Oscar Specialty Plans, Dental and Vision FAQs: Answers on Condition Plans, Perks and Coverage
These answers cover Oscar specialty plans, metal tiers, member perks, dental and vision. 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.
About Oscar, Member Perks and Care
Start here to learn about Oscar, its Care Team, virtual care and rewards. Then see how to enroll.
β What is Oscar Health?
Oscar is a health insurance company that sells individual and family plans.
Its tagline is "health insurance made for real life." Plans also come with a Care Team, a member app, and rewards.
π Where this applies: Every state where Oscar plans are sold
β Who underwrites Oscar health insurance?
Oscar Insurance Company and its affiliates underwrite Oscar medical coverage.
In addition, Oscar Management Corporation provides administrative services for all plans.
π Where this applies: Every state where Oscar plans are sold
β How many members does Oscar have?
Oscar reports about 3 million members.
It also says it operates in 21 states and is growing.
π Where this applies: Every state where Oscar plans are sold
β How many states is Oscar health insurance sold in?
Oscar says it operates in 21 states.
However, plan availability, networks, and benefits vary by state and county. A licensed agent can check what Oscar offers at your ZIP code.
π Where this applies: Every state where Oscar plans are sold
β Do Oscar members like their health plan?
Oscar reports a Net Promoter Score of 68.
It also says 4 out of 5 members would recommend Oscar to family and friends.
π Where this applies: Every state where Oscar plans are sold
β Are Oscar plans ACA Marketplace plans?
Yes, Oscar's individual plans go through CMS review and qualified health plan (QHP) certification.
That is the federal process for Marketplace plans. In addition, Oscar sells some plans off-exchange.
π Where this applies: Every state where Oscar plans are sold
β Where can I shop Oscar plans online?
Oscar points shoppers to hioscar.com/get-coverage to shop plans online.
Also, hioscar.com/individuals has general information. A licensed agent like Vivna can also quote and enroll you.
π Where this applies: Every state where Oscar plans are sold
β Are the Oscar plan details for the upcoming plan year final?
No, Oscar's flyers say plans remain subject to CMS review and QHP certification.
So service areas, benefits, premiums, networks, and drug coverage may still change.
π Where this applies: Every state where Oscar plans are sold
β Do Oscar benefits and networks differ by plan?
Yes, Oscar says specific benefits and networks may differ by plan and state.
Because of this, check the plan documents, including the Evidence of Coverage at hioscar.com/forms.
π Where this applies: Every state where Oscar plans are sold
β What is the Oscar app?
Oscar members get an easy-to-use online account and app.
In fact, Oscar calls this "tech that actually hits." It is where you manage your plan and reach support.
π Where this applies: Every state where Oscar plans are sold
β What is Oswell from Oscar?
Oswell is Oscar's AI health guide, available 24/7.
It gives general health and benefits information.
π Where this applies: Every state where Oscar plans are sold
β Can Oswell give me medical advice?
No, Oswell is not a doctor and does not diagnose or treat.
Also, its answers may be incomplete, and no clinician reviews them. In an emergency, call 911.
π Where this applies: Every state where Oscar plans are sold
β What is an Oscar Care Guide or Care Team?
Oscar members get a Care Team of dedicated Care Guides for care and coverage support.
In fact, Oscar says their only job is to help you.
π Where this applies: Every state where Oscar plans are sold
β How do I reach Oscar customer support?
You can reach Oscar's support team by phone, AI, or chat.
In fact, Oscar describes this as support "whenever, wherever."
π Where this applies: Every state where Oscar plans are sold
β Does every Oscar metal tier get the same Care Team?
Yes, Oscar says Bronze, Silver, and Gold members all get the same quality care.
Plus, a Care Team backs each one.
π Where this applies: Every state where Oscar plans are sold
β How does Oscar use AI with my information?
Oscar says it uses AI to make the member experience faster and more personalized.
It also says privacy is its first priority. In addition, strong safeguards and security practices protect member data.
π Where this applies: Every state where Oscar plans are sold
β What is Oscar Virtual Care?
Oscar Virtual Care is Oscar's 24/7 quick care service.
On most plans, Oscar lists the cost as $0. However, availability varies by service, location, and plan.
π Where this applies: Every state where Oscar plans are sold
β Is Oscar Virtual Care free?
Yes, Oscar lists 24/7 virtual care at $0 on most plans.
However, some HSA-compatible high-deductible plans and Secure plans may not get $0 visits before the deductible.
π Where this applies: Every state where Oscar plans are sold
β Do Oscar HSA plans get $0 virtual care?
Not always, since members on certain HSA-compatible high-deductible plans may pay for virtual visits.
This lasts until you meet the deductible. So check your plan documents for details.
π Where this applies: Every state where Oscar plans are sold
β Can I use Oscar virtual urgent care while traveling abroad?
No, Oscar's Virtual Urgent Care is not available internationally or in U.S. territories.
π Where this applies: Every state where Oscar plans are sold
β Can an Oscar virtual doctor prescribe medication?
Prescriptions may be available through Oscar virtual visits.
However, Oscar notes the provider may limit prescriptions, visits, and services at their discretion.
π Where this applies: Every state where Oscar plans are sold
β Does Oscar Virtual Care include mental health or behavioral health?
In some states, Oscar Virtual Care includes integrated behavioral health.
Currently, it is available only in Florida, Georgia, Texas, and Arizona.
π Where this applies: Arizona, Florida, Georgia and Texas
β Does Oscar still offer virtual primary care?
Oscar's flyers describe Oscar Virtual Care as 24/7 quick care, not as a primary care plan.
However, several specialty plans list $0 primary care visits. A licensed agent can explain how primary care works on your plan.
π Where this applies: Every state where Oscar plans are sold
β Does Oscar pay members for healthy activities?
