
• Complete your health profile.

Congratulations, you did it!

Having an online account makes it easy to do just about anything related to your health. Like:

• Easily pay your bill
• Review your recent claims
• Message your Care Team (opens in new tab)
• Refill prescriptions
• Find in-network options (opens in new tab) for doctors, providers, and facilities

You can also download the app (opens in new tab) to have care on the go. Pretty great, huh?

To download the Oscar app (opens in new tab):

• Search for Oscar Health in the App store (opens in new tab) or Google Play store (opens in new tab).
• Click Download. Then, open the app.
• Sign in by entering your email address and password.
• If you don’t already have an account, choose Create your account and verify your email address.

Need some help? Check out this step-by-step guide (opens in new tab) and we’ll walk you through the whole app download process. The Oscar app makes managing your plan on the go pretty simple.

If you experience an emergency, it’s important to let us know what happened so we can process your claim.

Here’s how it works:

1. Your provider will send a claim to your health insurer with a description of the services you received and why.
2. Your insurer will review the claim and send you an explanation of benefits showing what’s been covered. Your insurer will also pay your healthcare provider.
3. You may receive a bill from the provider if you owe anything (such as a copay, coinsurance, or a payment toward your deductible).

As always, if you find yourself needing emergency (opens in new tab) care, you should go directly to the nearest ER or call 911.

Log in to your Oscar account or app and use the prescription search tool to see if your medications are covered and what you can expect to pay. Or check out our Drug Formulary here (opens in new tab). It lists all the medications your plan covers (along with maximum dosage, quantity, and whether you’ll need pre-authorization).

Here are 3 simple ways to find in-network care:

• Search your account: Log into the app or your member account to easily find doctors, specialists, or facilities by name, specialty, or symptom. You can filter results by distance, language, and availability.
• Use $0 Virtual Urgent Care: Need care or a prescription ASAP? Connect with a doctor in as soon as 15 minutes.
• Ask your Care Team: Message or call your Care Team at 855-672-2755, and we’ll find the right match for you.

Great!

All you need to do is book a visit and you’re set. You can schedule something with your provider directly through your Oscar app or go to hioscar.com/search. If you have an Oscar Care provider, book a virtual visit with them directly through your Oscar app or at hioscar.com/member/virtual-primary-care.

Great. You can talk with a provider in as little as 15 min with Oscar’s Virtual Urgent Care1. It’s $0 and available 24/7 anywhere in the US. Yes, even at 2am.

We’re glad you know what you need. Find an in-network urgent care near you in the Oscar app or at hioscar.com/search.

Just message your Oscar Primary Care provider through your Oscar app or book an appointment at hioscar.com/member/virtual-primary-care.

Great! We recommend that you discuss seeing a specialist with your primary care provider before booking an appointment. This will help them stay informed about whatever you’re experiencing. Once you do, just book a visit and you’re set.

Find a provider or check to see if your provider’s in Oscar’s network in the Oscar app or at hioscar.com/care-options. You can search by specialty or condition.

Let’s do it!

Try Oscar Primary Care2. It’s already included in your plan, which is great! It’s just like regular primary care but from the comfort of your couch. Schedule a visit right from the Oscar app. Video and phone visits are $0. And your provider can connect you with in-person care if you need it.

Stop what you’re doing and go directly to the nearest emergency room or call 911. Find the nearest ER in the Oscar app or at hioscar.com/care-options. Oscar plans cover qualifying life-threatening emergency room services – even if the hospital is out-of-network.

On it! Let’s find the right provider for you. See the options below to find someone who can help you.

We’re happy to hear that you’re taking care of your health. Just choose an option below to connect with the right provider.

We’ve got you covered. Check out the options below and pick the one that best matches your needs.

Not to worry! A primary care provider can help direct you to the right provider. So let’s connect you with Oscar Primary Care. It’s already included in your plan and it’s just like regular primary care but from the comfort of home. You can schedule a visit right from the Oscar app. And your provider can connect you with in-person care if you need it.

No worries! You can talk with a provider in as little as 15 min with Oscar’s Virtual Urgent Care. It’s $0 and available 24/7 anywhere in the US.

Yes! You can get care from any in-network PCP. Just remember that you can only get specialist referrals from the PCP who’s on your profile.

Guided Care tip: If your PCP isn’t available, check in with their office to see if another provider in their practice can help you.

Yes, you absolutely can! As an Oscar Guided Care HMO member, you have full access to Oscar Primary Care – that way you can get primary care from home by video, messaging, or phone. If you’d like to choose a virtual PCP, you can do so right in your account.Want to learn more? Visit our Oscar Primary Care page.

With a Guided Care HMO plan, you’ll need a referral to see most specialists. There are some exceptions, though. Here’s a full list of specialists and scenarios where a referral isn’t required.

You may need a referral quickly at times, and your PCP might be busy. Don’t worry! We have a back up plan for you.Here are two ways to get a referral quickly if you can't get an appointment with your PCP right away:

• Call your PCP’s office and see if there is another provider in the practice who can give you a referral.
• Use Oscar’s Virtual Care. You’ll be able to talk to a provider in as little as 15 minutes right through the Oscar app. They’ll make sure you are taken care of and get you a referral as needed.

