Meet Oscar’s Chronic Care Plan | Blog | Oscar | hioscar Blog | Oscar
Meet Oscar’s Chronic Care Plan
In 2025, Oscar is launching a multi-condition plan for members with diabetes, pulmonary, and cardiovascular disease.
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At Oscar, we believe that healthcare isn’t one size fits all. Individuals have unique health needs based on many factors, including whether or not they live with a chronic illness. Chronic conditions such as high blood pressure, diabetes, or arthritis affect 6 in 10 adults (opens in new tab) in the US. Annually, individuals with chronic illnesses spend approximately five times (opens in new tab) more on medical expenses than people without chronic illnesses. Ninety percent of the nation’s $4.5 trillion in annual healthcare expenditures are for people with chronic and mental health conditions. Individuals managing chronic conditions deserve health plans that can help them navigate their care and manage expenses.
In 2025, Oscar is launching a multi-condition plan for members with diabetes, pulmonary, and cardiovascular disease – three common conditions impacting ACA members (opens in new tab). The plan makes it easier for members managing multiple chronic conditions to stay healthy.
Cardiovascular-kidney-metabolic (CKM) (opens in new tab) syndrome is a complex condition that includes cardiovascular disease, kidney disease, obesity and type 2 diabetes (1). Oscar helps uncomplicate CKM care by providing a unique solution that supports multiple CKM-related services in a more affordable way. Oscar’s Chronic Care Plan can reduce the cost of services that treat CKM syndrome by at least 25% (2), including many cardio-metabolic conditions that fall within CKM syndrome.
$50 toward healthy groceries when you complete an annual wellness exam
Access to gyms and on-demand fitness by the American Specialty Health Fitness’ Active&Fit program by completing any two routine services: hbA1c test, metabolic panel test, lipid test, UA (Urine Albumin) test, or diabetic eye exam. (5)
Oscar also offers single-condition plans (Diabetes Care Plan and Breathe Easy Plan), available in select states. (6)
Oscar’s Chronic Care Plan provides improved access to the medications, services, and treatments that can help our members feel their best. We offer personalized, member-focused health plans to meet the unique needs of our member base, and help make healthcare more accessible.
(1) Sources: Cleveland Clinic | What is CKM syndrome? Mass General Brigham | What is CKM Syndrome and Could You Have It?
(2) This plan is available in AZ, FL, GA, OH, and TX. In Georgia, the plan is named 'Silver Simple Multicondition.’
Source: 2024 Oscar internal analysis of average course of treatment for Diabetes, Pulmonary Related Conditions, CKM conditions. 25% savings is an average annual savings amount based on individual members who are on the base level Diabetes, Breathe Easy, Chronic Care CKM, or MultiCondition plans. Savings is an average for healthcare costs related to managing diabetes conditions, pulmonary related conditions, or multiple CKM conditions. Savings varies for members on Silver Cost Share reduction plans and Diabetes CSR150 plans. Note that treatment and costs for managing chronic conditions can vary widely and specific chronic condition plan names may vary by individual markets.
Oscar Medical coverage is underwritten by Oscar Insurance Company located in New York, New York. Plans sold in New York are underwritten by Oscar Insurance Corporation located in New York, New York. Plans sold in Florida are underwritten by Oscar Insurance Company of Florida. Plans sold in New Jersey are underwritten by Oscar Garden State Insurance Corporation. Administrative Services for all plans provided by Oscar Management Corporation.
Plans sold in Texas use policy and associated COC form numbers OSC-TX-IVL-HMO-EOC-2025-HIX OHIN-134128348; OSC-TX-IVL-HMO-EOC-2025 OHIN-134128297; GUIDED OSC-TX-IVL-HMO-GOLD-GUIDED-CARE-EOC-2025 OHIN-134128360; OSC-TX-IVL-EOC-2025 OHIN-134080911;OSC-TX-IVL-EOC-2025-HIX OHIN-134080906; OSC-TX-S-IVL-EOC-2025-HIX OHIN-134079760; OSC-TX-S-IVL-EOC-2025 OHIN-134079760. Plans sold in Virginia use policy and associated form numbers VA ON OSC-VA-IVL-EOC-2025-HIX OHIN-134065976; VA OFF OSC-VA-IVL-EOC-2025 OHIN-134065976.
HMO products are offered by Oscar Insurance Corporation and Oscar Buckeye State Insurance Corporation in Ohio, Oscar Health Plan, Inc. in Arizona and Illinois, Oscar Health Plan of Pennsylvania, Inc in Pennsylvania, Oscar Health Plan of Georgia in Georgia, Oscar Health Plan of North Carolina, Inc. in North Carolina, Oscar Managed Care of South Florida, Inc. in Florida, Oscar Health Plan of New York, Inc. in New York, and Oscar Managed Care in Texas.
All insurance policies and group benefit plans contain exclusions and limitations. For availability, costs, and complete details of coverage, contact a licensed agent or Oscar sales representative.
(3) Benefits and rewards can vary by Plan, and certain restrictions apply.
(4) Members must complete the flu vaccine and pneumonia vaccine in the same calendar year to earn the $25 reward.
(5) The Active&Fit program is provided by American Specialty Health Fitness, Inc. a subsidiary of American Specialty Health Incorporated (ASH). Active&Fit is a federally registered trademark of ASH. Once Oscar receives the required eligible claims, you’ll enjoy access to gyms and on-demand health classes through the remainder of the plan year, as long as you stay on the same plan.
(6) Silver Simple Diabetes plans are available in Florida, Texas, Iowa, Tennessee, Oklahoma, Georgia, Nebraska, Kansas, Missouri, North Carolina, Illinois, and Cleveland, Ohio. Silver Simple Breathe Easy COPD / Silver Simple Specialist Saver plans are available in Arizona, Oklahoma and Tennessee.
