Oscar Health is expanding its reach in the individual market and plans to offer coverage in 504 markets in 18 states for the 2025 plan year.
Oscar's 2025 slate focuses on offering services to meet personal preferences and needs, according to the release. Within that framework, the company announced Monday that it will roll out new offerings and benefits like Buena Salud, which is designed for Spanish-speaking members.
Through the program, enrollees will connect with Oscar in Spanish and will be linked to a care team and primary care provider who "share their cultural heritage." A 2022 Pew Research Center poll found that Hispanic and Latinx patients are more likely to seek care if their provider speaks Spanish, Oscar noted.
The program builds on the existing Hola Oscar offering and was developed by native Spanish-speaking workers at the company. Hispanic and Latinx members account for close to one-third of Oscar's total enrollment and represent the fastest-growing population in the Affordable Care Act (ACA) market overall.
Oscar is also rolling out new plans targeted to people with multiple chronic conditions. The company already offers in several states the Diabetes Care and Breathe Easy plans, which are for patients with diabetes and pulmonary conditions, respectively.
The new option, however, combines services for people with diabetes, pulmonary conditions and cardiovascular needs, according to the announcement. These conditions are common in the ACA population, and addressing them together can reduce costs significantly. Oscar said an internal analysis suggests savings of 25% or more.
The plans include $0 visits to a cardiologist, pulmonologist or endocrinologist along with $0 screenings, labs, primary care, behavioral health care and medications.
“Oscar makes shopping for healthcare easy with plans that fit every budget,” said Mark Bertolini, CEO of Oscar Health, in the press release. “People have control over the products they buy and use in every part of their life, except healthcare. Oscar is changing that. We give people the freedom to select plans that work best for them. Our members understand what they are buying, what it costs, and how it compares to other products.”
Oscar's 2025 plans also double down on its interest in individual coverage health reimbursement arrangements and include a new HMO that it says is designed for people seeking a "guide" on their healthcare journey. People who enroll in Guided Care HMO will choose a primary care provider who works with a network of specialists to manage their care needs.
Benefits range from $0 virtual urgent care visits and medications to lower costs on labs, Oscar said.