If you need help scheduling a Virtual Care appointment, just call your Care Team (855) 672-2755.

Here’s how you get a referral:

• First, book an appointment with your primary care provider and ask for a referral. If you have an Oscar Primary Care provider, all you have to do is message them to request a referral.
• Once your PCP submits your referral in their Oscar portal, we'll accept your referral instantly.*
• You can always see the status of your referral right in your account. It will list the number of visits you have and specialist recommendations, too.
• Once you have a valid referral, book an appointment with an in-network specialist.

* Review timelines may be affected by method of submission; the referring PCP also needs to be your PCP on file

Here’s how you select a PCP:

1. Create an Oscar account or log into your account if you already have one.
2. Type primary care provider into your search bar (or type the name of your PCP if you already have one). Add any additional filters as you see fit (location, gender, language, etc.). 
3. Once you find the PCP you’d like to select, click on their profile and then click “Add as primary care provider.” 

That’s it! 

Guided care tip: You’ll receive a little email from us confirming that we’ve received your PCP selection.

If you have any questions about your EOB, we’ve got you. Just call our Care Team at (855) 672-2755 or log in to your account to message them.

Absolutely! Here’s how:

Just log into your account and click the “edit” button next to your PCP’s name.

Then, search for “in-network primary care providers.” You can filter your search by things that matter to you like location, gender, language, and more.

When you’ve decided which PCP you’d like to select, click on their profile and then “Add as primary care provider.”

Your digital ID card will automatically update with your new PCP.Need help changing your PCP? Our Care Guides can help. Feel free to give them a call at (855) 672-2755, or message them right in your account. 

If you see this in your account, it’s because the provider who submitted your referral is not your PCP on file. Don’t worry, it’s pretty easy to fix. Just set this provider as your PCP in your account and we’ll make your referral valid right away.

If you don’t select a PCP, we’ll match you with someone we think you’ll love. (You can always change your PCP at any time — see below on how to do that.)

Don’t worry! You can always reach out to our Care Guides. They’re here to help you with things like this. Give them a call at (855) 672-2755 or log into your account to message them. 

Looking for your PCP? You’ll find them right in your Oscar account homepage. 

Want to change your PCP? You can do so at any time in your Oscar account as well.

Your PCP is your go-to for all things care and specialist referrals. Don’t forget: Referrals are required with your Guided Care plan.

The PCP you select doesn’t have to be someone you already know. The goal is to pick someone that you’d like to get to know. You can choose your PCP based on your location, language preference, or even speciality.

If the person you choose isn’t a good fit, you can always change your PCP at any time.

An ICHRA (Individual Coverage Health Reimbursement Arrangement) is a special health benefit where your employer gives you a tax-free monthly allowance to buy your own insurance (instead of picking a company plan for you).

Here’s how it works:

1. You choose the specific individual Oscar plan that fits your health needs and budget.
2. You pay your premium directly to Oscar.
3. You submit your payment history to your employer, and they reimburse you.

Just because a drug is generic doesn’t mean it’s less effective. The FDA makes sure the same active ingredients are present in the generic substituted product and that the generic drug is as effective as the equivalent brand drug. (The only thing that’s really different are the inactive ingredients.)

Many of the meds on the $3 list are generic versions of a brand drug. And if you’re switching to a generic medication, your pharmacist can easily make the switch for you.

If you’re switching to a therapeutic alternative — meaning a different drug with similar effects — you’ll need to talk to your doctor. If the switch is right for you, they’ll just need to write you a new prescription for the more affordable alternative.

Good news! Yes. Drugs on the $3 list will always be $3, whether you’ve hit your deductible or not.

Sometimes providers may send your tests to a lab that isn’t covered by Oscar. Always remember to ask your provider to send your lab work to BioReference, LabCorp or Quest Diagnostics, Oscar’s preferred lab partners, to avoid a surprise bill. Should that happen, however, please contact Oscar right away for help with this process.

There are some eligibility restrictions and limitations, but the following labs are generally covered:

• Iron-deficiency anemia screening
• Gestational diabetes screening
• Hepatitis B screening
• HIV screening
• Rh (D) blood typing and antibody testing incompatibility screening
• Syphilis screening
• Chlamydia screening
• Gonorrhea screening
• Asymptomatic Bacteriuria in the urinary tract not causing active symptoms, or other infection screenings
• Noninvasive prenatal screening (cell free DNA)

When you receive the following labs, you may be responsible for the entire cost, or a share of the cost, depending on your plan and whether the lab work was medically necessary. These include:

• Genetic testing (subject to medical necessity)
• Pregnancy testing (if not related to contraceptive removal)
• Ultrasounds (subject to cost-share)
• Sonograms (subject to cost-share)

All members of Oscar are eligible up to five visits with a certified lactation consultation during pregnancy or the duration of breastfeeding. 

Visits can be in an individual or group setting. Services provided during a lactation consultation include:

• Comprehensive maternal, child, and feeding assessment related to lactation
• Developing and implementing a personalized feeding plan
• Providing guidance and support to enable mothers to meet their breastfeeding goals

If you can’t find an in-network lactation consult, Oscar will need to sign a contract with your chosen lactation consult to have your visits covered. Your Care Team can help you through this process. Log in to your Oscar account online (opens in new tab) or in the Oscar app (opens in new tab), or call 1-855-672-2755.

