Oscar

Oscar was founded in 2012 to provide consumers with access to the affordable, high-quality health care they deserve.

Oscar offers affordable, easy-to-use health coverage designed to make care accessible for every lifestyle. Members get $0 Virtual Urgent Care visits, help from a dedicated Care Team, and access to low-cost prescriptions for common medications. With flexible Bronze, Silver, and Gold plan options, including tailored Chronic Condition and Diabetes plans, Oscar makes it simple to choose coverage that fits your health and budget. Every plan comes with convenient online account access for managing claims, bills, and digital ID cards anytime, anywhere.

*Based on publicly reported membership figures for insurers serving the Individual market during plan year 2020.

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2026 Oscar Plan Highlights

Download plan grid here

💊 Low-cost prescriptions – savings on commonly prescribed medications

👩‍⚕️ Dedicated Care Team – personalized help with claims, billing, and provider coordination

📱 $0 Virtual Urgent Care – 24/7 access to providers from your phone or computer

💬 Chronic Condition & Diabetes plans – tailored benefits like capped insulin costs and $0 PCP visits

💻 Easy online account access – manage claims, digital ID cards, and payments anytime

🏥 HMO network plans – coordinated care through in-network doctors and hospitals across Illinois

CHOOSING YOUR METAL TIER

There are 3 different metal tiers when it comes to Oscar health plans: Bronze, Silver, and Gold. You’ll receive the same quality of care and the same benefit s for all tiers.

BRONZE PLAN

Lower premium, higher out -of-pocket expenses 60%of covered health costs paid by Oscar, 40%paid by you. Good choice if you don’t expect to use your plan often, but still want coverage to protect you from very high costs

SILVER PLAN

Moderate premium, moderate out -of-pocket expenses. 70%of covered health costs paid by Oscar, 30%paid by you.
Cost share reductions available if you’re eligible. Good choice if you’re willing to pay a slightly higher monthly premium and get more care covered

GOLD PLAN

Higher premium, lower out -of-pocket expenses. 80%of covered health costs paid Oscar, 20%paid by you. Good choice if you need care often

CHOOSING YOUR PLAN SUITE

Within each tier there are 3 plan suites you can choose from. The plan suites range from Simple to Elite. The difference between them is the breakout of coinsurance and copays.

SIMPLE

Lowest monthly premium. More coinsurance based cost- shares. Mostly available in Bronze and Silver metal tiers.

CLASSIC

Mid to high monthly premium. Out- of- pocket costs will be a mix of coinsurance & copays. For example, you may have a copay for labs and coinsurance for a hospital stay

ELITE

Highest monthly premium. More copay based cost- shares. $0 medical deductible.

For members living with diabetes:

Designed to support individuals living with type 1 or type 2 diabetes, these plans make it easier and more affordable to manage your health every day. You’ll get predictable costs, enhanced coverage, and ongoing support tailored to your condition.

Highlights include:

💊 $100 monthly insulin cap for affordable access to medication
👩‍⚕️ $0 primary care and specialist visits related to diabetes management
🧪 $0 labs and diabetic eye/foot exams for routine monitoring
🩸 $0 testing supplies through the WellDia program (glucometer, test strips, lancets)
🤝 Personalized Care Team support plus 24/7 virtual visits at no cost

Virtual Care Offerings:

Oscar’s Virtual Urgent Care lets members connect with a provider anytime, from anywhere — usually within 15 minutes. Virtual visits are $0 on most plans and cover diagnosis, prescriptions, and refills, helping you get care without stepping foot in a clinic.

Highlights:

- 🕒 24/7 access to virtual urgent care from your phone or computer
- 💊 $0 visits for most plans (excludes HSA and Secure plan types)
- ⚕️ Get treatment, prescriptions, or refills in minutes — no waiting rooms required

*Oscar’s Virtual Urgent Care offerings are not available in US territories or internationally. Prescriptions, visits and services may be limited per provider discretion.

Oscar’s Hospital Network

In Illinois, Oscar offers two networks, depending on the county – Oscar’s Choicenetwork and Oscar’s Select network.
Oscar’s Illinois Choice service area includes Cook, DuPage, Kane, Kendall, Lake, andWill counties.
Oscar’s Illinois Select service area includes Cook County

COUNTY	Choice	Select
BLACK HAWK
MercyOne Cedar Falls Medical Center	✅	✅
MercyOne Waterloo Medical Center	✅	✅
CERRO GORDO
MercyOne North Iowa Medical Center	✅	✅
COOK
Advocate Christ Medical Center	✅	✅
Advocate Illinois Masonic Medical Center	✅	✅
Advocate South Suburban Hospital	✅	✅
Advocate Trinity Hospital	✅	✅
Endeavor Health Evanston Hospital	✅
Endeavor Health Northwest Community Hospital	✅
Endeavor Health Skokie Hospital	✅
Endeavor Health Swedish Hospital	✅
Gottlieb Memorial Hospital	✅	✅
Holy Cross Hospital	✅	✅
Humboldt Park Health	✅	✅
Jackson Park Hospital & Medical Center	✅	✅
Loretto Hospital	✅	✅
Loyola University Medical Center	✅	✅
Macneal Hospital	✅	✅
Mount Sinai Hospital	✅	✅
South Shore Hospital	✅	✅
St. Bernard Hospital	✅	✅
Thorek Memorial Hospital	✅	✅
Uchicago Medicine	✅
Uchicago Medicine Ingalls Memorial Hospital	✅
West Suburban Medical Center	✅	✅
DALLAS
MercyOne West Des Moines Medical Center	✅	✅
DUBUQUE
MercyOne Dubuque Medical Center	✅	✅
DUPAGE
Advocate Good Samaritan Hospital	✅	✅
Endeavor Health Edward Hospital	✅
Endeavor Health Elmhurst Hospital	✅
JASPER
MercyOne Newton Medical Center	✅	✅
KANE
Advocate Sherman Hospital	✅	✅
LAKE
Advocate Condell Medical Center	✅	✅
Advocate Good Shepherd Hospital	✅	✅
Vista Medical Center East	✅
POLK
MercyOne Des Moines Medical Center	✅	✅
ROCK ISLAND
MercyOne Genesis Silvis Medical Center	✅	✅
SCOTT
MercyOne Genesis Davenport Medical	✅	✅
MercyOne Genesis Davenport West Medical Center	✅	✅
WILL
Silver Cross Hospital	✅	✅
WOODBURY
MercyOne Siouxland Medical Center	✅	✅