Yes, Oscar members can earn rewards for completing qualifying activities.
In fact, Oscar sums it up as "Take care of you, get paid. Repeat."
π Where this applies: Every state where Oscar plans are sold
β What is Oscar Unlocks?
Oscar Unlocks is Oscar's rewards program, where you earn points for simple health tasks.
Then points can help cover premiums. You can also redeem them on your Oscar debit card.
π Where this applies: AL, AZ, FL, GA, IA, IL, KS, MO, MS, NC, NE, NJ, OH, OK, SC, TN, TX, VA
β How much can I earn for switching to a 90-day prescription with Oscar?
Several Oscar plans pay $30 for switching eligible medications to a 90-day supply.
This reward appears on the Chronic Care CKM, Breathe Easy, Diabetes Care, HelloMeno, and Buena Salud flyers.
π Where this applies: AL, AZ, FL, GA, IA, IL, KS, MO, MS, NC, NE, NJ, OH, OK, SC, TN, TX, VA
β Do I get an Oscar reward for a preventive care visit?
Yes, several Oscar specialty plans list $20 for completing a preventive care visit.
The Chronic Care CKM, Breathe Easy COPD, and Diabetes Care plans list this $20 reward.
π Where this applies: AL, AZ, FL, GA, IA, IL, KS, MO, MS, NC, NE, NJ, OH, OK, SC, TN, TX, VA
β Do Oscar rewards vary by plan?
Yes, Oscar says benefits and rewards vary by plan, and certain restrictions apply.
You can find details in the Evidence of Coverage and at hioscar.com/member/benefits/perks.
π Where this applies: Every state where Oscar plans are sold
β How do I enroll in an Oscar specialty plan like Diabetes Care or HelloMeno?
Choose the Oscar specialty plan by name when you shop.
You can enroll through a licensed agent like Vivna or at hioscar.com/get-coverage. Also, plan names vary by state and metal level.
π Where this applies: AL, AZ, FL, GA, IA, IL, KS, MO, MS, NC, NE, NJ, OH, OK, SC, TN, TX, VA
β Can I buy an Oscar condition-specific plan if I am healthy?
Yes, Oscar's Chronic Care CKM, Breathe Easy, and Diabetes Care plans are open regardless of disease status.
Similarly, HelloMeno is open to anyone eligible.
π Where this applies: AL, AZ, FL, GA, IA, IL, KS, MO, MS, NC, NE, NJ, OH, OK, SC, TN, TX, VA
β Are Oscar specialty plans only on HealthCare.gov?
Most Oscar specialty plans are Marketplace plans, but not all of them.
Some are off-exchange only in certain states. For example, RetireEase is off-exchange only in Florida and Texas.
π Where this applies: AL, AZ, FL, GA, IA, IL, KS, MO, MS, NC, NE, NJ, OH, OK, SC, TN, TX, VA
Oscar Diabetes Care Plan
The Diabetes Care Plan focuses on insulin, supplies and routine diabetes care. Also, see who can enroll.
β What is the Oscar Diabetes Care Plan?
It is an Oscar plan built for people with diabetes.
The plan offers $0 routine diabetes care and $0 testing supplies. In addition, insulin has a $100 monthly cap.
π Where this applies: AZ, FL, GA, IA, IL, KS, MO, NC, NE, OH, OK, SC, TN, TX, VA
β Which states offer the Oscar Diabetes Care Plan?
The flyer lists AZ, FL, GA, IA, IL, KS, MO, NC, NE, OK, SC, TN, TX, and VA.
Ohio also appears for both the Buckeye and Cleveland Clinic areas. So confirm availability in your county with a licensed agent.
π Where this applies: AZ, FL, GA, IA, IL, KS, MO, NC, NE, OH, OK, SC, TN, TX, VA
β Do I need to have diabetes to buy the Oscar Diabetes Care Plan?
No, the plan is available to all eligible persons, regardless of disease status.
However, members without type 1 or type 2 diabetes may get some reduced costs, but not all rewards.
π Where this applies: AZ, FL, GA, IA, IL, KS, MO, NC, NE, OH, OK, SC, TN, TX, VA
β Can I get the Oscar Diabetes Care Plan if I have prediabetes or gestational diabetes?
Yes, you can enroll in the Oscar Diabetes Care Plan with prediabetes or gestational diabetes.
You may get certain reduced costs. However, you are not eligible for all the rewards and incentives offered to members with diabetes.
π Where this applies: AZ, FL, GA, IA, IL, KS, MO, NC, NE, OH, OK, SC, TN, TX, VA
β What metal levels does the Oscar Diabetes Care Plan come in?
The Oscar Diabetes Care Plan comes in Bronze, Silver, and Gold.
Plan names are Bronze Simple Diabetes, Silver Simple Diabetes, and Gold Simple Diabetes. In addition, there is a Spanish-language plan, Buena Salud Bronce Simple Para Diabetes.
π Where this applies: AZ, FL, GA, IA, IL, KS, MO, NC, NE, OH, OK, SC, TN, TX, VA
β What visits are $0 on the Oscar Diabetes Care Plan?
Primary care, endocrinologist, and behavioral health visits are all $0 on this plan.
π Where this applies: AZ, FL, GA, IA, IL, KS, MO, NC, NE, OH, OK, SC, TN, TX, VA
β Does the Oscar Diabetes Care Plan cover eye and foot exams?
Yes, diabetic eye exams and foot exams are $0 on this plan.
π Where this applies: AZ, FL, GA, IA, IL, KS, MO, NC, NE, OH, OK, SC, TN, TX, VA
β Are labs free on the Oscar Diabetes Care Plan?
Yes, Oscar's Diabetes Care Plan lists labs at $0.
π Where this applies: AZ, FL, GA, IA, IL, KS, MO, NC, NE, OH, OK, SC, TN, TX, VA
β Does the Oscar Diabetes Care Plan cover insulin?