Oscar covers postpartum visits under your Oscar plan, if done with an in-network provider.

Oscar covers ultrasounds and sonograms, but they might be subject to x-rays and diagnostic imaging cost sharing under your plan. Check your Schedule of Benefits for more information and talk with your provider to see if they require prior authorization through Oscar.

An ultrasound exam is also used as part of the first trimester screen. Based on exam results, your doctor might suggest other tests or types of ultrasound to help detect a problem.

It’s common for women to have a standard ultrasound exam between 18 and 20 weeks, to look for signs of problems with the baby's organs and body systems, and to confirm the age of the fetus and proper growth.

Although some medications are considered safe during pregnancy, the effects of others are unknown. Certain medications can be harmful to the development of your baby when taken during the first three months of pregnancy, sometimes before knowing you’re pregnant. With some medications, the risk of not taking them might be more serious than the potential risk associated with taking them. Please don’t stop taking any medication without consulting first with your provider, as this could be potentially harmful.

If you were taking prescription medications before you became pregnant, please ask your healthcare provider about the safety of continuing to take them as soon as you find out you’re pregnant. Your provider will weigh the benefits to you, and any risks to your baby.

If you’re prescribed any new medications, please inform your doctor that you’re pregnant. It’s important to discuss the risks and benefits of the newly prescribed medicine with your healthcare provider.

If filled through an in-network pharmacy, some prenatal vitamins are covered by Oscar: Prenatabs Rx - Generic (Tier 1) and Citranatal - Preferred brand (Tier 2).

For any other prescription medications, check the Drug Formulary to make sure it’s covered.

Oscar offers mental health services for all our members, including counseling and resources for postpartum depression. 

Connect with a virtual mental health provider through Oscar’s partnership with Ginger. To get started, download the Ginger app (opens in new tab). The cost of these visits depends on your plan benefits (opens in new tab). 

If you’re looking for in-person mental health care, our partnership with Optum provides you with mental health care services and in-network providers that can meet your needs.

You can schedule an in-person visit through Optum, and search for providers via their online search portal (opens in new tab). When calling a provider's office to book an appointment, just let them know that you have Optum through Oscar.

If you feel that you’re in a crisis situation and need to speak to a therapist right away, please call Optum directly, or call us at 855-672-2755, and we’ll transfer you to their crisis line right away.

One breast pump is covered per pregnancy. You can order this pump while still pregnant, or after you deliver. Breast pumps, depending on the type, are covered in full as a preventive service. (Note: these items cannot be returned.) You can rent one from the hospital, or buy one from an in-network durable medical equipment (DME) vendor. To order a pump through a DME vendor, please contact: Byram Healthcare for Breast Pumps: 877-773-1972; or EdgePark Medical Supplies: 800-321-0591.

Being active during pregnancy has many great benefits, such as endorphins, improved sleep, and can help to keep your weight gain healthy. Some activities that are safe during pregnancy include walking, swimming, and yoga. Talk with your provider to find out what’s right for you. Meditation is another good way to calm the body during pregnancy. We’ve also partnered with Calm to offer you 40% off sleep and stress reduction tools. (You can download the Calm app for free.)

You’ve also got access to our new Fhitting Room partnership, with special prenatal classes. (Please avoid laying flat on your back after the second trimester, but again, consult with your provider about which activities are safe for you at various stages of pregnancy.)

With its skin-to-skin contact, breastfeeding can be a wonderful bonding activity between mother and child, and it offers many other benefits. Breastfed babies tend to have stronger immune systems, fewer colds and respiratory illnesses such as pneumonia, and fewer allergies and ear infections. Breast milk provides abundant (and easily absorbed) nutritional components, antioxidants, enzymes, immune properties, and live antibodies from the mother. Potential benefits for the mother by breastfeeding include faster weight loss after birth (burning around 500 extra calories a day to build milk supply); a lowered risk of anemia; lower risk of breast cancer; and production of the soothing hormones oxytocin and prolactin, which promote stress reduction and positive feelings in the nursing mother.

Oscar covers a number of birth, parenting, and lactation classes as preventive services, along with infant safety classes:

• Childbirth preparation/Lamaze classes
• Cesarean (C-section) birth classes
• Parenting classes
• Infant safety (including CPR) classes
• Lactation classes

Both parents can attend, and there are no limits. Classes can also be done in an individual or group setting. You’ll need to contact Oscar to pre-approve your attendance for these classes. You can contact your Care Team by logging in to your Oscar account online or in the app, or by calling 1-855-672-2755.

*Please note, these classes are not covered in Michigan.

Oscar covers well-baby (and well-child) care, which consists of routine physical examinations such as vision and hearing screenings, developmental assessment, anticipatory guidance, and laboratory tests ordered at the time of visit, as recommended by the American Academy of Pediatrics.

Immunizations and boosters as required by ACIP are also covered. This benefit is provided to members from birth through attainment of age 19 and is not subject to copayments, deductibles, or coinsurance when provided by a participating in-network provider.

