Oscar Health

What Oscar Health does

Oscar Health is a publicly traded health insurance company (NYSE: OSCR) founded in 2012 and headquartered in New York, operating across 20 U.S. states. The company sells individual and family ACA marketplace health plans, small group products, and Medicare Advantage plans, serving approximately 3.2 million members as of Q1 2026. Oscar's core differentiator is a full-stack, proprietary technology platform covering member engagement, care navigation, claims processing, and provider interactions, including AI-powered products such as the Oswell health agent (OpenAI-powered, completing 86% of member queries autonomously), the Superagent knowledge retrieval system, and the Care Router used by 76% of members. Member-facing services include $0 Virtual Urgent Care, $0 Oscar Primary Care in select markets, $3 prescription drugs, and dedicated Care Teams, supplemented by integrations with Capsule, CVS Mail Order, and Optum Behavioral Health.

The company generates revenue primarily through recurring monthly health insurance premiums across Bronze, Silver, and Gold tier plans, with cost-sharing structures of 60%/70%/80% respectively. Additional revenue streams include ICHRA employer products (B2B2C) and emerging marketplace commission economics via the Lucie Health Marketplace, a CMS-approved carrier-agnostic platform aggregating plans from UnitedHealth, Cigna, Centene, and Blue Cross. Distribution combines direct-to-consumer channels (website, mobile app, phone) with an extensive broker network (4 of 5 brokers recommend Oscar), provider referrals, and ICHRA employer arrangements.

FY2025 revenue reached $11.7 billion (up 27.5% from $9.2 billion in 2024), with Q1 2026 revenue of $4.58 billion (+53% YoY) and 2026 guidance of $18.7-19 billion. After achieving first profitability in 2024, the company posted a $443M net loss in 2025 due to elevated medical costs, then rebounded with record Q1 2026 net income of $679M and operating margin of 15.2%. The company went public on the NYSE in 2021, completed a $355M financing in September 2025, and has aggressively expanded its geographic footprint, with notable strategic moves including the dissolution of the Cigna+Oscar partnership, entry into Alabama and Mississippi, and partnerships with major health systems (Atrium Health, HCA Healthcare, Tampa General, Broward Health).

Name

Oscar Health

Legal name

Oscar Health, Inc.

Website

https://hioscar.com

Company type

Public

Founded year

2012

Operating status

Operating

Headcount range

1,001–5,000 employees

Short description

Oscar Health is a public health insurance company (NYSE: OSCR) selling ACA marketplace individual, family, small group, and Medicare Advantage plans across 20 U.S. states to approximately 3.2 million members, differentiated by its full-stack proprietary technology platform, AI-powered member services (Oswell), and integrated virtual care offerings.

Ownership category

akta.pro rank

Product category

Health Insurance

NAICS

Direct Health and Medical Insurance Carriers (524114), Direct Life, Health, and Medical Insurance Carriers (52411), Agencies, Brokerages, and Other Insurance Related Activities (5242)

SIC

Accident & Health Insurance (6321), Hospital & Medical Service Plans (6324), Insurance Agents, Brokers & Service (6411)

akta.pro primary industry

ACA Marketplace (On-Exchange) Individual Plans (FSAIAEAA)

akta.pro secondary industries

Off-Exchange Individual Major Medical Plans (FSAIAEAB), Medicare Advantage (MA) Plans (FSAIAGAA), Individual Supplemental Health (Hospital Indemnity, Critical Illness, Accident) (FSAIAEAD)

Keywords

• Individual health insurance
• ACA marketplace plans
• Medicare Advantage coverage
• Virtual care services
• Small group insurance