Yes, most insulin brands are $0 on the Oscar Diabetes Care Plan.
Also, Oscar guarantees a $100 monthly out-of-pocket maximum on insulin. If your state sets a lower cap, Oscar applies the lower amount.
π Where this applies: AZ, FL, GA, IA, IL, KS, MO, NC, NE, OH, OK, SC, TN, TX, VA
β Are other prescriptions covered on the Oscar Diabetes Care Plan?
Yes, Oscar says many other daily prescriptions are $0 on this plan.
Still, check the plan's drug list for your specific medications.
π Where this applies: AZ, FL, GA, IA, IL, KS, MO, NC, NE, OH, OK, SC, TN, TX, VA
β Does the Oscar Diabetes Care Plan cover glucose testing supplies?
Yes, diabetes testing supplies are $0 through Oscar's WellDia program.
However, you need a prescription from a licensed provider.
π Where this applies: AZ, FL, GA, IA, IL, KS, MO, NC, NE, OH, OK, SC, TN, TX, VA
β What is WellDia on Oscar?
WellDia is the Oscar Diabetes Management Program.
It provides $0 diabetes testing supplies built into your plan. The program is for enrolled Oscar members with type 1 or type 2 diabetes.
π Where this applies: AL, AZ, FL, GA, IA, IL, KS, MI, MO, MS, NC, NE, OH, OK, PA, TN, TX, VA
β How do I sign up for Oscar's WellDia diabetes program?
You need an Oscar account, must agree to the program terms, and must actively enroll.
For members under 18, a parent or guardian contacts Oscar.
π Where this applies: AL, AZ, FL, GA, IA, IL, KS, MI, MO, MS, NC, NE, OH, OK, PA, TN, TX, VA
β Which states have Oscar's WellDia diabetes program?
WellDia is for individual Oscar members with type 1 or 2 diabetes in select states.
Oscar offers it in AL, AZ, FL, GA, IA, IL, KS, MI, MO, MS, NC, NE, OH, OK, PA, TN, TX, and VA.
π Where this applies: AL, AZ, FL, GA, IA, IL, KS, MI, MO, MS, NC, NE, OH, OK, PA, TN, TX, VA
β Can I lose access to Oscar's WellDia program?
Yes, members can lose WellDia access if they no longer have a diabetes diagnosis.
Also, changing to an ineligible plan can end access.
π Where this applies: AL, AZ, FL, GA, IA, IL, KS, MI, MO, MS, NC, NE, OH, OK, PA, TN, TX, VA
β What rewards come with the Oscar Diabetes Care Plan?
You can earn $20 for a preventive care visit on this plan.
In addition, you can earn $30 for switching certain medications to a 90-day refill. However, your account must be paid up to receive rewards.
π Where this applies: AZ, FL, GA, IA, IL, KS, MO, NC, NE, OH, OK, SC, TN, TX, VA
β How much can I save with the Oscar Diabetes Care Plan?
Oscar says members can save up to 25% on annual healthcare costs.
That figure is an average from Oscar's internal analysis of diabetes treatment. Still, savings vary with use.
π Where this applies: AZ, FL, GA, IA, IL, KS, MO, NC, NE, OH, OK, SC, TN, TX, VA
β Where can I learn more about the Oscar Diabetes Care Plan?
You can learn more at hioscar.com/get-coverage/diabetes-care and hioscar.com/diabetes.
π Where this applies: AZ, FL, GA, IA, IL, KS, MO, NC, NE, OH, OK, SC, TN, TX, VA
Oscar Chronic Care CKM Plan
The CKM plan covers heart, kidney and metabolic conditions together. Here you can see its benefits and limits.
β What is the Oscar Chronic Care CKM Plan?
Oscar's Chronic Care CKM Plan is for people managing more than one condition.
It covers diabetes, COPD, and heart conditions together. Plus, it features $0 specialist visits and $0 labs.
π Where this applies: AL, AZ, FL, GA, IA, KS, MO, MS, NC, NJ, OH, OK, TN, TX
β Who is the Oscar Chronic Care CKM Plan designed for?
Oscar designed it for people managing multiple conditions, such as diabetes, COPD, and heart conditions.
Still, anyone eligible can enroll, regardless of disease status.
π Where this applies: AL, AZ, FL, GA, IA, KS, MO, MS, NC, NJ, OH, OK, TN, TX
β Do I need a diagnosis to buy the Oscar Chronic Care CKM Plan?
No, Oscar says the plan is available to all eligible persons, regardless of disease status.
π Where this applies: AL, AZ, FL, GA, IA, KS, MO, MS, NC, NJ, OH, OK, TN, TX
β Which states offer the Oscar Chronic Care CKM Plan?
Oscar offers the Chronic Care CKM Plan in 14 states, including Ohio.
The other 13 are AL, AZ, FL, GA, IA, KS, MO, MS, NC, NJ, OK, TN, and TX. Also, in Ohio, Oscar offers it in both the Buckeye and Cleveland Clinic areas.
π Where this applies: AL, AZ, FL, GA, IA, KS, MO, MS, NC, NJ, OH, OK, TN, TX
β What metal levels does the Oscar Chronic Care CKM Plan come in?
The Chronic Care CKM Plan comes in Bronze, Silver, and Gold versions.
However, names vary by state. Examples include Bronze Simple Chronic Care CKM, Silver 3750 Chronic Care CKM, and Gold 1500 Chronic Care CKM.
π Where this applies: AL, AZ, FL, GA, IA, KS, MO, MS, NC, NJ, OH, OK, TN, TX
β Is "MultiCondition Guided Care" the same as Oscar's Chronic Care CKM Plan?
Yes, in some states, MultiCondition Guided Care is a name for the Chronic Care CKM Plan.
