Oscar Health Plans in North Carolina, Ohio and More: Answers on Networks, Costs and Plan Choices
These answers cover Oscar health plans in North Carolina, Ohio, Missouri, New Jersey, Nebraska, Oklahoma, Pennsylvania and Mississippi. Licensed Vivna agents wrote each one in plain English. Because plans change by state, every answer shows where it applies. Call 888-730-6001 anytime for free help.
Vivna Insurance is an appointed, authorized broker for Oscar Health. We are an independent agency, not Oscar. Plans, costs and availability vary by state and county. Plan details come from Oscarβs current brochures and can change at renewal.
Oscar Plans in North Carolina
These answers cover Oscar networks, plan suites and costs in North Carolina. Also, check the plan grid for your county before you enroll.
β What Oscar health plans are available in North Carolina?
Oscar offers HMO plans in North Carolina in Bronze, Silver and Gold.
Many plans come in Atrium Health versions and versions with adult dental and vision. Also, Oscar sells several plans off exchange only.
π Where this applies: North Carolina
β Do I need a referral to see a specialist with Oscar in North Carolina?
No, an Oscar HMO in North Carolina lets you book with any in-network provider directly.
You do not need referrals. However, the plan will not cover care from providers outside the network.
π Where this applies: North Carolina
β Does Oscar have Atrium Health plans in North Carolina?
Yes, many Oscar North Carolina plans have a version labeled with Atrium Health.
For example, Bronze Classic Standard, Silver Core and Silver Simple Diabetes have one. Silver Classic Standard and Gold Classic Standard do as well.
π Where this applies: North Carolina
β Do Oscar plans in North Carolina include dental and vision?
Some do, since many North Carolina plans have a version with Adult Dental & Vision added.
For example, Bronze 8500 HSA, Silver Simple Diabetes, Silver 4500 and Gold Classic Standard come in that version.
π Where this applies: North Carolina
β What are the deductibles on Oscar plans in North Carolina?
Individual deductibles on standard Oscar North Carolina plans range from $0 to $9,000.
For example, Bronze Elite + PCP Saver Plus has a $0 medical deductible. By contrast, Silver Core has the highest at $9,000.
π Where this applies: North Carolina
β What are the out-of-pocket maximums on Oscar North Carolina plans?
Individual out-of-pocket maximums on standard Oscar North Carolina plans run from $6,000 to $12,000.
The Gold 2000 HSA Off Exchange plans are lowest at $6,000. By contrast, most Bronze plans sit at $12,000.
π Where this applies: North Carolina
β What specialty plans does Oscar offer in North Carolina?
Oscar's North Carolina brochure features the Diabetes Care Plan, a COPD-focused Specialist Saver plan and the CKM Plan.
The grid also lists Women's Health plans with menopause benefits.
π Where this applies: North Carolina
β Does Oscar have a COPD or asthma plan in North Carolina?
Yes, Oscar's brochure describes a plan for COPD and pulmonary conditions like asthma.
It includes $0 related pulmonary specialist visits. The grid also lists Bronze and Silver Simple Breathe Easy plans with Enhanced COPD Benefits, with Atrium Health.
π Where this applies: North Carolina
β What does the Oscar Diabetes Care Plan include in North Carolina?
Oscar highlights $0 routine diabetes care, $0 testing supplies and $0 insulin.
In addition, Silver Simple Diabetes plans show $0 primary care and $0 preferred generics. There are also versions with Atrium Health and with adult dental and vision.
π Where this applies: North Carolina
β Which Oscar plans in North Carolina are sold off exchange only?
In North Carolina, Oscar sells several Bronze, Silver and Gold plans off exchange only.
Bronze options are Bronze 8500 HSA and Bronze 3000. Silver options are 6000 HSA, 4500, 3750 Chronic Care CKM, 3000 and 1500. Finally, Gold options are 3000 Women's Health, 2000 HSA and 2000.
π Where this applies: North Carolina
β What do Oscar CSR silver plans cost in North Carolina?
Oscar's North Carolina CSR 150 plans have $0 deductibles and $2,950 to $3,500 out-of-pocket maximums.
CSR 200 plans have $300 to $850 deductibles. Meanwhile, CSR 250 plans have $2,900 to $4,800 deductibles and $8,500 to $9,450 maximums.
π Where this applies: North Carolina
β Which Oscar Silver plans have CSR versions in North Carolina?
Several Oscar Silver plans in North Carolina have CSR versions.
These include Silver Core, Silver Simple Diabetes, Silver Classic Standard and Silver Simple PCP Saver. Atrium Health CKM, Breathe Easy and Women's Health plans also have CSR versions.
π Where this applies: North Carolina
β Can I get a CSR plan with dental and vision from Oscar in North Carolina?
Yes, Silver Simple Diabetes with Adult Dental & Vision comes in CSR 150, 200 and 250 versions.
Oscar also offers Atrium Health versions. For example, the CSR 150 version has a $0 deductible and $0 primary care.
π Where this applies: North Carolina
Oscar Plans in Ohio
These answers cover Oscar networks, plan suites and costs in Ohio. Also, check the plan grid for your county before you enroll.
β What Oscar health plans are available in Ohio?
Oscar offers HMO plans in Ohio in Bronze, Silver and Gold, plus Platinum off exchange.
There are two plan grids: Cleveland Clinic plans and a second Ohio lineup (the Buckeye grid). Also, many plans come with adult dental and vision.
