Oscar Health API
The public surface is a CMS-mandated FHIR R4 Patient Access API served through 1upHealth with SMART on FHIR OAuth, plus provider directory and formulary endpoints. The +Oscar enterprise APIs are sales-gated. There is no broad self-serve REST API beyond the regulatory FHIR set.
Frequently asked questions
Oscar Health scores C on the API Report Card. The public surface is a CMS-mandated FHIR R4 Patient Access API served through 1upHealth with SMART on FHIR OAuth, plus provider directory and formulary endpoints. The +Oscar enterprise APIs are sales-gated. There is no broad self-serve REST API beyond the regulatory FHIR set.
Oscar Health has an official API, but teams routinely hit its limits: gated access, partial coverage, or paid tiers. Most end up supplementing it with exports or an unofficial API layer like Supergood.
Oscar Health is a publicly traded (NYSE: OSCR) technology-driven health insurance carrier founded in 2012 by Joshua Kushner, Kevin Nazemi, and Mario Schlosser, headquartered in New York City.
Primary vertical: Healthcare / Insurance, specifically the individual and small-group ACA marketplace, with growing ICHRA exposure. A member shops Oscar plans on healthcare.gov or hioscar.com during open enrollment, picks an HMO/EPO, and downloads the Oscar app to access their ID card, search in-network providers, message a Care Team, start a $0 virtual urgent-care visit, request prescription delivery, view claims/EOBs, and pay premiums.
Medium-high inside the ACA exchange segment, low across U.S. health insurance overall. Oscar reported approximately 3.4 million members for full-year 2025 (up from 1.7M end of 2024 and 1M end of 2023) and roughly $11.7B in 2025 revenue, with a 2026 outlook above $18B.
For members, Oscar's systems are the source of truth for active coverage status, deductible/OOP accumulators, in-network status of providers, prior-authorization decisions, prescription benefits, claims adjudication, and EOBs, silent failures in eligibility or claims APIs translate directly to denied care at the pharmacy counter, surprise bills, and care delays.
Founded October 2012, IPO'd March 3, 2021 on the NYSE under OSCR raising approximately $1.4B. Oscar is one of the older 'insurtech' carriers and one of the few survivors after Bright Health's collapse and Clover's struggles.
Grades measure one thing: can a customer's engineering team get their own data out programmatically? We check six things (whether a real API exists, how access is gated, data coverage, auth quality, docs and developer experience, and stability) and roll them into a letter grade. Grades get re-verified, and they only move on evidence.