For example, CKM plan names include Bronze Simple MultiCondition Guided Care and Silver Simple MultiCondition Guided Care. Also, Silver MultiCondition Care is another.
π Where this applies: AL, AZ, FL, GA, IA, KS, MO, MS, NC, NJ, OH, OK, TN, TX
β What doctor visits are $0 on the Oscar Chronic Care CKM Plan?
Primary care, cardiologist, endocrinologist, pulmonologist, and behavioral health visits are $0.
However, coverage follows clinical guidelines.
π Where this applies: AL, AZ, FL, GA, IA, KS, MO, MS, NC, NJ, OH, OK, TN, TX
β Does the Oscar Chronic Care CKM Plan cover cardiac rehab?
Yes, cardiac rehab is $0 on the Oscar Chronic Care CKM Plan.
Pulmonary rehab is also $0 on this plan.
π Where this applies: AL, AZ, FL, GA, IA, KS, MO, MS, NC, NJ, OH, OK, TN, TX
β Are lab tests free on the Oscar Chronic Care CKM Plan?
Yes, Oscar's Chronic Care CKM Plan lists lab tests at $0.
π Where this applies: AL, AZ, FL, GA, IA, KS, MO, MS, NC, NJ, OH, OK, TN, TX
β Does the Oscar Chronic Care CKM Plan cover diabetic eye and foot exams?
Yes, diabetic eye exams and foot exams are both $0 on this plan.
π Where this applies: AL, AZ, FL, GA, IA, KS, MO, MS, NC, NJ, OH, OK, TN, TX
β Does the Oscar Chronic Care CKM Plan cover oxygen?
Yes, oxygen services are $0 on the Oscar Chronic Care CKM Plan.
π Where this applies: AL, AZ, FL, GA, IA, KS, MO, MS, NC, NJ, OH, OK, TN, TX
β How much is insulin on the Oscar Chronic Care CKM Plan?
The CKM flyer lists a $0 monthly out-of-pocket maximum on insulin.
However, the fine print says insulin caps depend on state rules. Oscar applies the lower of the state cap or $100. So confirm the details in your plan documents.
π Where this applies: AL, AZ, FL, GA, IA, KS, MO, MS, NC, NJ, OH, OK, TN, TX
β Does the Oscar Chronic Care CKM Plan cover inhalers?
Yes, inhalers are listed at $0 on the Oscar Chronic Care CKM Plan.
Many other daily prescriptions are $0 as well.
π Where this applies: AL, AZ, FL, GA, IA, KS, MO, MS, NC, NJ, OH, OK, TN, TX
β Does the Oscar Chronic Care CKM Plan help me quit smoking?
Yes, generic Chantix and nicotine replacement are $0 on this plan.
π Where this applies: AL, AZ, FL, GA, IA, KS, MO, MS, NC, NJ, OH, OK, TN, TX
β How much can I save with the Oscar Chronic Care CKM Plan?
Oscar says members can save up to 25% in annual healthcare costs.
That figure is an average from Oscar's internal analysis. However, actual savings vary based on how much care you use.
π Where this applies: AL, AZ, FL, GA, IA, KS, MO, MS, NC, NJ, OH, OK, TN, TX
β What rewards come with the Oscar Chronic Care CKM Plan?
You can earn $20 for a preventive care visit on this plan.
In addition, you can earn $30 for switching inhalers and certain medications to a 90-day refill. Points can help cover premiums.
π Where this applies: AL, AZ, FL, GA, IA, KS, MO, MS, NC, NJ, OH, OK, TN, TX
β Does the Oscar Chronic Care CKM Plan include a gym discount?
Yes, the flyer lists discounted gym memberships as part of the plan's rewards.
π Where this applies: AL, AZ, FL, GA, IA, KS, MO, MS, NC, NJ, OH, OK, TN, TX
β Where can I learn more about the Oscar Chronic Care CKM Plan?
Oscar's page for this plan is hioscar.com/get-coverage/chronic-care-ckm.
Also, a licensed agent like Vivna can compare it with other plans in your area.
π Where this applies: AL, AZ, FL, GA, IA, KS, MO, MS, NC, NJ, OH, OK, TN, TX
Oscar Breathe Easy COPD Plan
Breathe Easy is built for people managing asthma or COPD. These answers explain its benefits and savings.
β What is the Oscar Breathe Easy COPD Plan?
It is an Oscar plan for people managing asthma or COPD.
The plan offers $0 routine care and $0 inhalers. It also offers up to 25% annual savings.
π Where this applies: AZ, FL, GA, IA, NC, OH, OK, TN, TX
β Is the Oscar Breathe Easy plan for asthma too?
Yes, Oscar describes Breathe Easy as a plan for managing asthma or COPD.
π Where this applies: AZ, FL, GA, IA, NC, OH, OK, TN, TX
β Do I need a COPD diagnosis to buy the Oscar Breathe Easy plan?
No, you do not need a COPD diagnosis to buy this plan.
In fact, Oscar says the plan is available to all eligible persons, regardless of disease status.
π Where this applies: AZ, FL, GA, IA, NC, OH, OK, TN, TX
β Which states offer the Oscar Breathe Easy COPD Plan?
Oscar offers the Breathe Easy COPD Plan in AZ, FL, GA, IA, NC, OK, TN, and TX.
In addition, it is available in Ohio in both the Buckeye and Cleveland Clinic areas.
π Where this applies: AZ, FL, GA, IA, NC, OH, OK, TN, TX
β What are the plan names for Oscar Breathe Easy?
Breathe Easy plan names vary by metal level and state.
For example, they include Bronze Simple Breathe Easy with Enhanced COPD Benefits. They also include Silver Simple Breathe Easy with Enhanced COPD Benefits. Another is Silver Simple Specialist Saver with COPD.