Standard guidelines recommend a postpartum visit at 4-6 weeks for all new mothers. Mothers with complications (e.g. gestational diabetes, preeclampsia) may go earlier. 

Post-delivery care typically consists of services provided by the registered professional nurse or physician, including:

• Physical assessment of the Newborn and mother
• Parent education
• Assistance and training in breast or bottle feeding,
• Education and services for complete childhood immunizations
• Any necessary and appropriate clinical tests
• Submission of a metabolic specimen satisfactory to the state laboratory

Typically, an OB-GYN—a provider who is both an Obstetrician (OB) and Gynecologist (GYN)—is the most common. Be sure to find someone who takes Oscar. If your provider goes out of network, and you’re in your first trimester, you’ll have to change to an in-network provider for your care to be covered.

If you’re pregnant when becoming a new member—and in your second or third trimester, and the provider you’ve established care with is out-of-network—you can continue obstetrical care with this provider through the end of the pregnancy. Log in to your Oscar account online, or in the Oscar mobile app, to find an in-network provider.

You can also choose to have a licensed midwife take care of you during the pregnancy. If your midwife is out-of-network, Oscar will need to sign a contract with them to have the services covered. Your Care Team can help you in this process. You can contact them from your Oscar account online or in the app, or by calling 1-855-672-2755.

Note that Oscar won’t cover duplicative routine services provided by both a midwife and another clinician.

A miscarriage results in the loss of a fetus before 20 weeks of pregnancy. It typically happens during the first trimester, or first three months, of the pregnancy. Miscarriages can happen for a variety of medical reasons, many of which aren't within a person's control. (There are more than 3 million cases in the U.S. each year.) If you’ve suffered a miscarriage, please know that we’re here to support you. You can also contact our mental health partner, Optum at 1-877-852-4305 for more information.

Babies are typically covered for a certain length of time under the mother’s plan before they will need their own coverage, however, this is dependent on the state in which you live.

If you’re based in California: Please notify Oscar or Covered California to add your newborn to your policy. If you enrolled through the marketplace, you’ll need to contact the marketplace to have your child added. As always, reference your Certificate of Coverage, or call your Care Team at 1-855-672-2755 to find out the timeframe for enrolling your baby in their own coverage. (You’ll need a copy of birth certificate or proof from the hospital reflecting the date of birth.)

If you're based in New York: New York offers a health insurance plan for children, called Child Health Plus (CHP). Newborns who are eligible for CHP can receive coverage from Oscar until their CHP coverage kicks in. Please contact Oscar for more details.

You can order this pump while you’re still pregnant, or after you deliver. Breast pumps, depending on the type, are covered in full as a preventive service. It’s important to choose carefully, as these items cannot be returned. To order a pump through a DME vendor, please contact the following:

• Byram Healthcare for Breast Pumps: 877-773-1972
• EdgePark Medical Supplies: 800-321-0591

The vendors can tell you what’s available for a $0 copayment breast pump. Obtaining a breast pump requires a prescription from your provider. For more help, please contact your Care Team from your account online, or in the Oscar app, or call them at (855) 672-2755.

Yes, benefits and rewards can vary by plan, and certain restrictions apply. Eligibility for rewards requires a member’s account to be in good payment standing without any overdue balance. Once a member’s account is current, the reward will be signed, sealed, and delivered.

Talk to your broker about what benefits, rewards, and perks come with each plan. Once you become an Oscar member, you’ll see all your rewards and perks on the Perks Page.

Once you become an Oscar member, go to the Oscar Unlocks Page and start unlocking! Participation in the Oscar Digital Rewards Program is available to all active IFP and ICHRA members (subscriber, spouse, and dependents age 18 and up), excluding those that reside in NJ and OK.

Here’s how you earn the reward: Create an Oscar account, log into the Oscar app, opt into paperless communications, and complete a health profile to receive a $50 gift card. Contact a licensed agent or Oscar sales representative for details.

Buena Salud plans include Spanish communications, access to Spanish-speaking healthcare providers, and dedicated Spanish-speaking customer service teams. They include tailored health programs and exclusive rewards like $50 toward healthy groceries for completing an annual checkup. Buena Salud plans are available in Arizona, Georgia, Illinois, and Texas.

For more info, go to hioscar.com/blog/introducing-buena-salud.

Getting what you need to stay healthy goes beyond medical care. So with support from FindHelp, we offer you a way to find free and reduced cost resources near you. Use the Oscar Community Resources tool to conveniently locate local programs and services to help with food, utilities, transportation, and more.

Here’s how to find what you need:

• Go to Oscar Community Resources
• Enter your zip code
• Find resources nearby including food banks, transportation programs, rent assistance, and more

ICHRA Off-Exchange Only Plans are plans only available to off-exchange members. For more info, contact a licensed agent or Oscar sales representative.

For more info about WellDia eligibility and benefits — go to hioscar.com/welldia.

For more info about the Breathe Easy COPD Plan eligibility, benefits, and rewards — go to hioscar.com/asthma-copd.

For more info about the Chronic Care CKM Plan eligibility, benefits, and rewards — go to hioscar.com/chronic-care.