π Where this applies: Ohio
β Does Oscar offer Cleveland Clinic plans in Ohio?
Yes, Oscar's Ohio Cleveland Clinic grid lists Bronze, Silver and Gold plans labeled Cleveland Clinic.
They include Classic, Simple, Core, Elite and condition-focused plans. The grid also shows CSR versions.
π Where this applies: Ohio
β Do I need a referral to see a specialist with Oscar in Ohio?
No, an Oscar HMO in Ohio lets you book with any in-network provider directly.
You do not need referrals. However, the plan will not cover care from providers outside the network.
π Where this applies: Ohio
β Which companies offer Oscar HMO plans in Ohio?
Oscar Insurance Corporation and Oscar Buckeye State Insurance Corporation offer Oscar's HMO products in Ohio.
π Where this applies: Ohio
β What are the deductibles on Oscar plans in Ohio?
In both Ohio lineups, individual deductibles on standard plans range from $0 to $9,000.
For example, $0-deductible options include Gold 0 Off Exchange, Gold Elite Saver Plus and Platinum 0 Off Exchange.
π Where this applies: Ohio
β What are the out-of-pocket maximums on Oscar Ohio plans?
Standard plan maximums run from $6,000 to $12,000 on Oscar's Cleveland Clinic plans in Ohio.
However, the other Ohio grid adds Platinum 0 Off Exchange at $5,500.
π Where this applies: Ohio
β Does Oscar offer a Platinum plan in Ohio?
Yes, Oscar offers a Platinum plan in Ohio off exchange.
Platinum 0 Off Exchange has a $0 deductible and a $5,500 out-of-pocket max. Primary care is $5, labs are $5 and preferred generics are $0. Also, the grid lists a version with adult dental and vision.
π Where this applies: Ohio
β What specialty plans does Oscar offer in Ohio?
Oscar's Ohio brochure features the Diabetes Care Plan, the HelloMeno plan and the Chronic Condition CKM Plan.
The grids also list Breathe Easy COPD plans and Women's Health plans with menopause benefits.
π Where this applies: Ohio
β What does the Oscar Diabetes Care Plan include in Ohio?
Oscar highlights $0 routine diabetes care, $0 testing supplies and $0 insulin.
It also cites up to 25% saved on healthcare each year. Silver Simple Diabetes plans show $0 primary care. In addition, a Gold Simple Diabetes plan has a $1,000 deductible.
π Where this applies: Ohio
β Does Oscar have an early retirement plan in Ohio?
Yes, Oscar's Cleveland Clinic grid lists Gold Simple with Early Retirement Benefits.
The grid also lists a version with adult dental and vision. This plan has a $3,000 deductible, an $8,500 out-of-pocket max and $0 primary care visits.
π Where this applies: Ohio
β Do Oscar plans in Ohio include dental and vision?
Some do, since many Ohio plans have a version with Adult Dental & Vision.
That also applies to Cleveland Clinic plans. For example, Bronze 8500 HSA, Silver Simple Diabetes and Gold Elite Saver Plus come in that version.
π Where this applies: Ohio
β Which Oscar plans in Ohio are sold off exchange only?
In Ohio, Oscar sells several Bronze, Silver, Gold and Platinum plans off exchange only.
Bronze options are Bronze 8500 HSA and Bronze 3000. Silver options are 7000, 6000 HSA, 5300, 3950 HSA, 3750 CKM and 3000. Gold options are 4000, 3000 Women's Health, 2000 HSA, 1500 and 0. Finally, Platinum 0 is off exchange only too.
π Where this applies: Ohio
β What do Oscar CSR silver plans cost in Ohio?
Oscar's Ohio CSR 150 plans have $0 deductibles and $2,950 to $3,500 out-of-pocket maximums.
CSR 200 plans have $300 to $850 deductibles. Meanwhile, CSR 250 plans have $2,900 to $4,800 deductibles and $8,500 to $9,600 maximums.
π Where this applies: Ohio
β Which Oscar Silver plans have CSR versions in Ohio?
In Ohio, Silver Core, Silver Simple Chronic Care CKM and Silver Simple Diabetes have CSR versions.
Silver Classic Standard, PCP Saver, Breathe Easy COPD and Women's Health plans have them too.
π Where this applies: Ohio
β Can I get a Cleveland Clinic CSR plan from Oscar in Ohio?
Yes, Oscar's Cleveland Clinic grid shows CSR 150, 200 and 250 versions of several Silver plans.
For example, Silver Core CSR 150 has a $0 deductible, a $3,200 maximum and $5 primary care.
π Where this applies: Ohio
Oscar Plans Across These 8 States
Some Oscar rules apply in every state on this page. So start here for plan types, enrollment and getting care.
β Is Oscar Virtual Care really $0 on Oscar plans in my state?
Yes, Oscar Virtual Care is $0 on most Oscar plans.
Oscar's brochures list 24/7 Oscar Virtual Care at $0. The plan grids also show $0 on nearly every plan. However, on HSA-compatible high-deductible plans, it is $0 only after you meet the deductible. Availability also varies by service, location and plan.
π Where this applies: MS, MO, NE, NJ, NC, OH, OK, PA
β Is integrated behavioral health through Oscar Virtual Care available in Missouri, Ohio, Pennsylvania or the other states listed here?
No, integrated behavioral health through Oscar Virtual Care is not available in these states.
Oscar says it is currently available only in Florida, Georgia, Texas and Arizona. Still, Oscar plans in these states cover mental health office visits, with costs that vary by plan.