π Where this applies: AZ, FL, GA, IA, NC, OH, OK, TN, TX
β What visits are $0 on the Oscar Breathe Easy COPD Plan?
Primary care, pulmonologist, and behavioral health visits are all $0 on this plan.
π Where this applies: AZ, FL, GA, IA, NC, OH, OK, TN, TX
β Are inhalers free on the Oscar Breathe Easy COPD Plan?
Yes, inhalers are listed at $0 on the Oscar Breathe Easy COPD Plan.
Plus, many other daily prescriptions are $0 too.
π Where this applies: AZ, FL, GA, IA, NC, OH, OK, TN, TX
β Does the Oscar Breathe Easy plan cover pulmonary rehab and lung function tests?
Yes, pulmonary rehab and pulmonary function tests are both $0 on this plan.
π Where this applies: AZ, FL, GA, IA, NC, OH, OK, TN, TX
β Does the Oscar Breathe Easy plan cover home oxygen?
Yes, oxygen services are $0 on the Oscar Breathe Easy plan.
In addition, the plan includes full-service respiratory care, including oxygen therapy and recovery programs.
π Where this applies: AZ, FL, GA, IA, NC, OH, OK, TN, TX
β Does the Oscar Breathe Easy plan have a quit-smoking program?
Yes, its tobacco cessation program covers nicotine patches, gum, and medications at $0.
Generic Chantix is also $0.
π Where this applies: AZ, FL, GA, IA, NC, OH, OK, TN, TX
β What rewards come with the Oscar Breathe Easy COPD Plan?
You can earn $20 for a preventive care visit on this plan.
Also, you can earn $10 for a pulmonary function test. In addition, switching inhalers and certain medications to a 90-day refill earns $30.
π Where this applies: AZ, FL, GA, IA, NC, OH, OK, TN, TX
β Does Oscar Breathe Easy pay a reward for flu and pneumonia shots?
Yes, members earn a $25 reward for getting both the flu and pneumonia vaccines.
However, members must get both shots in the same calendar year.
π Where this applies: AZ, FL, GA, IA, NC, OH, OK, TN, TX
β How much can I save with the Oscar Breathe Easy COPD Plan?
Oscar says members can save up to 25% on annual healthcare costs.
That figure is an average from Oscar's internal analysis of lung-related care. Still, actual savings vary with use.
π Where this applies: AZ, FL, GA, IA, NC, OH, OK, TN, TX
β What is the difference between Oscar Breathe Easy and the Chronic Care CKM Plan?
Breathe Easy focuses on asthma and COPD.
By contrast, Chronic Care CKM covers diabetes, COPD, and heart conditions together. CKM also adds $0 cardiologist, endocrinologist, cardiac rehab, and diabetic exams.
π Where this applies: AZ, FL, GA, IA, NC, OH, OK, TN, TX
β Where can I learn more about the Oscar Breathe Easy COPD Plan?
Oscar's page for this plan is hioscar.com/get-coverage/asthma-copd.
In addition, the Evidence of Coverage at hioscar.com/forms has more details.
π Where this applies: AZ, FL, GA, IA, NC, OH, OK, TN, TX
Oscar HelloMeno Womenβs Health Plan
HelloMeno adds menopause care to a full health plan. In addition, see its rewards and who can join.
β What is Oscar HelloMeno?
HelloMeno is Oscar's women's health plan with menopause benefits.
It offers specialized menopause care, $0 copays on key services, and rewards. In addition, the plan covers the whole family.
π Where this applies: AZ, FL, GA, IA, KS, MO, NE, NJ, OH, OK, SC, TN, TX, VA, NC
β Who is the Oscar HelloMeno plan for?
It is most suitable for women experiencing or past natural or forced menopause.
Still, anyone eligible can enroll.
π Where this applies: AZ, FL, GA, IA, KS, MO, NE, NJ, OH, OK, SC, TN, TX, VA, NC
β Can my family be on the Oscar HelloMeno plan?
Yes, Oscar says HelloMeno includes coverage for the whole family.
π Where this applies: AZ, FL, GA, IA, KS, MO, NE, NJ, OH, OK, SC, TN, TX, VA, NC
β Which states offer Oscar HelloMeno?
The flyer lists AZ, FL, GA, IA, KS, MO, NE, NJ, OH, OK, SC, TN, TX, and VA.
In addition, North Carolina has its own version with Atrium Health.
π Where this applies: AZ, FL, GA, IA, KS, MO, NE, NJ, OH, OK, SC, TN, TX, VA, NC
β What are the plan names for Oscar HelloMeno?
HelloMeno plan names vary by state.
They are Silver Simple Women's Health with Menopause Benefits and Silver Simple Women's Health with Menopause Benefits Guided Care.
π Where this applies: AZ, FL, GA, IA, KS, MO, NE, NJ, OH, OK, SC, TN, TX, VA, NC
β What is $0 on the Oscar HelloMeno plan?
Primary care, OB/GYN, and mental health visits are $0 on HelloMeno.
Routine labs and bone-density scans are $0 as well. Expert menopause virtual care is also $0.
π Where this applies: AZ, FL, GA, IA, KS, MO, NE, NJ, OH, OK, SC, TN, TX, VA, NC
β Does Oscar HelloMeno cover hormone therapy?
Yes, hormone therapy prescriptions are listed at $0 on HelloMeno.
So are SSRIs and related symptom-relief prescriptions.
π Where this applies: AZ, FL, GA, IA, KS, MO, NE, NJ, OH, OK, SC, TN, TX, VA, NC
β Does Oscar HelloMeno cover bone density scans?
Yes, bone-density scans and routine labs are $0 on HelloMeno.
π Where this applies: AZ, FL, GA, IA, KS, MO, NE, NJ, OH, OK, SC, TN, TX, VA, NC
β What is Elektra Health on the Oscar HelloMeno plan?