For more info about the Diabetes Care Plan eligibility, benefits, and rewards — go to hioscar.com/diabetes.

For more info about the Hy-Vee Plan eligibility, benefits, and rewards — go to hioscar.com/hy-vee-health/member.

For more info about HelloMeno eligibility, benefits, and rewards — go to hioscar.com/hellomeno.

Log in to your Oscar account or app (or use the quick link above!) to message your Care Team. Or call them at 855-672-2755.

Your provider will assess your health and any existing conditions, and they’ll recommend a personalized care plan for you, which may include writing prescriptions. Your Oscar Primary Care provider will not write prescriptions for you that were prescribed by another provider or specialist unless they deem them medically necessary based on your specific needs.

If you need a one-time last minute refill for something that was prescribed by a provider outside of Oscar Care, we encourage you to use Oscar Virtual Urgent Care. All Oscar members can use Oscar Virtual Urgent Care regardless of whether they have a primary care provider through Oscar Primary Care or not.

You absolutely can. Just log into your account and select your virtual primary care provider just as you would your in-person one. You can learn more about Oscar Primary Care** here (opens in new tab).

A video call is a great way to see your provider face-to-face, but you won't need a device with a camera to use Oscar Primary Care. You can always talk with your provider by phone.

You can book a phone or video visit right here, using the Oscar app, or logging into your Oscar account here.

If you haven’t done so already, you’ll need to create an online account and fill out your Health Profile by answering a few questions about your health history. Once that’s completed, tap “Book a Primary Care Visit” on your Oscar account home screen. Then you can choose a provider and schedule an appointment as needed. To get help with setting up an appointment, just call your Care Team or send them a message through your Oscar account.

Oscar Primary Care is great if you’re looking to establish long-term care with a primary care provider. They get to know your unique needs and can help you manage your whole health, including chronic care management for issues like high blood pressure, diabetes, and more.

When something urgent comes up, Virtual Urgent Care offers you a care alternative to get care right away for things like pink-eye, skin issues, minor sprains and bruises, flu, sore throat, etc. You can easily request a phone or message consultation from the comfort of your home through our app. However, if you’re having a medical emergency, go to your nearest emergency room or dial 911.

Virtual visits by phone or video chat are $0 in select markets.* You can also message your provider between visits for $0.

After an Oscar Primary Care visit, your provider may suggest you get in-person care and will direct you to the right specialist, lab or imaging facility.

Oscar Primary Care is comprehensive care that comes to you by phone or video chat. You’ll usually talk to the same provider every time (and you can skip the waiting room). Best of all, your Oscar Primary Care visits are $0 in select markets.*

Oscar’s Virtual Urgent Care is available on all Oscar plans. Oscar members can use Virtual Urgent Care in all 50 states, however it is not available in US territories or internationally. Prescriptions, visits and services may be limited per provider discretion.

Oscar Primary Care offerings vary by market and may not be available in your area. Oscar Primary Care offerings are only available for members ages 18 and over.

Oswell is only available to members who are logged into their member portal. This helps keep member data private. At Oscar, member data is protected with strong encryption and security controls.

What sets Oswell apart is its personalized approach. It draws from member medical records, interactions with Oscar care guides, and plan benefit details to deliver tailored answers and support specific to the individual.

Oswell combines the best of AI with the best of expert physicians, giving members access to seamless, personalized healthcare information. When you ask Oswell a health or wellness question, he first gathers information and shares some basic guidance. If your question is more complicated, sensitive, or if you just need more help, Oswell connects you directly with our Care Team during our clinical hours (8am to 9pm, 7 days/week).

Oswell is available in English and Spanish.

Oswell provides general health and benefits information only. It is not a doctor and does not provide medical advice, diagnosis, or treatment, and does not create a provider-patient relationship. The chatbot does not provide therapy or behavioral-health treatment.The chatbot’s answers may be inaccurate or incomplete, and are not reviewed by a clinician. Do not rely on it for decisions about your health. Always talk to a qualified clinician about your specific questions. Do not ignore or delay seeking professional medical advice because of something you read here.In an emergency, call 911. For a mental health crisis, call or text 988.Use of Oswell is governed by Oscar’s Terms of Service.

Oswell covers all of your health and wellness questions. These include things like:

• “Can you help me refill my diabetes med? I forgot the name of it.”
• “My doctor said something about high cholesterol. Explain the lab results she gave me and what I should do.”
• “My hip hurts. Is it just my arthritis? Or which doctor can I see asap and how much would it” cost?

Oswell is a wellness AI chatbot built to make healthcare easier, more connected, and more personal. Oswell pulls from medical records, interactions with Oscar care guides, and plan benefit documents to help members understand their medications, explain common test results, check drug interactions, assist with prescriptions refills, review symptoms, provide questions to ask their doctors, and more.

Oswell is rolling out in phases to Oscar insurance members 18+. If you have access to Oswell, you will see it within your Oscar account. We expect to launch Oswell to all Oscar insurance members in the coming months.

Absolutely! All Oscar members have the freedom to go to the provider of their choice — it’s your healthcare, you know better. Just log into your account to change your PCP.

It’s really easy. We even made you a little step by step guide (opens in new tab).