π Where this applies: MS, MO, NE, NJ, NC, OH, OK, PA
β Can Oscar Virtual Care visits be used outside the U.S.?
No, Oscar says its Virtual Urgent Care offerings are not available internationally.
They are not available in U.S. territories, either.
π Where this applies: MS, MO, NE, NJ, NC, OH, OK, PA
β What is Oswell on Oscar plans?
Oswell is Oscar's 24/7 AI health guide inside your Oscar account and app.
It gives general health and benefits information only. However, it is not a doctor, and its answers may be incomplete. In an emergency, call 911.
π Where this applies: MS, MO, NE, NJ, NC, OH, OK, PA
β Do Oscar members get rewards?
Yes, Oscar says members can earn rewards for completing qualifying activities.
However, the brochures do not list the activities or amounts. So check your Oscar account for details.
π Where this applies: MS, MO, NE, NJ, NC, OH, OK, PA
β What metal tiers does Oscar offer in my state?
Bronze, Silver and Gold are the metal tiers in Oscar's brochures.
Oscar pays about 60% on Bronze, 70% on Silver and 80% on Gold. In addition, New Jersey and Ohio grids show Platinum plans sold off exchange.
π Where this applies: MS, MO, NE, NJ, NC, OH, OK, PA
β How do I choose between Oscar Bronze, Silver and Gold?
Bronze has lower premiums but higher costs when you get care.
Silver balances the two. Gold, by contrast, costs more each month but less when you use care. As a result, it fits people who expect frequent care.
π Where this applies: MS, MO, NE, NJ, NC, OH, OK, PA
β What is the difference between Oscar Simple, Simple Clinical, Classic and Elite plans?
Simple plans have lower monthly bills but a bigger share of costs when you get care.
Meanwhile, Simple Clinical plans add savings for chronic conditions. Classic plans mix copays and coinsurance. Finally, Elite plans have a $0 medical deductible and regular copays.
π Where this applies: MS, MO, NE, NJ, NC, OH, OK, PA
β Do Oscar Elite plans have a pharmacy deductible?
Yes, Oscar Elite plans often have a pharmacy deductible.
Bronze Elite + PCP Saver Plus has a $0 medical deductible but a $7,500 pharmacy deductible. Similarly, Gold Elite Saver Plus has a $0 medical deductible and a $2,750 pharmacy deductible.
π Where this applies: MO, NE, NC, OH, OK, PA
β How does the Oscar Bronze Elite + PCP Saver Plus plan work?
Bronze Elite + PCP Saver Plus has a $0 medical deductible and a $7,500 pharmacy deductible.
It also has a $12,000 out-of-pocket max, and primary care visits are $50. In addition, many services use flat copays. For example, you pay $2,500 for the ER and $3,000 per hospital day, up to 2 days.
π Where this applies: MO, NE, NC, OH, OK, PA
β How does the Oscar Gold Elite Saver Plus plan work?
Gold Elite Saver Plus has a $0 medical deductible and a $2,750 pharmacy deductible.
It also has an $11,750 out-of-pocket max. Primary care is $20, specialists $50 and urgent care $25. However, hospital care and imaging are 35% coinsurance.
π Where this applies: Missouri, Ohio and Pennsylvania
β What is the Oscar Silver Core Plan?
The Oscar Silver Core Plan is a Silver plan with a $9,000 deductible and a $10,300 out-of-pocket max.
Primary care visits are $50, and specialist visits are $90. Also, if you qualify for cost-sharing reductions, CSR versions lower those costs sharply.
π Where this applies: MO, NE, NC, OH, OK, PA
β Are the first primary care visits free on Oscar Bronze Simple diabetes, CKM and COPD plans?
Yes, these Bronze Simple plans show your first 3 primary care visits at $0.
After that, you pay $50 per visit. The deductible is $5,500 for an individual.
π Where this applies: MO, NE, NC, OH, OK, PA
β What do mental health office visits cost on Oscar Simple Clinical plans?
Oscar's grids price a mental health office visit the same as a primary care visit on these plans.
So on many of these plans, a mental health visit is $0 or a low copay.
π Where this applies: MO, NE, NJ, NC, OH, OK, PA
β How do Oscar Bronze 8500 HSA Off Exchange plans work?
Oscar Bronze 8500 HSA Off Exchange plans have an $8,500 individual deductible, the same as the out-of-pocket max.
Once you meet it, covered services, including virtual care, cost $0. The plan is also HSA-compatible and sold off exchange.
π Where this applies: Missouri, North Carolina, Ohio and Oklahoma
β How much are generic drugs on Oscar plans in my state?
Preferred generics are $4 on many Oscar plans in these states.
However, several diabetes, women's health and CSR 150 plans show $0. Classic Standard plans run $15 to $25. Also, HSA plans may apply the deductible first.
π Where this applies: MO, NE, NC, OH, OK, PA
β What does "Off Exchange" mean in an Oscar plan name?
"Off Exchange" means the plan is sold outside the Marketplace exchange.
For example, Oscar's Oklahoma PPO grid is labeled off exchange only. Ask a licensed agent how that affects any financial help.
π Where this applies: Missouri, New Jersey, North Carolina, Ohio and Oklahoma
β Does Oscar offer cost-sharing reduction (CSR) plans in my state?
Yes, Oscar offers cost-sharing reduction (CSR) plans for eligible clients in these states.