Headquarters

HQ city

New York

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2C

Offering type

Services

Cost components

Operations, Personnel, Technology or R&D, Marketing or Sales, Infrastructure

Revenue model

1. Health Insurance Premiums - Individual Market: Oscar Health generates the majority of its revenue from individual and family health insurance plans sold through ACA marketplaces and off-exchange. Members pay monthly premiums in exchange for coverage. Revenue grew 53% to $4.58 billion in Q1 2026, with membership growing 56% to 3.2 million members.
2. ICHRA Employer Plans: Individual Coverage Health Reimbursement Arrangement (ICHRA) products where employers set monthly allowances and employees shop for individual plans on the marketplace. This represents a growing B2B2C revenue stream targeting small and large employers.
3. Small Group Plans: Health insurance plans for small businesses, expanding Oscar's customer base beyond individual consumers to employer groups.
4. Lucie Health Marketplace Commissions: The carrier-agnostic marketplace aggregates plans from multiple carriers and may generate revenue through commissions or fees from carrier partnerships. This positions Oscar as a platform beyond selling only its own plans.

Pricing tiers

Go-to-market motion3 records

Distribution channels5 records

Marketing channels7 records

Core offering

Oscar Health is a healthcare technology company that sells individual, family, small group, and Medicare Advantage health insurance plans primarily through ACA marketplaces and off-exchange channels across 20 U.S. states. Its insurance plans are differentiated by a proprietary full-stack technology platform that integrates AI-powered member services (Oswell agent), $0 virtual urgent and primary care, $3 prescription pricing, and a 24/7 concierge Care Team. The company has also launched the Lucie Health Marketplace, a carrier-agnostic platform that aggregates and compares health plans from multiple insurers.

Product overview

Oscar Health is a healthcare technology company offering a full-stack technology platform with integrated health insurance and care services. The core offering is Oscar Health Insurance, an ACA marketplace health plan available in 20 states for individuals, families, and small groups. This core product is enhanced by a suite of technology-powered services including Virtual Urgent Care and Oscar Primary Care ($0 virtual care options), the Oswell AI health agent (OpenAI-powered autonomous agent handling 86% of member queries), the Care Team concierge support, and the Superagent AI system for insurance questions. The company recently launched Lucie Health Marketplace, a carrier-agnostic platform aggregating plans from multiple insurers including UnitedHealth, Cigna, and Centene. Specialized offerings include the HelloMeno menopause plan (first in individual market) and ICHRA employer benefits. Oscar's technology differentiates through AI-driven operational efficiency, with the Care Router automating 76% of member interactions and delivering industry-leading NPS of 66.

Differentiator

Problem solved

Functional benefit

Brands

• Lucie Health Marketplace: AI-powered all-in-one healthcare shopping platform aggregating individual market health plans and ancillary products from multiple carriers.
• HelloMeno
• Oswell
• Oscar Unlocks
• Oscar Primary Care

Products and services

• Individual and Family Health Insurance Plans Tiered ACA marketplace health plans (Bronze, Silver, Gold) sold to individuals and families across 20 U.S. states through Healthcare.gov, state exchanges, and off-exchange direct channels. Includes virtual care, prescription coverage, Care Team support, and access to in-network providers.
• Small Group Health Insurance

Quantifiable outcome

• Net Promoter Score of 69 vs industry average of ~3 (21x higher)
• +7 more outcomes

Named customers6 records

Segments4 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration4 records

AI capability5 records

Feature7 records

Partnerships

14 partnerships are on record, tiered core and minor.