We put together some tips & tricks (opens in new tab) to make sure you can always get an appointment.

Nothing. But you may miss out on having a true health ally. That’s why we suggest you connect with a provider at the beginning of your plan year. It will help you have a go-to provider for routine care and anything you need to stay on top of your health.

That’s ok. We’ll select a PCP we think will match your needs. And don’t worry, you can always explore the network and change providers, if needed.

That’s fine. We’ll just change your selection on our end to make sure the provider you’re seeing matches your records.

PCP selection just means you choose a primary care provider (PCP), and let us know who they are. You have up to 30 days after your coverage begins to choose your provider right through your Oscar online account. If you don’t choose one within that time, we will assign you a PCP so you have a go-to health partner.

Ideally, you should select your PCP within 30 days after your coverage begins.

Selecting a PCP helps you establish a relationship with someone you trust. Having someone dedicated to your health over time can lead to better health outcomes. It also makes it a lot easier for us to coordinate your care, send personalized health reminders, and keep all your claims and bills in order. And, best of all, you still don’t need a referral to see a specialist.

If you want to switch your Oscar plan, here's what you need to do depending on how/where you enrolled:

If you enrolled through HealthCare.gov or directly on Oscar’s site: You can switch to another Oscar plan with our easy-to-use enrollment tool by logging into your online account (opens in new tab) once Open Enrollment starts on November 1. You can also use this tool to compare your Oscar plan options and to check if you may qualify for financial assistance.

If you enrolled through your state Marketplace, like NY State of Health, Get Covered NJ, Georgia Access, Virginia Insurance Marketplace, Get Covered Illinois, or Pennie: You can switch to another Oscar plan once Open Enrollment starts on November 1 in most states*. Switch to a new Oscar plan through your state Marketplace by contacting your broker or calling us at (855) 672-2794.

• * If you enrolled through the NY State of Health marketplace, you need to wait until November 16 to make a plan change for the upcoming year.

Have questions?

• Call (855) 672-2794 to speak to an Enrollment Guide during Open Enrollment. As an Oscar member, you can also call or message your Care Team through your Oscar account online or in the Oscar app.

If you're interested in Oscar, it’s easy to get a quote and enroll online (opens in new tab). First, tell us a little about your health to see which plans we recommend (don’t worry, nothing you say there will impact your price) and then follow the enrollment prompts. It takes about five minutes if you don’t qualify for financial assistance and a few more (well worth it) minutes if you do.

If you’re qualified for Advance Premium Tax Credits, you’ll finish the enrollment process on the government marketplace website for your state, which might be New York State of Health (opens in new tab), Covered California (opens in new tab), Get Covered NJ (opens in new tab) or HealthCare.gov (opens in new tab). You can also apply directly through these marketplaces to see all the plans from all the insurers in your area.

You will need to renew or enroll in health insurance coverage each year! Here are a few ways to make sure you’re covered:

• If you’re already an Oscar member you can keep an eye out for a plan renewal notification that will be sent to you before Open Enrollment (opens in new tab).
• If you work with an insurance broker (opens in new tab), your broker can help you renew your Oscar plan during Open Enrollment.
• You can also call us at (855) 672-2794 from 9 a.m. - 8 p.m. EST during Open Enrollment. One of our licensed Enrollment Guides will be able to assist you — in English or in Spanish!

If your plan is not meeting your needs, you can switch to another plan if you have a qualifying life event, or during Open Enrollment for the next plan year.

If you’re sure you want to cancel your plan, here’s how:

• If you enrolled through the Marketplace, visit HealthCare.gov (opens in new tab) or your state's exchange website.
• If you enrolled with a broker, contact them directly.
• If you enrolled directly with Oscar, call us at (855) 672-2755.

Before canceling, make sure you’re aware of the following:

• If you cancel your plan, you won’t be able to re-enroll in coverage outside of Open Enrollment for the next plan year, unless you have a qualifying life event.
• There are significant benefits to having coverage — and risks to going without. Medical care without insurance can be costly, so it’s important to be protected against the unexpected.
• Plan coverage can help keep you healthy with free preventive care.

To know if Medicaid Redetermination will impact your coverage, look out for a letter from the Department of Health and Human Services to see if you're still covered. If you’re no longer eligible, Oscar has great plans that'll make your transition easy. Check out Oscar's plans here (opens in new tab).

In order to save money on health insurance, it will depend on how much you earn. You may qualify for financial assistance in the form of tax credits immediately applied to your premiums to make your coverage more affordable.

If you qualify, you can apply your tax credits (opens in new tab) to any plan in the marketplace. To qualify for tax credits, you have to report the income you expect to earn as a household (that means your spouse’s paycheck, your kids' jobs, etc.).

If you’re married, you have to file your taxes jointly to qualify for assistance. If you’re married but filing separately, you won’t be able to claim tax credits. To claim your credits, you have to enroll through the marketplace.

Simply log into your Oscar account when open enrollment starts on November 1. Our shopping tool will automatically recalculate your savings, verify your doctors and prescriptions, and help you find your best-fit plan for 2027.

If you’ve recently experienced a major life change like switching jobs, moving, or having a baby, you may be eligible to switch plans now. See if you qualify here.