Oscar's grids show Silver plans in CSR 150, CSR 200 and CSR 250 versions. Each version also lowers the deductible, out-of-pocket max and copays compared with the standard Silver plan.
π Where this applies: MO, NE, NJ, NC, OH, OK, PA
β Could Oscar plan benefits change before I enroll?
Possibly, because Oscar's plan grids are advance previews that remain subject to CMS review and certification.
As a result, service areas, benefits, premiums and networks can change. So confirm final details when you enroll.
π Where this applies: MO, NE, NJ, NC, OH, OK, PA
β What happens after I enroll in an Oscar plan?
First, pay your first month's premium, and Oscar emails your plan and payment details.
Then get your ID card in the Oscar app or digital wallet. Finally, create your Oscar account to pay bills, check benefits and set up autopay.
π Where this applies: MS, MO, NE, NJ, NC, OH, OK, PA
β When does my Oscar coverage start working?
Oscar says your coverage is good to go once you pay your first month's premium.
Still, ask a licensed agent about your exact start date.
π Where this applies: MS, MO, NE, NJ, NC, OH, OK, PA
β How do I find doctors and hospitals in the Oscar network?
Use Oscar's provider search at hioscar.com/search/networks to find in-network doctors and hospitals.
However, benefits and networks may differ by plan. So search under the exact plan you are considering.
π Where this applies: MS, MO, NE, NJ, NC, OH, OK, PA
β What is a maximum out-of-pocket on an Oscar plan?
A maximum out-of-pocket is the most you pay for covered care in a year.
This limit includes deductibles, copays and coinsurance. Then, once you hit it, the plan pays 100% of covered costs for the rest of the year.
π Where this applies: MS, MO, NE, NJ, NC, OH, OK, PA
β What is the difference between a copay and coinsurance on an Oscar plan?
A copay is a flat fee, while coinsurance is a percentage of the bill.
For example, a copay might be $35 for an in-network visit. With 20% coinsurance, you pay 20% and the plan pays 80%.
π Where this applies: MS, MO, NE, NJ, NC, OH, OK, PA
Oscar Plans in Missouri
These answers cover Oscar networks, plan suites and costs in Missouri. Also, check the plan grid for your county before you enroll.
β What Oscar health plans are available in Missouri?
Oscar offers EPO plans in Missouri in Bronze, Silver and Gold.
The lineup includes Classic, Simple, Elite and Core plans, Hy-Vee Health plans, and condition-focused plans. Also, Oscar sells several plans off exchange only.
π Where this applies: Missouri
β Do I need a referral to see a specialist with Oscar in Missouri?
No, Oscar's Missouri EPO plans let you book with in-network specialists directly.
You do not need a referral from your primary care provider. That said, coverage applies to in-network providers.
π Where this applies: Missouri
β What are the Hy-Vee Health plans from Oscar in Missouri?
The plan names promise $0 visits, $0 select generics and $0 routine labs at Hy-Vee Health Exemplar Care.
In Missouri, options include Bronze 9000, Bronze 3000, Silver 5750, Silver 0, Gold 3000 and Gold 1500.
π Where this applies: Missouri
β Are all visits free on Oscar Hy-Vee Health plans in Missouri?
Not necessarily, since the plan names tie the $0 visits, generics and labs to Hy-Vee Health Exemplar Care.
Oscar's grid also lists regular copays, such as a $35 to $75 primary care visit. So confirm details in the plan documents.
π Where this applies: Missouri
β What are the deductibles on Oscar plans in Missouri?
Individual deductibles on standard Oscar plans in Missouri range from $0 to $9,000.
For example, $0-deductible options include Bronze Elite + PCP Saver Plus and Hy-Vee Health Silver 0. Gold 0 Off Exchange and Gold Elite Saver Plus are also $0.
π Where this applies: Missouri
β What is the highest out-of-pocket max on Oscar Missouri plans?
On standard Oscar Missouri plans, individual out-of-pocket maximums run from $6,000 to $12,000.
The lowest is the Gold 2000 HSA Off Exchange plan at $6,000. By contrast, many Bronze plans sit at $12,000.
π Where this applies: Missouri
β Does Oscar offer diabetes, chronic condition and menopause plans in Missouri?
Yes, Oscar's Missouri brochure features the Diabetes Care Plan, the Chronic Condition CKM Plan and the HelloMeno plan.
The grid also shows Bronze and Silver Simple Diabetes and CKM plans. In addition, it lists Women's Health plans with menopause benefits.
π Where this applies: Missouri
β What does the Oscar Diabetes Care Plan include in Missouri?
Oscar's Missouri brochure highlights $0 routine diabetes care, $0 testing supplies and $0 insulin.
In addition, the Silver Simple Diabetes plan shows $0 primary care visits and $0 preferred generics.
π Where this applies: Missouri
β What do Oscar Women's Health plans with menopause benefits cost in Missouri?
The Silver Simple Women's Health plan has a $6,000 deductible and $0 primary care visits.
Also, the Gold 3000 Women's Health plan, sold off exchange, shows $0 primary care and $0 preferred generics.
π Where this applies: Missouri
β Which Oscar plans in Missouri are sold off exchange only?
In Missouri, Oscar sells several Bronze, Silver and Gold plans off exchange only.
Bronze options are Bronze 8300 HSA and Bronze 3000. Silver options are 6000 HSA, 4500, 3750 Chronic Care CKM, 3000 and 1500. Finally, Gold options are 3000 Women's Health, 2000 HSA, 2000, 1500 and 0.