Elektra Health is Oscar's menopause care partner for HelloMeno members.
HelloMeno members get access to specialized Elektra clinicians and personalized treatment plans. They also get one-on-one coaching.
π Where this applies: AZ, FL, GA, IA, MO, NE, OH, OK, TN, TX
β Is Elektra Health free on Oscar HelloMeno?
The flyer lists $0 access to Elektra clinicians on HelloMeno.
However, the fine print says cost-sharing for virtual care, coaching, prescriptions, and labs follows your medical plan. So check your policy for details.
π Where this applies: AZ, FL, GA, IA, MO, NE, OH, OK, TN, TX
β Which states include Elektra Health with Oscar HelloMeno?
Oscar includes Elektra Health with HelloMeno in AZ, FL, GA, IA, MO, NE, OH, OK, TN, and TX.
In Ohio, it applies in the Buckeye and Cleveland Clinic areas. However, Oklahoma members are not eligible for Elektra Health rewards.
π Where this applies: AZ, FL, GA, IA, MO, NE, OH, OK, TN, TX
β How much can I save with Oscar HelloMeno?
Oscar says members can save up to $900 a year on healthcare.
In addition, Oscar cites up to 25% annual savings. That figure is an average that varies with use.
π Where this applies: AZ, FL, GA, IA, KS, MO, NE, NJ, OH, OK, SC, TN, TX, VA
β What rewards come with Oscar HelloMeno?
You can earn $50 for a women's health scan or screening.
In addition, you can earn $30 for switching eligible prescriptions to a 90-day supply.
π Where this applies: AZ, FL, GA, IA, KS, MO, NE, NJ, OH, OK, SC, TN, TX, VA, NC
β Where can I learn more about Oscar HelloMeno?
You can learn more on Oscar's page at hioscar.com/get-coverage/hellomeno.
π Where this applies: AZ, FL, GA, IA, KS, MO, NE, NJ, OH, OK, SC, TN, TX, VA, NC
β Is Oscar HelloMeno available in North Carolina?
Yes, HelloMeno is available in North Carolina.
However, HelloMeno partners there with Atrium Health instead of Elektra Health.
π Where this applies: North Carolina
β What does Atrium Health provide on Oscar HelloMeno in North Carolina?
Members get $0 access to specialized Atrium Health clinicians.
The plan also includes personalized treatment plans and one-on-one coaching with Atrium Health.
π Where this applies: North Carolina
β Who can use Atrium Health on Oscar HelloMeno in North Carolina?
Eligible NC members enrolled through HealthCare.gov in a Women's Health with Menopause Benefits plan qualify.
However, cost-sharing for virtual care, in-person care, prescriptions, and labs follows your plan.
π Where this applies: North Carolina
β What is $0 on Oscar HelloMeno in North Carolina?
Primary care, OB/GYN, and mental health visits are $0 on HelloMeno in North Carolina.
Routine labs, bone-density scans, and expert menopause virtual care are also $0. Hormone therapy and SSRI prescriptions are $0 as well.
π Where this applies: North Carolina
Oscar Metal Tiers and Plan Suites
These answers explain Oscar bronze, silver and gold plans. As a result, you can match a tier to the care you expect.
β What metal tiers does Oscar offer?
Oscar plans come in three metal tiers: Bronze, Silver, and Gold.
Each tier balances the monthly premium against what you pay when you get care.
π Where this applies: Every state where Oscar plans are sold
β What is an Oscar Bronze plan?
Bronze has a lower premium and higher out-of-pocket costs.
Oscar's cheat sheet shows 60% paid by Oscar and 40% paid by you. Overall, it fits people who rarely need care but want protection from major medical bills.
π Where this applies: Every state where Oscar plans are sold
β What is an Oscar Silver plan?
Silver has a moderate premium and moderate out-of-pocket costs.
Oscar's cheat sheet shows 70% paid by Oscar and 30% paid by you. Overall, it fits people who expect routine care.
π Where this applies: Every state where Oscar plans are sold
β What is an Oscar Gold plan?
Gold has a higher premium and lower out-of-pocket costs.
Oscar's cheat sheet shows 80% paid by Oscar and 20% paid by you. Overall, it fits people with ongoing health needs who want predictable costs.
π Where this applies: Every state where Oscar plans are sold
β Can I get cost-sharing reductions on an Oscar plan?
Yes, eligible clients can get cost-sharing reductions on Oscar Silver plans.
π Where this applies: Every state where Oscar plans are sold
β Does Oscar offer Platinum plans?
Oscar's cheat sheet lists only three metal tiers: Bronze, Silver, and Gold.
π Where this applies: Every state where Oscar plans are sold
β What are Oscar plan suites?
Within each metal tier, Oscar offers 4 plan suites: Simple, Simple Clinical, Classic, and Elite.
Overall, the main difference is how costs split between copays and deductibles.
π Where this applies: Every state where Oscar plans are sold
β What is the Oscar Simple plan suite?
Simple plans are budget-friendly "just in case" coverage.
They fit healthier people who want protection without high monthly bills.
π Where this applies: Every state where Oscar plans are sold
β What is the Oscar Simple Clinical plan suite?
Simple Clinical plans offer extra savings for people managing chronic conditions.
For example, they have lower out-of-pocket costs for ongoing care.
π Where this applies: AL, AZ, FL, GA, IA, IL, KS, MO, MS, NC, NE, NJ, OH, OK, PA, SC, TN, TX, VA
β Which states offer Oscar Simple Clinical plans?
Oscar lists Simple Clinical plans in 19 states.
They are AL, AZ, FL, GA, IA, IL, KS, MO, MS, NC, NE, NJ, OH, OK, PA, SC, TN, TX, VA. However, in New Jersey, Simple Clinical is off-exchange only.