If you want to switch your Oscar plan, here's what you need to do depending on how/where you enrolled:

If you enrolled through HealthCare.gov or directly on Oscar’s site: You can switch to another Oscar plan with our easy-to-use enrollment tool by logging into your online account (opens in new tab) once Open Enrollment starts on November 1. You can also use this tool to compare your Oscar plan options and to check if you may qualify for financial assistance.

If you enrolled through your state Marketplace, like NY State of Health, Get Covered NJ, Georgia Access, Virginia Insurance Marketplace, Get Covered Illinois, or Pennie: You can switch to another Oscar plan once Open Enrollment starts on November 1 in most states*. Switch to a new Oscar plan through your state Marketplace by contacting your broker or calling us at (855) 672-2794.

• * If you enrolled through the NY State of Health marketplace, you need to wait until November 16 to make a plan change for the upcoming year.

Have questions?

• Call (855) 672-2794 to speak to an Enrollment Guide during Open Enrollment. As an Oscar member, you can also call or message your Care Team through your Oscar account online or in the Oscar app.

Medicaid Redetermination is the process in which individuals & families reapply to keep their Medicaid coverage for themselves and beneficiaries, or transition to another type of coverage, including ACA, if they’re no longer eligible for Medicaid.

Wondering what makes Oscar different? With Oscar, you can expect:

• An entire team available to you: Oscar Care (opens in new tab) gives you personalized virtual care from the comfort of your home, at work, or on-the-go.
• $3 prescriptions: We talked to doctors and analyzed member data to find ways to reduce drug costs to $3 or less. Check out our $3 meds list.*
• An easy way to find a doctor: Use the search tool (opens in new tab) to get access to top-rated hospitals and doctors in your neighborhood

*$3 drug list only available for non-standard plans. A non-standard plan has 6T. Tier 1a indicates medication that are $3

Oscar’s Virtual Urgent Care offerings are not available in US territories or internationally. If you have an HSA-compatible high-deductible health plan or a Secure plan, you won't be eligible for $0 visits. Prescriptions, visits and services may be limited per provider discretion.

Before enrolling in health insurance there are a few things you should do:

1. Figure out where to apply. If you’re interested in getting insurance through your state, check out the federal marketplace, HealthCare.gov (opens in new tab).

2. Estimate your household income. You’ll need an estimate of your total household income before tax for the upcoming year.

3. Make sure an individual plan is right for you. You may not be able to get a plan through HealthCare.gov (opens in new tab) if you:

• Get insurance through your job. If your employer (or your spouse’s employer) offers health insurance, you can’t buy insurance through the healthcare exchange unless their plans are deemed “unaffordable.” For more information regarding employer-sponsored coverage and the exchange you can review the information provided on HealthCare.gov.
• Qualify for Medicaid or CHIP. Medicaid (opens in new tab) and CHIP (opens in new tab) are more affordable options for low-income people. You can find out if you qualify for Medicaid in your state (or qualify for subsidies (opens in new tab) on a Marketplace plan) at healthcare.gov/lower-costs (opens in new tab).

4. Figure out who needs coverage. Maybe you’re the only person who needs an individual health insurance plan because you’re not married or your spouse’s insurance doesn’t cover family members. Or maybe you, your spouse, and your kids all need a family plan. Whatever the case, you’ll want to be sure everyone in your household, including your dependents (opens in new tab), is covered.

5. Note everyone’s social security number and dates of birth. You’ll need both for everyone who will be on your plan.

6. Gather immigration paperwork, if applicable. If anyone in your family is not a citizen, but needs insurance, see HealthCare.gov’s full listing of immigration document types (opens in new tab).

7. Jot down everyone’s employer information. You’ll need the employer business names, addresses, and phone numbers for everyone in your household who files a tax return.

8. Grab your tax return from last year. You’ll use this to input your tax information. It also helps you to determine your modified adjusted gross income (MAGI) (opens in new tab), which is used to figure out if you qualify for tax credits or any other savings with a exchange plan.

9. Pick your plan. Do your research to figure out what kind of plan is best for you and your family.

If you're looking to sign up for health insurance, there are multiple avenues available:

• National Health Insurance Marketplace: To enroll in an ACA plan, visit healthcare.gov (opens in new tab), the national marketplace website, where you can explore a wide range of health insurance plans offered by different insurers.
• State-based Health Insurance Exchanges: Depending on your state, you may have a state-based health insurance exchange (opens in new tab) that you'll use to apply and enroll in coverage.
• Private Insurance Companies: If you’d like to sign up for a health insurance plan directly through a private health insurer such as Oscar, you can do so on our website at hioscar.com/individuals (opens in new tab), or contact the insurer directly.
• Health Insurance Broker: Health insurance brokers are licensed professionals who are experts in health insurance. They can guide you through the enrollment process on the exchange, or through an insurer directly.
• Employer-sponsored Health Insurance: If you're employed, check if your employer offers health insurance coverage. Speak with your Human Resources department or benefits coordinator to get the necessary information.

Oscar Care (opens in new tab) gives you a unique virtual care experience from the comfort of your home, at work, or on-the-go. With every Oscar plan, members get access to Oscar Care - an integrated approach to health care. Oscar Care includes Virtual Urgent Care (opens in new tab) and, in some markets, $0 Virtual Primary Care (opens in new tab) visits.