π Where this applies: Missouri
β Which Oscar plans in Missouri are HSA-compatible?
Several Oscar Missouri plans are HSA-compatible, including Bronze 8300 HSA Off Exchange and Bronze Classic Standard.
The Bronze Simple Diabetes and CKM plans also qualify. In addition, Bronze Classic 4700, Bronze Elite + PCP Saver Plus, Silver 6000 HSA and Gold 2000 HSA qualify.
π Where this applies: Missouri
β What do Oscar CSR silver plans cost in Missouri?
Oscar's Missouri CSR 150 plans have $0 deductibles and $2,950 to $3,500 out-of-pocket maximums.
CSR 200 plans have $300 to $850 deductibles, with $3,600 to $4,000 maximums. Meanwhile, CSR 250 deductibles run $2,900 to $4,800.
π Where this applies: Missouri
β Which Oscar Silver plans have CSR versions in Missouri?
Several Oscar Silver plans in Missouri have CSR versions.
These include Silver Core, Silver Simple Chronic Care CKM, Silver Simple Diabetes and Silver Classic Standard. Silver Simple Women's Health and Silver Simple PCP Saver also have CSR versions.
π Where this applies: Missouri
β Does Oscar show AIAN plans for Missouri?
Oscar's Missouri plan grids list no separate Native American and Alaska Native (AIAN) plan versions.
Still, you can ask a licensed agent or the Marketplace about AIAN cost-sharing options.
π Where this applies: Missouri
Oscar Plans in New Jersey
These answers cover Oscar networks, plan suites and costs in New Jersey. Also, check the plan grid for your county before you enroll.
β What Oscar health plans are available in New Jersey?
Oscar offers EPO plans in New Jersey.
The grid shows Bronze, Silver and Gold plans on exchange. It also shows off-exchange plans, including Platinum. Plan names include Classic, Simple, Elite Plus and PCP Saver.
π Where this applies: New Jersey
β Do I need a referral to see a specialist with Oscar in New Jersey?
No, Oscar's New Jersey EPO plans let you see in-network specialists directly.
You do not need a referral. However, coverage applies to in-network providers.
π Where this applies: New Jersey
β Does Oscar offer a Platinum plan in New Jersey?
Yes, Oscar offers a Platinum plan in New Jersey off exchange.
The Platinum 0 Off Exchange plan has a $0 deductible and a $5,500 out-of-pocket max. Also, primary care is $10, specialists are $25 and urgent care is $15.
π Where this applies: New Jersey
β What are the deductibles on Oscar plans in New Jersey?
Individual deductibles on standard Oscar New Jersey plans range from $0 to $6,000.
For example, Gold 0 and Platinum 0 off-exchange plans have $0 deductibles. By contrast, the Bronze HSA plans sit at $6,000.
π Where this applies: New Jersey
β What are the out-of-pocket maximums on Oscar New Jersey plans?
Individual out-of-pocket maximums on standard Oscar New Jersey plans run from $5,500 to $12,000.
Platinum 0 is lowest at $5,500. By contrast, Bronze Classic, Bronze 3000 and Silver Elite Plus are highest at $12,000.
π Where this applies: New Jersey
β Do Oscar New Jersey plans cap what I pay for brand-name drugs?
Some Oscar New Jersey plans do cap what you pay for brand-name drugs.
Several plans charge coinsurance up to a stated maximum, such as $125, $150 or $250. Others use flat copays instead, like $50 for preferred brands on Gold 0. So check each plan's drug tiers.
π Where this applies: New Jersey
β How does the Oscar Silver Elite Plus plan work in New Jersey?
Oscar's Silver Elite Plus plan in New Jersey has a $2,500 deductible and a $12,000 out-of-pocket max.
It also has a $250 pharmacy deductible. Primary care is $30 and labs are $25. In addition, hospital stays cost $500 per day after deductible, up to 3 days.
π Where this applies: New Jersey
β Does Oscar offer chronic condition or menopause plans in New Jersey?
Yes, Oscar's New Jersey grid lists both plan types, sold off exchange.
Gold 1500 Chronic Care CKM Off Exchange has $10 primary care visits. Meanwhile, Gold 2500 Women's Health with Menopause Benefits Off Exchange has $0 primary care.
π Where this applies: New Jersey
β Which Oscar plans in New Jersey are sold off exchange only?
In New Jersey, Oscar sells several Bronze, Silver, Gold and Platinum plans off exchange only.
Bronze and Silver options include Bronze 6000 HSA, Bronze 3000, Silver 2500 HSA, Silver 2500 and Silver 1750. Gold options include Women's Health 2500, Chronic Care CKM 1500, Gold 1500 and Gold 0. Finally, Platinum 0 is also off exchange.
π Where this applies: New Jersey
β Which Oscar plans in New Jersey are HSA-compatible?
Oscar's New Jersey grid lists four HSA-compatible plans.
They are Bronze 6000 HSA Off Exchange, Bronze Simple HSA, Bronze Classic and Silver 2500 HSA Off Exchange. On the three HSA-named plans, however, care including virtual care applies the deductible first.
π Where this applies: New Jersey
β What do Oscar CSR silver plans cost in New Jersey?
Oscar's New Jersey CSR 150 plans have $0 to $100 deductibles and $2,500 to $3,000 out-of-pocket maximums.
CSR 200 deductibles run $0 to $850. Meanwhile, CSR 250 plans have $500 to $2,500 deductibles and $7,500 to $9,600 maximums.
