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1. Company Snapshot

1.a. Company Description

Oscar Health, Inc.provides health insurance products and services in the United States.The company offers Individual & Family, Small Group, and Medicare Advantage plans, as well as +Oscar, a technology driven platform designed to help providers and payor clients to engage with members and patients.


It also provides reinsurance products.The company was formerly known as Mulberry Health Inc.and changed its name to Oscar Health, Inc.


in January 2021.Oscar Health, Inc.was incorporated in 2012 and is headquartered in New York, New York.

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1.b. Last Insights on OSCR

Oscar Health's recent performance was driven by strong growth prospects and an attractive valuation. The company's Q4 2025 earnings revealed a revenue increase to $2.81 billion, driven by individual member retention and technology-driven operational efficiency. For 2026, Oscar Health targets $18.7-19.0B revenue, 82.4-83.4% MLR, and $250-450M operating earnings. Piper Sandler analysts upgraded their rating, citing optimism for revenue growth and market share gains. Additionally, AXQ Capital LP increased its holdings by 168.9%. The company's focus on AI-driven cost reductions and targeted product offerings supports margin expansion.

1.c. Company Highlights

2. Oscar Health's 2025 Earnings Report: A Strong Foundation for 2026 Growth

Oscar Health's total revenue for 2025 surged 28% year-over-year to $11.7 billion, driven by significant membership growth, partially offset by an increase in the net risk adjustment payable. The company's SG&A expense ratio improved by approximately 160 basis points year-over-year to 17.5%, demonstrating the effectiveness of their cost management strategies. The actual EPS came out at '-1.24489', missing estimates at '-0.9214'. Analysts estimate next year's revenue growth at 3.2%, indicating a slowdown in growth momentum.

Publication Date: Feb -17

📋 Highlights
  • Revenue Growth:: Total revenue rose 28% YoY to $11.7 billion in Q4 2025, driven by membership expansion despite a net risk adjustment payable increase.
  • SG&A Efficiency:: SG&A expense ratio improved 160 bps YoY to 17.5%, with further 140 bps improvement expected in 2026 (target 15.8–16.3%).
  • 2026 EBIT Outlook:: Earnings from operations projected at $250–450 million in 2026, a $750 million improvement YoY, with 1.9% operating margin at midpoint.
  • 2026 Revenue Guidance:: Total revenue expected to reach $18.7–$19 billion in 2026, up 61% YoY at the midpoint, fueled by a 28% weighted rate increase and strong retention.
  • Medical Loss Ratio (MLR):: MLR projected to narrow 450 bps YoY to 82.4–83.4% in 2026, reflecting improved risk adjustment (20% of direct premiums) and member mix.

Guidance for 2026: Strong Revenue Growth and Improved Profitability

Oscar Health expects total revenues to be in the range of $18.7 billion to $19 billion in 2026, representing a 61% year-over-year increase at the midpoint. This growth is driven by above-market growth during open enrollment, solid retention, and rate increases. The weighted average rate increase for 2026 was approximately 28%. The company expects earnings from operations to be in the range of $250 million to $450 million, a significant improvement of nearly $750 million year-over-year, implying an operating margin of approximately 1.9% at the midpoint.

Risk Adjustment and Medical Loss Ratio: Key Factors to Watch

Oscar Health expects risk adjustment as a percentage of direct premiums to be approximately 20% in 2026. The company's medical loss ratio is expected to be in the range of 82.4% to 83.4%, representing 450 basis points of year-over-year improvement at the midpoint. As Richard Blackley noted, "Oscar is picking up a large share of young, healthy members, which is driving risk adjustment higher." This highlights the importance of managing risk adjustment and medical loss ratio to achieve profitability.

Valuation Metrics: Assessing What's Priced In

Oscar Health's current valuation metrics indicate a mixed picture. The P/S Ratio stands at 0.3, while the EV/EBITDA ratio is -2.9, suggesting that the market is pricing in significant growth and improvement in profitability. The P/B Ratio is 3.89, indicating that the stock is trading above its book value. With a Net Debt / EBITDA ratio of 6.0, the company's leverage is a concern. As Oscar Health navigates the challenges of risk adjustment and medical loss ratio, investors will be watching these metrics closely to assess the company's progress towards achieving profitability.

