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Oscar Health
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Latest analysis
Updated Nov 5, 2026
Oscar Health raises full-year 2026 earnings guidance for a third time as Q3 MLR improves 450 bps and risk adjustment data confirms favorable book positioning.
Oscar Health delivered its strongest quarter in company history, with Q3 2026 revenue of $5.1 billion (up roughly 70% year-over-year) and an MLR of 84%, 450 basis points better than the prior-year period, driven by disciplined pricing and moderately favorable utilization. A $250 million favorable risk adjustment settlement in Q3 — reflecting Oscar's improved relative risk position versus the market — accelerated confidence in reserve adequacy and enabled a third guidance raise, lifting the full-year earnings from operations midpoint to $900 million, $550 million above original guidance. Management enters 2027 open enrollment with a 14% weighted-average rate increase, a 24% larger county footprint, and explicit market share targets tied to 850,000 lives from competitor exits.
Tone: bullishRevenue
$11.7B
OSCR 10-K · FY 2025
Employees
2,305
Revenue FY2024
$9.2B
Founded
2012
Profile
OSCR 10-K Item 1 · Feb 13, 2026Oscar Health is a healthcare technology company that offers ACA-compliant individual and family health insurance plans powered by a proprietary cloud-native, end-to-end technology platform. The company serves approximately 2.0 million effectuated members across 18 states and deploys its technology externally through the +Oscar platform for providers and payors. In 2025, Oscar expanded into brokerage services and enrollment infrastructure through the acquisition of three early-stage businesses to support its ICHRA strategy.
Read filing description ↓ Collapse description ↑
Oscar is a leading healthcare technology company built around a full stack technology platform and a relentless focus on member experience. We offer health plans through the ACA serving individuals, families, and employees. We have been challenging the status quo in the healthcare system since our founding in 2012 and are dedicated to making a healthier life accessible and affordable for all. Our technology drives superior experiences, deep engagement, and high-value clinical care, earning us the trust of approximately 2.0 million effectuated members, as of December 31, 2025. In addition to supporting our insurance business, our differentiated technology platform also powers both providers and payors through +Oscar. We offer Campaign Builder, an engagement and recommendation platform that leverages the wisdom from 13+ years of building the Oscar member experience. The platform leverages data and AI to identify high value opportunities for engagement and to deliver personalized interactions to improve care with real time reporting and analytics to measure key outcomes and insights. In 2025, we also acquired early-stage businesses with capabilities to help us power Individual Coverage Health Reimbursement Arrangements ('ICHRA') and further diversify the Company. These assets include Lucie, Inc. (f/k/a INSXCloud, Inc.), a direct enrollment technology platform; IHC Specialty Benefits, Inc., an individual market brokerage; and Healthinsurance.org, LLC, a consumer education website. Oscar's innovative technology-enabled model - made up of Oscar's insurance business, +Oscar platform, and brokerage services, and enrollment platform - is uniquely positioned to meet the rising expectations of individuals, families, brokers, employers and employees, as well as +Oscar clients.
Primary products
- ACA individual health plans (Catastrophic, Bronze, Silver, Gold, Platinum)
- +Oscar Campaign Builder
- Lucie, Inc. direct enrollment technology platform
- IHC Specialty Benefits individual and supplemental health products
- Healthinsurance.org consumer education website
- Virtual care
Business segments
End markets
Geographies
Named customers
For the year ended December 31, 2025, 93% of premiums were earned directly from CMS and 7% were from our members.
“We believe that our principal competitive features affecting our ability to retain and increase membership include the range and prices of health plans offered, breadth and quality of provider network, comprehensiveness of coverage, benefits and wellness programs, quality of service, and member experience, responsiveness to member needs, market presence, financial stability, and reputation.” Competitive position, as stated in the filing
Revenue commentary · FY 2025
Total revenue increased from approximately $9.18 billion in 2024 to approximately $11.70 billion in 2025, driven primarily by growth in premium revenue as membership expanded from approximately 1.68 million to 2.04 million effectuated members.
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