π Where this applies: New Jersey
β Which Oscar Silver plans have CSR versions in New Jersey?
In New Jersey, Silver Classic, Elite Plus, Simple, Simple PCP Saver and Classic Saver Plus have CSR versions.
Each comes in CSR 150, 200 and 250 versions.
π Where this applies: New Jersey
β How much is a primary care visit on Oscar CSR plans in New Jersey?
It depends on the plan, but CSR 150 versions show $0 to $5 primary care visits.
For example, Silver Classic Saver Plus CSR 150 shows $3. However, the Silver Simple CSR plans apply the deductible first.
π Where this applies: New Jersey
β Does Oscar's New Jersey brochure list diabetes or menopause plans?
No, Oscar's New Jersey brochure does not include a specialty plans page.
However, the New Jersey grid does show off-exchange Chronic Care CKM and Women's Health plans.
π Where this applies: New Jersey
Oscar Plans in Nebraska
These answers cover Oscar networks, plan suites and costs in Nebraska. Also, check the plan grid for your county before you enroll.
β What Oscar health plans are available in Nebraska?
Oscar offers EPO plans in Nebraska in Bronze, Silver and Gold.
The lineup includes Bryan Health plans, Hy-Vee Health plans and Diabetes plans. It also includes Women's Health plans with menopause benefits.
π Where this applies: Nebraska
β Do I need a referral to see a specialist with Oscar in Nebraska?
No, Oscar's Nebraska EPO plans let you book with in-network specialists directly.
You do not need a referral. That said, coverage applies to in-network providers.
π Where this applies: Nebraska
β Does Oscar have Bryan Health plans in Nebraska?
Yes, many Oscar Nebraska plans come in a version labeled with Bryan Health.
For example, Bronze Classic Standard, Bronze Simple Diabetes and Silver Core have one. Silver Classic Standard, Silver Simple PCP Saver and Gold Classic Standard also have one.
π Where this applies: Nebraska
β What are the Hy-Vee Health plans from Oscar in Nebraska?
The plan names promise $0 visits, $0 select generics and $0 routine labs at Hy-Vee Health Exemplar Care.
In Nebraska, options include Bronze 9000, Bronze 3000, Silver 5750, Silver 0, Gold 3000 and Gold 1500.
π Where this applies: Nebraska
β What are the deductibles on Oscar plans in Nebraska?
Individual deductibles on standard Oscar Nebraska plans range from $0 to $9,000.
The $0-deductible options are Bronze Elite + PCP Saver Plus with Bryan Health and Hy-Vee Health Silver 0. However, both have a separate pharmacy deductible.
π Where this applies: Nebraska
β What are the out-of-pocket maximums on Oscar Nebraska plans?
Individual out-of-pocket maximums on standard Oscar Nebraska plans run from $8,000 to $12,000.
The Hy-Vee Health Gold 3000 and Gold 1500 plans have the lowest maximum at $8,000.
π Where this applies: Nebraska
β Does Oscar offer a diabetes plan in Nebraska?
Yes, Oscar's Nebraska brochure features the Diabetes Care Plan.
It comes with $0 routine diabetes care, $0 testing supplies and $0 insulin. Also, Silver Simple Diabetes plans show $0 primary care and $0 preferred generics.
π Where this applies: Nebraska
β Does Oscar offer a menopause plan in Nebraska?
Yes, Oscar's Nebraska brochure features the HelloMeno plan with specialized care and $0 copays.
The grid also lists Silver Simple Women's Health with Menopause Benefits, which has $0 primary care. In addition, the grid shows a Bryan Health version.
π Where this applies: Nebraska
β Does Oscar sell off-exchange plans in Nebraska?
Oscar's Nebraska plan grids do not list any plans labeled off exchange.
Still, a licensed agent can confirm current options.
π Where this applies: Nebraska
β Which Oscar plans in Nebraska are HSA-compatible?
In Nebraska, Bronze Classic Standard and Bronze Simple Diabetes are HSA-compatible, each with or without Bryan Health.
Bronze Classic 4700 and Bronze Elite + PCP Saver Plus, both with Bryan Health, also qualify.
π Where this applies: Nebraska
β What do Oscar CSR silver plans cost in Nebraska?
Oscar's Nebraska CSR 150 plans have $0 deductibles and $2,950 to $3,500 out-of-pocket maximums.
CSR 200 plans have $300 to $850 deductibles. Meanwhile, CSR 250 plans have $2,900 to $4,800 deductibles and $8,500 to $9,450 maximums.
π Where this applies: Nebraska
β Which Oscar Silver plans have CSR versions in Nebraska?
In Nebraska, Silver Core with Bryan Health, Silver Simple Diabetes and Silver Classic Standard have CSR versions.
Silver Simple Women's Health and Silver Simple PCP Saver with Bryan Health also have them.
π Where this applies: Nebraska
β Do Oscar Nebraska CSR 150 plans have a pharmacy deductible?
No, several Oscar Nebraska CSR 150 plans show a $0 pharmacy deductible.
Also, preferred generics are $0 on these plans.
π Where this applies: Nebraska
Oscar Plans in Oklahoma
These answers cover Oscar networks, plan suites and costs in Oklahoma. Also, check the plan grid for your county before you enroll.
β What Oscar health plans are available in Oklahoma?
Oscar offers HMO plans in Oklahoma in Bronze, Silver and Gold.
In addition, Oscar has an Oklahoma PPO grid of plans sold off exchange only.