• Broward HealthcoreStrategic or Co-development Partner · 26 December 2025Major South Florida hospital system partnership providing in-network coverage for Oscar Health members starting January 1, 2026. The timing is critical ahead of the ACA marketplace enrollment deadline. The partnership fills a gap left after Broward Health's contract split with Florida Blue left over 17,000 customers out of network for nonemergency services.
• BenaVestminorChannel Partner/ Reseller/ Distributor · 10 December 2025National FMO (Field Marketing Organization) providing AI-driven contracting platform to help insurance agents get appointed with Oscar Health efficiently for 2026 expansion into Alabama and Mississippi.
• Atrium HealthcoreStrategic or Co-development Partner · 5 November 2025Major health system partnership in Charlotte, North Carolina for Oscar's 2026 health plan offerings. Atrium Health is one of the largest health systems in the region, providing comprehensive provider network for Oscar members.
• HCA HealthcarecoreStrategic or Co-development Partner · 5 November 2025Hospital partnership in Tampa Bay Area, Florida for Oscar's 2026 individual and family health plan offerings. Part of Oscar's expansion in Florida market.
• Tampa General HospitalcoreStrategic or Co-development Partner · 5 November 2025Major Tampa hospital partnership providing in-network coverage for Oscar members in the Tampa Bay Area for 2026 plans. Complements HCA Healthcare partnership for comprehensive coverage.
• Optum Behavioral HealthcoreTechnology or IntegrationBehavioral health services partnership providing in-network mental health services including talk therapy, substance abuse services, psychiatry, and autism care for Oscar members.
• UnitedHealth GroupminorChannel Partner/ Reseller/ DistributorCarrier partner integrated into Oscar's Lucie Health Marketplace, enabling members to compare and purchase UnitedHealth Group plans alongside Oscar offerings on the carrier-agnostic platform.
• CignaminorChannel Partner/ Reseller/ DistributorCarrier partner integrated into Oscar's Lucie Health Marketplace for plan aggregation and comparison.
• CenteneminorChannel Partner/ Reseller/ DistributorCarrier partner integrated into Oscar's Lucie Health Marketplace for plan aggregation and comparison.
• Blue Cross PlansminorChannel Partner/ Reseller/ DistributorBlue Cross and Blue Shield plans integrated into Oscar's Lucie Health Marketplace for broader plan selection.
• AflacminorChannel Partner/ Reseller/ DistributorSupplemental coverage provider integrated into Lucie Health Marketplace for ancillary products like accident coverage.
• Golden Rule (UnitedHealthcare)minorChannel Partner/ Reseller/ DistributorSupplemental coverage provider integrated into Lucie Health Marketplace.
• Allstate Health SolutionsminorChannel Partner/ Reseller/ DistributorSupplemental coverage provider integrated into Lucie Health Marketplace.
• Hy-Vee HealthcoreStrategic or Co-development PartnerPartnership with Hy-Vee to deliver no-cost care, local access, and everyday wellness perks. Combines grocery retail presence with Oscar's health insurance technology.

Scale indicators14 records

Recent moves18 records

Expansion highlights6 records

Direct peers

• Centene Corporation: Centene operates the Ambetter brand, the largest ACA marketplace insurer by membership. It is the most direct competitor to Oscar in the individual ACA exchange segment and competes head-to-head in overlapping states.
• Molina Healthcare: Molina is a government-focused health insurer with meaningful ACA marketplace exposure through its MyChoice and Ambetter-adjacent products. Comparable as a mid-scale public insurer competing for individual ACA enrollees.

Emerging players

• Alignment Healthcare: Tech-enabled Medicare Advantage insurer using proprietary technology platform to drive member engagement. Comparable as a smaller, technology-first public insurer competing in select geographies against incumbents.
• Clover Health: Technology-focused health insurer serving Medicare Advantage members through its Clover Assistant software platform. Comparable as a smaller public insurer leveraging proprietary AI/software to compete against large carriers.

Broad incumbents

• Humana: Major national insurer with the second-largest Medicare Advantage franchise and growing individual ACA presence. Competes with Oscar in overlapping geographies and offers complementary product lines that Oscar lacks.
• Elevance Health (Anthem):

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/oscarhealth
• YouTubeyoutube.com/user/OscarHealthInsurance
• Facebookfacebook.com/OscarHealth
• Instagraminstagram.com/oscarhealth
• LinkedInlinkedin.com/company/oscar-health

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles10 records

Subsidiaries13 records

Funding overview

Funding rounds12 records

Investors31 records

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments4 records

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Oscar Health