π Where this applies: AL, AZ, FL, GA, IA, IL, KS, MO, MS, NC, NE, NJ, OH, OK, PA, SC, TN, TX, VA
β What is the Oscar Classic plan suite?
Classic plans give predictable everyday coverage.
They also have lower deductibles and fewer surprise costs.
π Where this applies: Every state where Oscar plans are sold
β What is the Oscar Elite plan suite?
Elite is Oscar's top-tier suite for people who use more care.
It features a $0 medical deductible, so coverage starts right away.
π Where this applies: Every state where Oscar plans are sold
β Does any Oscar plan have a $0 deductible?
Yes, Oscar Elite plans feature a $0 medical deductible.
However, deductibles on other suites vary by plan and state.
π Where this applies: Every state where Oscar plans are sold
β Which Oscar plan suite is best if I have a chronic condition?
Oscar designed Simple Clinical for people managing chronic conditions.
Elite also suits people who use more care. In addition, Oscar has condition-focused plans for diabetes, COPD, and menopause.
π Where this applies: Every state where Oscar plans are sold
Oscar RetireEase Plans
RetireEase plans target early retirees who are not yet on Medicare. Here you can see how they work.
β What is Oscar RetireEase?
RetireEase is an Oscar plan for people who retire early and need coverage until Medicare at 65.
It offers fixed copays for doctor visits, physical therapy, and meds.
π Where this applies: Arizona, Florida, Ohio, South Carolina and Texas
β Who is Oscar RetireEase designed for?
Oscar designed RetireEase for people retiring early who need quality coverage until 65.
It also fits people who want low fixed copays and protection for savings against a medical emergency.
π Where this applies: Arizona, Florida, Ohio, South Carolina and Texas
β Which states offer Oscar RetireEase?
Oscar offers RetireEase in Arizona, Florida, Ohio, South Carolina, and Texas.
π Where this applies: Arizona, Florida, Ohio, South Carolina and Texas
β Can I buy Oscar RetireEase on HealthCare.gov?
Whether you can buy RetireEase on HealthCare.gov depends on your state.
In Arizona, Ohio (Cleveland Clinic area), and South Carolina, it is on-exchange only. By contrast, in Florida and Texas it is off-exchange only.
π Where this applies: Arizona, Florida, Ohio, South Carolina and Texas
β Is Oscar RetireEase sold off-exchange in Florida and Texas?
Yes, RetireEase is available off-exchange only in Florida and Texas.
So, ask a licensed agent how that affects any financial help you might qualify for.
π Where this applies: Florida and Texas
β What are the copays on Oscar RetireEase?
Primary care visits, physical therapy, and routine labs have fixed copays from $0 to $35.
Specialist care for cardiology and orthopedics also has fixed-rate copays.
π Where this applies: Arizona, Florida, Ohio, South Carolina and Texas
β Does Oscar RetireEase cover prescriptions?
Yes, RetireEase includes $0 prescription coverage for everyday medications.
π Where this applies: Arizona, Florida, Ohio, South Carolina and Texas
β Does Oscar RetireEase cover specialists like cardiologists?
Yes, cardiology and orthopedics specialist care comes with fixed-rate copays.
π Where this applies: Arizona, Florida, Ohio, South Carolina and Texas
β What happens to Oscar RetireEase when I turn 65?
Oscar designed RetireEase to bridge you until Medicare at 65.
Also, a licensed agent can help you plan the move to Medicare.
π Where this applies: Arizona, Florida, Ohio, South Carolina and Texas
β Where can I learn more about Oscar RetireEase?
You can learn more on Oscar's page at hioscar.com/get-coverage/retire-ease.
In addition, full benefits are in the Evidence of Coverage at hioscar.com/forms.
π Where this applies: Arizona, Florida, Ohio, South Carolina and Texas
Hola Oscar and Buena Salud Plans
Hola Oscar offers support in Spanish, and Buena Salud plans add extra benefits. So see where each one is sold.
β What is Hola Oscar?
Hola Oscar is Oscar's Spanish-language support program.
In fact, Oscar says it takes any Oscar plan and makes it Spanish-speaking.
π Where this applies: Every state where Oscar plans are sold
β Can I get an Oscar plan with Spanish-speaking doctors?
Yes, Hola Oscar connects members with Spanish-speaking providers.
As a result, symptoms and treatment plans don't get lost in translation.
π Where this applies: Every state where Oscar plans are sold
β Does Oscar have a Spanish-speaking Care Team?
Yes, Hola Oscar pairs members with a dedicated team of Spanish-speaking Care Guides.
These Care Guides also understand members' cultural and real-life health needs.
π Where this applies: Every state where Oscar plans are sold
β Will Oscar send me health reminders in Spanish?
Yes, Hola Oscar members get wellness tips, appointment reminders, and health guidance in Spanish.
π Where this applies: Every state where Oscar plans are sold
β Do I need a special plan to use Hola Oscar?
No, Oscar says Hola Oscar works with any Oscar plan.
You can shop plans at hioscar.com/get-coverage. Plus, holaoscar.com/get-coverage lets you shop in Spanish.
π Where this applies: Every state where Oscar plans are sold
β How satisfied are Spanish-speaking Oscar members?
Oscar says its Spanish-speaking members rate satisfaction nearly 2 times higher than the industry average.
π Where this applies: Every state where Oscar plans are sold
β Is Hola Oscar available in Ohio?
Yes, Oscar publishes a Spanish-language Hola Oscar flyer for Ohio.
It describes the same Spanish-speaking providers and Care Guides.
π Where this applies: Ohio
β What is the difference between Hola Oscar and Buena Salud?
Hola Oscar adds Spanish support to any Oscar plan.
By contrast, Buena Salud is a set of plans where documents, account, and communications are all in Spanish. Oscar sells Buena Salud in Georgia, Illinois, and Texas.
