Oscar Health Medicare Advantage: A Tech-Driven Approach to Medicare Coverage

Oscar Health was founded in 2012 as a technology-driven health insurance company and expanded into Medicare Advantage in select markets before largely stepping back from it. The company's approach to insurance differs from traditional carriers in emphasis, with heavy investment in member experience technology, app-based care management, and a concierge team model. Its Medicare Advantage presence today is mostly historical, since Oscar wound most of it down to concentrate on the individual ACA marketplace, but for context on how a tech-first insurer approached Medicare, and where its member-experience strengths lie, Oscar is still worth understanding.

Bryce's Take

Oscar is one I look at for clients who are genuinely comfortable with app-based health management and who have asked about better member experience. The technology investment is real, since the app is better than most carrier apps, the Care Team model works, and telehealth at $0 is a meaningful benefit for people who use it. The limitation is availability: if they are not in your market, the conversation ends there. And even where they are available, I always verify the network depth before recommending them.

Overview of Oscar Health Medicare plans

Oscar Health offers Medicare Advantage HMO plans in select states and metropolitan markets. The company acquired Cigna's Medicare operations in several markets and has expanded its presence in the Southeast and other regions. Oscar also offers MA-PD plans with drug coverage bundled in. The company's Medicare footprint is more limited than national carriers, with concentration in specific urban and suburban markets.

Strengths

Oscar's technology investment distinguishes it from traditional carriers. The Oscar app provides care navigation, appointment booking, telehealth access, prescription management, and direct messaging with care team members. $0 copay telehealth visits are a standard feature of most Oscar plans. The company assigns each member a Care Team, a dedicated group of advisors who provide support navigating care, benefits, and administrative questions. Star ratings in markets where Oscar has established presence have been competitive. For tech-comfortable Medicare enrollees, the app-driven member experience is genuinely better than most legacy carriers.

Weaknesses

Oscar's geographic availability is limited. The company is not a national option and operates in far fewer markets than UnitedHealthcare, Humana, or Aetna. Provider networks in newer markets may be less developed than established carriers with decades of local contracting. Some Medicare-age adults may find the technology-forward approach less accessible if they prefer phone-based member service. Oscar is also a newer company in the Medicare market, with less track record than carriers with fifty-plus years of Medicare experience.

Plan types and what they offer

Oscar Medicare Advantage plans are primarily HMO designs with zero or low premiums and bundled Part D coverage. Extra benefits typically include dental, vision, and hearing allowances as well as the technology-driven care navigation tools. Telehealth at $0 copay is a meaningful differentiator for members who use virtual care.

Star ratings

Oscar has earned four stars in several of its markets, reflecting its investment in member experience metrics. The company's care navigation model supports strong satisfaction scores.

How big is Oscar Health, really?

Oscar Health is a publicly traded, technology-first insurer, and as of 2024 its revenue ran roughly in the range of $9 billion, with the company reaching its first full year of profitability that year. The important nuance for a Medicare review is that Oscar's profitable core is the individual ACA marketplace, not Medicare Advantage, and its MA presence is now minimal because it largely exited and wound down those plans to focus where it makes money. So while Oscar is a real and increasingly stable company, its Medicare footprint should be understood as mostly historical rather than a live, growing option for most shoppers. These figures are approximate, reflect where things stood as of 2024, and change every year, so treat them as a rough sense of scale.

What members actually say

Oscar is generally well regarded for its app and overall member experience, which was the whole point of its technology-first approach, and members who used its plans often praised the digital navigation, the telehealth access, and the care team model. That said, most of the current member sentiment reflects Oscar as an ACA marketplace player rather than a Medicare Advantage carrier, since that is where its members are today. For the Medicare context specifically, the takeaway is that the member-experience strengths were real but the MA option has largely gone away, so the praise is more a signal of how a modern insurer can operate than a reason to seek out an Oscar Medicare plan now.

The trend: is Oscar Health adding or cutting benefits?

For Medicare Advantage the trend at Oscar is clear, since it exited the space and is concentrating on the ACA marketplace, so rather than trimming MA benefits it stepped away from that line altogether. In the background the whole Medicare Advantage industry was under pressure for the 2025 and 2026 plan years, with CMS rate changes, the phase-in of the v28 risk-adjustment model, and rising medical costs driving carriers to exit counties, reduce dental, OTC, and flex allowances, raise out-of-pocket maximums, and narrow networks, and with nearly two million members nationwide caught in discontinued plans. Oscar's retreat fits a smaller carrier deciding Medicare was not its best use of capital. Because MA benefits and even participation reset every year during the Annual Enrollment Period, the only reliable way to know what is actually available to you for the coming year is to compare the current-year plans in your zip code, which a quick call can lay out.

Who Oscar tends to fit well

Oscar's plans work well for Medicare enrollees comfortable using apps and digital health tools as their primary mode of interacting with their health plan, those who value the telehealth-first model and $0 telehealth copays, people in Oscar's service areas where its network includes their providers, and those who want more personalized digital support than legacy carriers typically offer.

Bryce Casson

Licensed Independent Medicare Broker

Bryce Casson is an independent Medicare insurance broker who works with every major carrier. He does not represent any single insurer, which means his recommendations are based on what actually fits each client's situation, not on commissions or quotas.