Oscar's Virtual Primary Care offerings vary by market and may not be available in your area. Oscar's Virtual Primary Care offerings are only available for members ages 18 and over. Learn more here (opens in new tab).

Don't sweat it! Your digital ID card is always ready. Just log into the Oscar app or your member account to view it instantly right from your home page.

If you need to see a provider and still don’t have your ID card, no problem. You can view your virtual ID card at any time within the home page of your online member account under 'Quick Links'.

To change or update the personal information on your ID card (like your name or address) follow these steps:

• If you bought a plan through a state-based exchange: Just contact them and let them know what’s changed. You’ll find the number of all state-based exchanges on healthcare.gov or on the state's health insurance exchange website.
• If you bought a plan directly through Oscar: And you’re the primary account holder or responsible party, just send us a secure message or contact your Care Team directly.

One thing to note: Your new address needs to be within Oscar’s existing service area to keep your coverage going.

Oscar doesn’t have group numbers for our members on the Individual and Family Plans, so don’t worry that it’s not on your ID card. If someone requested your Group ID, just let them know you don’t have one.

Yes, you can enroll in the Diabetes Care Plan and WellDia. You must be enrolled in an Oscar medical plan and have type 1 or type 2 diabetes to enroll in WellDia.

Please refer to any applicable expiration details provided at the time you receive a reward.

If you are eligible, you’ll receive communications from Oscar with information on how to enroll. If you have any questions or need help enrolling in WellDia, just call Oscar at (855) 672-2755.

Use the pharmacy benefits built into the plan to request refills of diabetic testing supplies (meters, test strips, lancets) or insulin.

Once you complete an activity, the claim from your visit (or prescription refill) will serve as verification of completion and you will be sent your gift card.

If you have not received your rewards, you can call your Care Team at (855) 672-2755.

No, it does not exclude you from other rewards and incentives programs. Check our Perks page for additional rewards and incentives that may be available to you.

Yes, this plan can help save money and manage the condition for people living with type 1 or type 2 diabetes. If you have pre-diabetes or gestational diabetes, this plan may offer reduced costs, but you will not be eligible to engage in the rewards and incentives program offerings for members living with diabetes.

The Diabetes Care Plan includes:

• $0 Primary doctor visits
• $0 Behavioral health visits
• $0 Endocrinologist visits
• $0 Labs (including HbA1C screening, urinalysis, metabolic panel, lipid panel)
• $0 Diabetic eye and foot exams
• $100 out-of-pocket monthly maximum on insulin

Accu-Chek® is Oscar's preferred brand for diabetic testing supplies (meters, test strips, lancets). Preferred brands for insulin are Basaglar, Tresiba, Levemir, Humulin U-500, Fiap, and Novolin/Novolog.

The Diabetes Care Plan is a medical plan option offered through Oscar that includes primary care, specialist care, $0 services, and more that are focused on supporting members living with type 1 or type 2 diabetes. This plan may also be a good fit for those with pre-diabetes or gestational diabetes.

Members use the pharmacy benefits built into the plan to request refills of diabetic testing supplies (meters, test strips, lancets) or insulin.

WellDia is Oscar’s diabetes management program, helping members manage their type 1 or type 2 diabetes and stay on top of regular blood glucose testing. WellDia members receive $0 Accu-Chek® test strips, lancets, and a new glucometer. WellDia is offered at no cost to you. You must be enrolled in an Oscar medical plan and have type 1 or type 2 diabetes to be eligible for WellDia.

Members living with type 1 or type 2 diabetes and enrolled in the Diabetes Care plan can earn:

• $30 for switching a qualifying brand name drug from 30-day to 90-day refill
• $50 toward healthy groceries by completing an annual wellness exam
• Access to gyms and on-demand fitness by the American Specialty Health Fitness’ Active&Fit program by completing any two routine services (like labs and a diabetic eye exam)

Members who are not currently living with diabetes, are pre-diabetic, or live with gestational diabetes are not eligible for these rewards and incentives.

Be sure to check our Perks page for additional rewards and incentives that may be available to you.

Our Diabetes Care Plan is available in Arizona, Florida, Georgia , Iowa, Illinois, Kansas, Missouri, North Carolina, Nebraska, Ohio (Buckeye), Ohio (Cleveland), Oklahoma, Tennessee, and Texas.

Dexcom G6 and G7 are Oscar’s preferred continuous glucose monitors (CGM) and are also available to members through prior authorization. See here (opens in new tab) for Oscar's medical necessity criteria for CGMs. The devices are enabled by Bluetooth® and easily connect to the mySugr app (opens in new tab).

This plan is available in Arizona, Florida, Georgia , Iowa, Illinois, Kansas, Missouri, North Carolina, Nebraska, Ohio (Buckeye), Ohio (Cleveland), Oklahoma, Tennessee, and Texas.

Enrollment into the plan is not limited to diabetic members and the lower cost shares for non-diabetic related services and supplies (labs, PCP visits, Tier 1a drugs) are not restricted based on a member having a specific chronic condition.