π Where this applies: Oklahoma
β Does Oscar offer a PPO in Oklahoma?
Yes, Oscar offers a PPO in Oklahoma, sold off exchange only.
The PPO lineup includes Bronze 8500 HSA and Bronze 3000. Silver options are 6000 HSA, 4500, 3750 CKM, 3000 and 1500. Finally, Gold options are 2000 HSA and 2000.
π Where this applies: Oklahoma
β Do I need a referral to see a specialist with Oscar in Oklahoma?
Not on the HMO plans, where Oscar says you can book with any in-network provider directly.
You do not need referrals. However, the plan will not cover care from providers outside the HMO network.
π Where this applies: Oklahoma
β What are the deductibles on Oscar plans in Oklahoma?
Individual deductibles on standard Oscar Oklahoma plans range from $0 to $9,150.
Bronze Simple has the highest at $9,150. By contrast, Bronze Elite + PCP Saver Plus has a $0 medical deductible.
π Where this applies: Oklahoma
β What are the out-of-pocket maximums on Oscar Oklahoma plans?
Oscar's standard Oklahoma plans have individual out-of-pocket maximums from $6,000 to $12,000.
In fact, Gold 2000 HSA Off Exchange has the lowest maximum, at $6,000.
π Where this applies: Oklahoma
β How does the Oscar Bronze Simple plan work in Oklahoma?
Oscar Bronze Simple in Oklahoma has a $9,150 deductible and a $12,000 out-of-pocket max.
After the deductible, most services are 10% coinsurance. Plus, virtual care is $0 and preferred generics are $4.
π Where this applies: Oklahoma
β What specialty plans does Oscar offer in Oklahoma?
Oscar's Oklahoma brochure features the Diabetes Care Plan, the Chronic Care CKM Plan and the HelloMeno plan.
In addition, the grids list Breathe Easy COPD plans and Silver Simple Women's Health with Menopause Benefits.
π Where this applies: Oklahoma
β What does the Oscar Diabetes Care Plan include in Oklahoma?
Oscar's Diabetes Care Plan highlights $0 routine diabetes care, $0 testing supplies and $0 insulin.
In Oklahoma, Silver Simple Diabetes shows $0 primary care and $0 preferred generics. It also carries a $6,500 deductible.
π Where this applies: Oklahoma
β What Gold plans does Oscar offer in Oklahoma?
Oscar's Oklahoma HMO grid lists Gold Classic Standard, with a $2,500 deductible and $8,600 maximum.
Off exchange, there are also Gold 2000 HSA and Gold 2000 PPO plans.
π Where this applies: Oklahoma
β What do Oscar CSR silver plans cost in Oklahoma?
In Oklahoma, Oscar CSR 150 plans have $0 deductibles and $2,950 to $3,500 maximums.
By contrast, CSR 200 plans have $300 to $850 deductibles. CSR 250 plans have $2,900 to $4,800 deductibles and $8,500 to $9,450 maximums.
π Where this applies: Oklahoma
β Which Oscar Silver plans have CSR versions in Oklahoma?
In Oklahoma, Silver Core, Silver Simple Chronic Care CKM and Silver Simple Diabetes have CSR versions.
Silver Classic Standard also has them. In addition, Breathe Easy COPD, Women's Health and PCP Saver plans have CSR versions.
π Where this applies: Oklahoma
β Does Oscar offer AIAN plans in Oklahoma?
Oscar's Oklahoma HMO and PPO grids are titled as including AIAN (Native American and Alaska Native) versions.
However, the grid pages list no separate AIAN plan details. So, ask a licensed agent to confirm AIAN options.
π Where this applies: Oklahoma
β Which Oscar plans in Oklahoma are HSA-compatible?
Several Oscar bronze, silver and gold plans in Oklahoma are HSA-compatible.
These include Bronze Simple, Bronze Classic Standard, and the Bronze Simple Diabetes, CKM and Breathe Easy plans. Bronze Elite + PCP Saver Plus and Bronze 8500 HSA also qualify. So do Silver 6000 HSA and Gold 2000 HSA.
π Where this applies: Oklahoma
Oscar Plans in Pennsylvania
These answers cover Oscar networks, plan suites and costs in Pennsylvania. Also, check the plan grid for your county before you enroll.
β What Oscar health plans are available in Pennsylvania?
Oscar offers HMO plans in Pennsylvania at the Bronze, Silver and Gold levels.
The lineup includes Classic, Simple, Core and Elite plans, plus a Buena Salud diabetes plan. However, the grids show no off-exchange plans.
π Where this applies: Pennsylvania
β Do I need a referral to see a specialist with Oscar in Pennsylvania?
No, with an Oscar HMO in Pennsylvania you can book any in-network provider directly, with no referrals.
However, Oscar will not cover care from providers outside the network.
π Where this applies: Pennsylvania
β Which company offers Oscar HMO plans in Pennsylvania?
Oscar Health Plan of Pennsylvania, Inc. offers Oscar's HMO products in Pennsylvania.
π Where this applies: Pennsylvania
β What is the Oscar Buena Salud Diabetes Plan in Pennsylvania?
Buena Salud offers culturally aligned care with native Spanish-speaking doctors and Care Guides.
As a result, you won't need translation. In fact, Oscar says Buena Salud has 130% higher satisfaction than the industry average.
π Where this applies: Pennsylvania
β What does the Buena Salud Bronce Simple Para Diabetes plan cost in Pennsylvania?