3. NewsRoom

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The Best Stocks to Invest $1,000 in This February

Feb -17

Source: fool.com

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Oscar Health: Macro Headwinds Hurt In 2025 Are Expected; Eyes On Massive Price Discovery In 2026

Feb -13

Source: seekingalpha.com

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Oscar Health Q4: Tricky 2025, Promising 2026 - Long-Term Bull Thesis Attractive

Feb -11

Source: seekingalpha.com

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Oscar Health Stock Is a Screaming Buy Right Now

Feb -11

Source: fool.com

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Why Oscar Health Stock Ticked up on Tuesday

Feb -11

Source: fool.com

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Oscar Health Bets On 2026 Profit Turnaround After Tough 2025

Feb -10

Source: benzinga.com

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Oscar Health, Inc. (OSCR) Q4 2025 Earnings Call Transcript

Feb -10

Source: seekingalpha.com

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Oscar Health (OSCR) Q4 Earnings: Taking a Look at Key Metrics Versus Estimates

Feb -10

Source: zacks.com

4. Business Breakdown

4.a. Revenues by Country

4.b. Revenues by Segment

5. Expected revenues mid-term growth (9.98%)

6. Segments

Insurance and Related Activities

Expected Growth: 9.98%

Oscar Health, Inc.'s 9.98% growth in Insurance and Related Activities is driven by increasing demand for affordable healthcare, expansion into new markets, and strategic partnerships. Additionally, the company's user-friendly technology platform and data-driven approach to healthcare have improved customer engagement and retention, contributing to its growth.

7. Detailed Products

Individual and Family Plans

Oscar Health offers individual and family health insurance plans that provide comprehensive coverage for medical expenses, including doctor visits, hospital stays, and prescriptions.

Small Group Plans

Oscar Health offers small group health insurance plans designed for businesses with 1-50 employees, providing comprehensive coverage and flexible plan options.

Medicare Advantage Plans

Oscar Health offers Medicare Advantage plans that provide comprehensive coverage for seniors and individuals with disabilities, including medical, hospital, and prescription drug coverage.

Oscar for Business

Oscar for Business is a health insurance platform designed for larger businesses, providing customizable plan options, data analytics, and personalized support.

Oscar Virtual Care

Oscar Virtual Care is a telemedicine platform that provides 24/7 access to virtual doctor visits, allowing members to receive medical care from the comfort of their own homes.

8. Oscar Health, Inc.'s Porter Forces

Forces Ranking

Threat Of Substitutes

Oscar Health, Inc. operates in a highly competitive market with many substitutes available, but its unique selling proposition and customer loyalty programs help to mitigate the threat.

Bargaining Power Of Customers

Oscar Health, Inc. customers have a high bargaining power due to the availability of alternative health insurance providers, which can lead to a loss of customers if prices are not competitive.

Bargaining Power Of Suppliers

Oscar Health, Inc. has a diversified supplier base, which reduces the bargaining power of individual suppliers, and the company's scale of operations also gives it negotiating power.

Threat Of New Entrants

While there are barriers to entry in the health insurance market, new entrants can still disrupt the market, and Oscar Health, Inc. needs to continuously innovate to stay ahead of the competition.

Intensity Of Rivalry

The health insurance market is highly competitive, with many established players, and Oscar Health, Inc. needs to differentiate itself through its products and services to gain market share.

9. SWOT Analysis

Strength

Weaknesses

Opportunities

Threats

10. Capital Structure

10.a. Balance Sheet

10.b. Weighted Average Cost of capital

Value
Debt Weight 27.09%
Debt Cost 8.13%
Equity Weight 72.91%
Equity Cost 12.19%
WACC 11.09%
Leverage 37.16%

11. Quality Control: Oscar Health, Inc. passed 3 out of 9 key points

12.a Historical Valuation

12.b Price/Earnings Ratio

12.c Margin Valuation

12.d Peers Valuation

Peers Group Analysis

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Neurocrine Biosciences

A-Score: 5.8/10

Value: 2.0

Growth: 9.3

Quality: 8.5

Yield: 0.0

Momentum: 8.5

Volatility: 6.7

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United Therapeutics

A-Score: 5.6/10

Value: 3.9

Growth: 8.6

Quality: 7.9

Yield: 0.0

Momentum: 9.0

Volatility: 4.3

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Viatris

A-Score: 5.2/10

Value: 8.9

Growth: 2.0

Quality: 3.2

Yield: 7.0

Momentum: 3.0

Volatility: 7.0

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Elevance Health

A-Score: 5.0/10

Value: 6.4

Growth: 5.7

Quality: 6.8

Yield: 3.0

Momentum: 2.0

Volatility: 6.3

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Molina Healthcare

A-Score: 4.0/10

Value: 8.4

Growth: 6.3

Quality: 5.7

Yield: 0.0

Momentum: 0.0

Volatility: 3.7

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Oscar Health

A-Score: 4.0/10

Value: 8.2

Growth: 8.1

Quality: 2.6

Yield: 0.0

Momentum: 3.5

Volatility: 1.3

1-Year Total Return ->

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Peers Metrics

12.e Scoring Insights

12.f DCF BETA

Parameters

Short Term Growth

Short term Time

Long-Term Growth

WACC

Target Price

13.23$

Current Price

13.23$

Potential

-0.00%

Expected Cash-Flows