Insurance startup Oscar Health is planning another big expansion for next year. The company plans to offer individual and family plans in 19 new markets, including four new states: Arkansas, Iowa, Oklahoma and North Carolina — pending regulatory approval.
Oscar started in 2012, offering individual plans on state ACA exchanges. Since then, it has expanded to offer Medicare Advantage plans, and more recently teamed up with Cigna to offer co-branded small group plans.
In June, the company raised $225 million in funding led by Baillie Gifford and Coatue Management.
The company is also rolling out a benefit that would give its members free access to virtual primary care visits. While several insurers have temporarily waived telehealth copays in light of the ongoing Covid-19 pandemic, Oscar is structuring a new plan option around virtual primary care.
“We have been thinking about and working on a virtual primary care offering for a few years now, but COVID has definitely accelerated our timeline for bringing it to market,” an Oscar spokeswoman wrote in an email.
The benefit includes unlimited telehealth primary care visits, certain prescriptions, labs and diagnostic imaging orders with no copay. Initial specialist referrals would also available with no copay. Oscar expects to offer virtual primary care in 10 markets next year, including Miami, Denver, Dallas, Los Angeles and New York, subject to regulatory approval.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
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