Maternity and newborn care

Frequently asked questions

• How can I find an in-network provider to see throughout my pregnancy?
  • Making sure all your providers, pharmacies, and labs are in-network is important, so your coverage can apply. You can easily find a provider, or check to see if yours is in Oscar’s network, by logging in to your Oscar account online or in the Oscar mobile app. Don’t have an account yet? It’s easy to set up. Just head to hioscar.com/getstarted, and follow the instructions.Please note: Because providers can leave the Oscar network at any time, we encourage you to call the provider you wish to see before seeking any services, and make sure they still take Oscar health insurance. You should also double check to see if the facility the provider delivers at is in Oscar’s network, too!
• Which costs am I responsible for?
  • Out-of-pocket costs depend on factors such as the metallic tier of coverage you have — Bronze, Silver, or Gold — and your deductible and copayments. Diagnostic services (non-routine) for pregnancy, and other medical services you receive that are not related to your pregnancy, will be subject to cost sharing. Make sure your care is in-network to avoid out-of-network costs. Log in to your Oscar account online, or in the Oscar mobile app, to find in-network facilities and providers.
• What kinds of office visits should I expect?
  • Routine prenatal care visits with an in-network provider are covered as a preventive service. (The number of routine visits will depend on your provider.)After the first visit, most prenatal visits include: 

    • Checking your blood pressure and weight
    • Checking the baby’s heart rate 

    Prenatal visits, or elective care received outside of Oscar’s network, aren’t covered, unless authorized by Oscar. Emergency visits, or services received out-of-network, are limited to conditions that require immediate attention. Diagnostic prenatal care is covered at a different cost-share, as determined in your Schedule of Benefits. You can access your benefits by logging in to your Oscar account online or in the Oscar app.
• When and how should I order a breast pump?
  • 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 1-855-672-2755.
• How can I add my newborn to my plan?

  • Babies are typically covered for a certain length of time under the mother’s plan before they’ll need their own coverage; however, this depends on the state.

    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.

• Which mental health resources can I access?
  • We’ve partnered with Optum to curate our network of mental health providers and open doors to additional resources for our members. Our partnership gives you access to a large selection of physicians, clinical resources, and mental health support.You can search for a doctor on hioscar.com or in the Oscar app, or call your Care Team at 1-855-672-2755. We’ll connect you with a mental health expert who can help you find a mental health provider.