Buena Salud Bronce Simple Para Diabetes has a $5,500 deductible and a $12,000 out-of-pocket max.
Your first 3 primary care visits are $0, then $50. Plus, preferred generics are $4 and urgent care is $40.
π Where this applies: Pennsylvania
β What are the deductibles on Oscar plans in Pennsylvania?
Oscar's standard Pennsylvania plans have individual deductibles from $0 to $9,000.
Bronze Elite + PCP Saver Plus and Gold Elite Saver Plus have $0 medical deductibles. By contrast, Bronze Classic PCP Saver Plus and Silver Core have $9,000 deductibles.
π Where this applies: Pennsylvania
β What are the out-of-pocket maximums on Oscar Pennsylvania plans?
Oscar's standard Pennsylvania plans have individual out-of-pocket maximums from $10,000 to $12,000.
In fact, Silver Simple PCP Saver and Gold Simple have the lowest maximum, at $10,000.
π Where this applies: Pennsylvania
β What is an Rx Ded plan from Oscar in Pennsylvania?
Oscar Rx Ded plans add a separate $450 pharmacy deductible.
In Pennsylvania, Oscar's grid lists Bronze Classic 4700 Rx Ded and Silver Classic Rx Ded. Even so, preferred generics are still $4.
π Where this applies: Pennsylvania
β How does the Oscar Bronze Classic PCP Saver Plus plan work in Pennsylvania?
Bronze Classic PCP Saver Plus has a $9,000 deductible and a $12,000 out-of-pocket max.
Primary care visits are $30 and urgent care is $40. However, specialists are 50% after the deductible.
π Where this applies: Pennsylvania
β What do Oscar CSR silver plans cost in Pennsylvania?
In Pennsylvania, Oscar CSR 150 plans have $0 deductibles and $2,400 to $3,200 maximums.
By contrast, CSR 200 plans have $300 to $850 deductibles. CSR 250 plans have $3,500 to $4,800 deductibles and $8,500 to $9,600 maximums.
π Where this applies: Pennsylvania
β Which Oscar Silver plans have CSR versions in Pennsylvania?
In Pennsylvania, Silver Core, Silver Classic, Silver Classic Rx Ded and Silver Simple PCP Saver have CSR versions.
For example, Silver Classic CSR 150 shows $3 primary care visits.
π Where this applies: Pennsylvania
β Does Oscar offer a Diabetes Care, CKM or HelloMeno plan in Pennsylvania?
Oscar's Pennsylvania brochure features only the Buena Salud Diabetes Plan.
In addition, the Pennsylvania grids list no other condition-focused plans.
π Where this applies: Pennsylvania
Oscar Plans in Mississippi
These answers cover Oscar networks, plan suites and costs in Mississippi. Also, check the plan grid for your county before you enroll.
β What Oscar health plans are available in Mississippi?
Oscar offers HMO plans in Mississippi with a range of premiums, deductibles and plan types.
Metal tiers are Bronze, Silver and Gold. In addition, cost-sharing reductions are available for eligible clients.
π Where this applies: Mississippi
β Do I need a referral to see a specialist on an Oscar plan in Mississippi?
No, an Oscar HMO in Mississippi lets you book with any in-network provider directly.
You do not need referrals. For example, you can see an in-network gastroenterologist without a PCP referral.
π Where this applies: Mississippi
β Does Oscar cover out-of-network doctors in Mississippi?
Generally no, because Oscar's Mississippi plans are HMOs.
Oscar's brochure says care outside the network will not be covered. Still, check the plan documents for emergency care rules.
π Where this applies: Mississippi
β Does Oscar offer a chronic condition plan in Mississippi?
Yes, Oscar's Mississippi brochure features the Chronic Condition CKM Plan.
It is built for COPD, diabetes and heart conditions together. The brochure also highlights $0 specialist visits, $0 labs and up to 25% annual savings on healthcare.
π Where this applies: Mississippi
β Is the Oscar Diabetes Care Plan sold in Mississippi?
Oscar's Mississippi brochure features only the Chronic Condition CKM Plan.
That plan covers diabetes along with COPD and heart conditions. Still, ask a licensed agent which Oscar plans are offered in your county.
π Where this applies: Mississippi
β Where can I see deductibles and copays for Oscar plans in Mississippi?
Visit hioscar.com/get-coverage to see plans in your area, or ask a licensed agent.
That's because the Mississippi brochure does not list plan-by-plan costs.
π Where this applies: Mississippi
π More Oscar and ACA Plan Guides
These answers cover Oscar plans state by state. When you want more depth, these guides from our licensed agents explain networks, metal tiers and subsidies. Then, if a question comes up, call 888-730-6001 anytime.
π Oscar and ACA Guides
𧩠More Oscar FAQ Libraries
π Questions About Oscar Health Plans in Your State?
These answers cover the most common Oscar questions, but every county and family is different. Therefore, our licensed agents compare Oscar and other ACA plans for free.
Best of all, our help costs you nothing. Request a free quote online, or call 888-730-6001 to speak with an agent today. You can also reach us through our contact page.
- π 888-730-6001
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- π Deerfield Beach, Florida
Official resources: the Oscar Health website, HealthCare.gov, and the National Association of Insurance Commissioners.
Vivna Insurance is an appointed, authorized broker for Oscar Health. We are an independent agency, not Oscar. Plans, costs and availability vary by state and county. Plan details come from Oscarβs current brochures and can change at renewal.