π Where this applies: Every state where Oscar plans are sold
β What is the Oscar Buena Salud plan?
Buena Salud is Oscar's plan line built fully in Spanish.
Your documents, account, and communications are all in Spanish. It also includes Spanish-speaking doctors and Care Guides.
π Where this applies: Georgia, Illinois and Texas
β Which states offer Oscar Buena Salud plans?
The Buena Salud flyer lists Georgia, Illinois, and Texas.
However, availability varies by area, so confirm with a licensed agent.
π Where this applies: Georgia, Illinois and Texas
β Are Oscar Buena Salud Care Guides native Spanish speakers?
Yes, Buena Salud includes native-speaking Care Guides.
Members also get access to Spanish-speaking doctors who understand their background.
π Where this applies: Georgia, Illinois and Texas
β Does Buena Salud have health programs for Hispanic members?
Yes, Oscar says Buena Salud includes health programs built for the Hispanic community.
π Where this applies: Georgia, Illinois and Texas
β Does Oscar Buena Salud offer rewards?
Yes, Buena Salud members can earn $30 for switching eligible prescriptions to a 90-day supply.
They also get access to rewards for routine health tasks.
π Where this applies: Georgia, Illinois and Texas
β How do Spanish-speaking members rate Oscar Buena Salud?
Oscar reports a Net Promoter Score of 87 among Spanish-speaking members.
In fact, it says this is 200% above the industry average.
π Where this applies: Georgia, Illinois and Texas
β Is there a Buena Salud plan for diabetes?
Yes, the Diabetes Care Plan includes a Bronze version called Buena Salud Bronce Simple Para Diabetes.
However, availability depends on your state.
π Where this applies: Georgia, Illinois and Texas
β How do I enroll in an Oscar Buena Salud plan?
Contact a licensed agent or an Oscar sales representative to enroll in Buena Salud.
You can also choose a plan at hioscar.com/get-coverage.
π Where this applies: Georgia, Illinois and Texas
Oscar Dental and Vision Benefits
Some Oscar plans include adult dental and vision benefits. These answers explain what they cover.
β Do Oscar health plans include dental and vision?
Some Oscar plans include medical, dental, and vision all in one plan.
Oscar offers these embedded plans in AZ, FL, GA, NC, OH, SC, TN, and TX.
π Where this applies: AZ, FL, GA, NC, OH, SC, TN, TX
β Which states offer Oscar plans with dental and vision built in?
Oscar offers them in Arizona, Florida, Georgia, North Carolina, Ohio, South Carolina, Tennessee, and Texas.
π Where this applies: AZ, FL, GA, NC, OH, SC, TN, TX
β Do I get separate ID cards for Oscar medical, dental, and vision?
No, Oscar's embedded plans give you one ID card for medical, dental, and vision.
You also get one account and one app for all three.
π Where this applies: AZ, FL, GA, NC, OH, SC, TN, TX
β Is preventive dental free on Oscar's embedded dental plan?
Yes, cleanings, exams, and routine X-rays are $0 for adults.
π Where this applies: AZ, FL, GA, NC, OH, SC, TN, TX
β What is the dental annual maximum on Oscar's embedded dental plan?
Oscar's embedded dental plan has a $1,000 annual maximum.
It applies toward basic and major restorative care.
π Where this applies: AZ, FL, GA, NC, OH, SC, TN, TX
β Does Oscar's embedded dental plan cover fillings, crowns, or other major work?
The plan covers basic and major restorative care up to the $1,000 annual maximum.
However, the flyer does not list coinsurance or waiting periods. So check the plan documents for those details.
π Where this applies: AZ, FL, GA, NC, OH, SC, TN, TX
β How do I find a dentist with Oscar's embedded dental plan?
Your Oscar account has a built-in dentist lookup.
The same account also integrates your dental claims.
π Where this applies: AZ, FL, GA, NC, OH, SC, TN, TX
β Does Oscar's embedded vision plan cover eye exams?
Yes, annual routine eye exams are $0 on Oscar's embedded vision plan.
π Where this applies: AZ, FL, GA, NC, OH, SC, TN, TX
β Does Oscar's embedded vision plan cover glasses or contacts?
Yes, the plan includes an annual allowance for frames, lenses, or contact lenses.
However, the flyer does not state the dollar amount, so check your plan documents.
π Where this applies: AZ, FL, GA, NC, OH, SC, TN, TX
β Does Oscar's embedded vision plan cover kids?
Yes, Oscar includes enhanced pediatric vision with comprehensive eye care.
In addition, Oscar says pediatric vision has zero accumulators.
π Where this applies: AZ, FL, GA, NC, OH, SC, TN, TX
β Do Oscar dental and vision plans include medical coverage too?
Yes, these embedded plans include comprehensive medical coverage.
That coverage includes 24/7 $0 Oscar Virtual Care, Care Guides, Oswell, and rewards.
π Where this applies: AZ, FL, GA, NC, OH, SC, TN, TX
β Where can I learn more about Oscar's dental and vision plans?
You can learn more on Oscar's page at hioscar.com/get-coverage/oscar-vision-dental.
Benefits vary by plan, so review the Evidence of Coverage at hioscar.com/forms.
π Where this applies: AZ, FL, GA, NC, OH, SC, TN, TX
π More Oscar and Health Plan Guides
These answers cover each Oscar specialty plan. When you want more depth, these guides from our licensed agents explain plan options, telehealth and dental coverage. Then, if a question comes up, call 888-730-6001 anytime.
π Oscar and Health Plan Guides
𧩠More Oscar FAQ Libraries
π Questions About an Oscar Specialty Plan?
These answers cover the most common questions about Oscar specialty plans, but every family is different. Therefore, our licensed agents compare Oscar 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
- βοΈ memberservices@vivna.net
- 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.