Quick answer
Oscar Health is a standalone, publicly traded insurer that sold Marketplace plans in 20 states and about 573 counties in 2026, covering roughly 2.9 million members. It’s adding South Carolina for 2027 and posted more than $1 billion in net income over the first half of 2026, a turnaround after years of inconsistent profits. Oscar’s plans lean on a virtual-first primary care model, and a 2024 analysis found its claims-denial rate running above the average for HealthCare.gov insurers.
Key takeaways
- Oscar covered about 2.9 million members in 2026 across 20 states and 573 counties, with membership up 46% year over year in the second quarter.
- Second-quarter 2026 revenue reached $4.88 billion, up 70.4% from a year earlier, and Oscar’s first-half 2026 net income topped $1 billion.
- Oscar is adding South Carolina for 2027 and is targeting 400 to 600 additional counties by 2029, with growth that Forbes attributes partly to Aetna and Cigna pulling back from the ACA market.
- KFF’s 2024 analysis of ACA claims denials found Oscar denied 25% of in-network claims, above the roughly 19% average across the HealthCare.gov insurers it studied.
- A Texas class action filed in June 2025 alleges Oscar charged cost-sharing for diagnostic breast imaging that state law requires to be free; the allegations are unproven.
On this page
What Oscar Health is and how big it’s gotten
Oscar Health, Inc. (NYSE: OSCR) is a publicly traded insurer built around individual and family Marketplace plans, not a subsidiary of a larger conglomerate the way Ambetter or UnitedHealthcare’s exchange plans are. In 2026 it sold plans in 20 states and about 573 counties, with about 2.9 million members. The company’s growth has been unusually fast: second-quarter 2026 revenue hit $4.88 billion, up 70.4% year over year, and membership grew 46% over the same period. Oscar’s first-half 2026 net income topped $1 billion, a notable shift for a company that had struggled to post consistent quarterly profits in its earlier years. Management credits disciplined pricing and AI-driven cost controls for part of the turnaround.
Where Oscar sells plans, and where it’s growing for 2027
Oscar is adding South Carolina to its Marketplace footprint for 2027 and says it’s targeting 400 to 600 additional counties by 2029. Forbes has framed Oscar’s expansion as coming partly at the expense of Aetna and Cigna, both of which are exiting the ACA marketplace; see what to do if your insurance company leaves the Marketplace if that applies to you. Oscar doesn’t publish one nationwide description of its network model, so confirm whether your own doctors are in-network for your specific plan and state rather than assuming it works like a PPO or an HMO you’ve had before.
What a 2027 Oscar plan might cost
Like every Marketplace insurer, Oscar’s rate changes for 2027 differ a lot by state and were still moving through regulatory review as of late September 2026.
| State | Oscar’s 2027 rate change | Status |
|---|---|---|
| Pennsylvania | +1.4% | Approved (lowest of PA’s 14 insurers) |
| Michigan | +11.9% | Approved |
| North Carolina | +18.0% | Proposed |
| Alabama | +33.8% | Approved |
| New Jersey | +29.3% | Proposed |
| Arizona | +33.9% | Proposed (highest of 6 continuing insurers) |
Given that range, run your own numbers for Arizona or New Jersey rather than assuming Oscar’s national trend applies to you, and see how to lower your Marketplace premium once you’ve compared plans.
Plan features: a virtual-first model
Oscar’s plans are built around Oscar Medical Group, a virtual primary care service that’s been part of its model since around 2021: members are assigned a virtual primary-care team and can get no-cost virtual visits as part of their plan. That’s a different starting point than an insurer that simply licenses a regional provider network, and it can suit people who are comfortable managing routine care by video and message before an in-person visit. It also means the value of an Oscar plan depends more than usual on how comfortable you are with virtual-first care, so weigh that alongside the plan’s deductible and out-of-pocket maximum when you compare options.
Quality, complaints and a lawsuit to know about
KFF’s 2024 analysis of ACA claims denials, drawn from HealthCare.gov insurer data, found Oscar Health denying 25% of in-network claims, above the roughly 19% average it calculated across the insurers it studied; fewer than 1% of denied claims nationally get appealed, and insurers upheld about two-thirds of the appeals that were filed. If a claim is denied, see how to appeal a health insurance claim denial for the process. Quality can differ from one state’s Oscar plan to the next, so check the specific plan: HealthCare.gov shows a star rating for each plan while you shop, and the NAIC’s Consumer Insurance Search shows complaint history for the company that issues it. Separately, a class action filed in June 2025 in federal court in Houston alleges Oscar charged deductibles and coinsurance for diagnostic breast imaging that, according to the complaint, Texas law has required insurers to cover with no cost-sharing since 2022. These are allegations in a lawsuit, not findings of wrongdoing.
Pros and cons
Pros
- Fast-growing footprint, with a new state (South Carolina) and hundreds of additional counties planned through 2029.
- Strong recent financial results, including a return to consistent profitability in 2026.
- No-cost virtual primary care built into the plan design rather than offered as an add-on.
Cons
- A 25% in-network claims-denial rate in KFF’s 2024 analysis, above the average for insurers it studied.
- An unresolved class action alleging improper cost-sharing for diagnostic breast imaging in Texas.
- Virtual-first care won’t suit everyone, and networks differ by state, so check that your doctors are covered.
Other insurer guides: Ambetter, Blue Cross Blue Shield, Cigna, Kaiser Permanente, Molina and UnitedHealthcare. See also the best health insurance companies.
Compare 2027 Oscar plans against other insurers in your area: get quotes by ZIP code.
Frequently asked questions
Is Oscar Health a good option for 2027?
It depends on what you value. Oscar is growing fast, added South Carolina for 2027, and builds virtual primary care into its plans, but KFF’s 2024 data put its in-network claims-denial rate above average, so compare its specific plan details and network against other insurers in your area.
Does Oscar Health cover my state?
Oscar sold plans in 20 states in 2026 and is adding South Carolina for 2027, with more counties planned through 2029. Confirm availability in your specific county when you shop, since Oscar doesn’t sell everywhere.
Is Oscar Health financially stable?
Its recent results are strong. Oscar posted more than $1 billion in net income over the first half of 2026, along with fast revenue growth, after years of inconsistent profits.
What is the Texas lawsuit against Oscar about?
A class action filed in June 2025 alleges Oscar charged cost-sharing for diagnostic breast imaging that Texas law requires to be covered at no cost. The allegations haven’t been proven in court.
Sources
- Forbes: Oscar Health plans major Obamacare expansion over next three years
- FinancialContent/StockStory: Oscar Health Q2 deep dive
- Milberg: Oscar Health Insurance case page
- KFF: Claims denials and appeals in ACA Marketplace plans in 2024
- HealthCare.gov: Quality ratings
- NAIC: How to file a complaint and research complaints against insurance carriers
This article is general information, not insurance, tax or legal advice. Rate changes and plan availability vary by state and county, and the lawsuit described involves unproven allegations. Last reviewed September 2026.