Does Oscar Health cover GLP-1s?

What Oscar Health says on its own pages (hioscar.com), sorted by topic. Your own plan documents decide what you get.

Read Sep 28, 2026. Each line names the plan type it applies to.

Does it depend on your employer or plan?

Oscar states coverage is subject to the member’s policy terms and applicable state and federal law.Employer and commercial plans:Coverage of services is subject to the terms, conditions, limitations of a member’s policy and applicable state and federal law.hioscar.com, Sep 29, 2026

Oscar’s pharmacy clinical guidelines establish clinical criteria for utilization management decisions.Individual (ACA) plans:Clinical guidelines are developed and adopted to establish evidence-based clinical criteria for utilization management decisions.hioscar.com, Sep 29, 2026
Oscar lists a current pharmacy clinical guideline titled “Weight Loss Agents” (PG070, Ver. 10); the criteria themselves are in a PDF.Employer and commercial plans:Weight Loss Agents (PG070, Ver. 10)hioscar.com, Sep 29, 2026
Oscar says its clinical guidelines apply to all commercial policies.Employer and commercial plans:The clinical guidelines are applicable to all commercial policies.hioscar.com, Sep 29, 2026

Oscar has a pharmacy clinical guideline for Zepbound for obstructive sleep apnea (PG255, Ver. 4); criteria are in a PDF.Employer and commercial plans:Zepbound (tirzepatide) for the Treatment of Obstructive Sleep Apnea (PG255, Ver. 4)hioscar.com, Sep 29, 2026
Oscar also has a New York-specific Zepbound OSA guideline (PG276, Ver. 2).Employer and commercial plans:Zepbound (tirzepatide) for the Treatment of Obstructive Sleep Apnea - New York (PG276, Ver. 2)hioscar.com, Sep 29, 2026

Oscar has a pharmacy clinical guideline for Wegovy for cardiovascular risk reduction or MASH (PG194, Ver. 6); criteria are in a PDF.Employer and commercial plans:Wegovy (semaglutide) for Cardiovascular Risk Reduction or Metabolic Dysfunction-Associated Steatohepatitis (MASH) (PG194, Ver. 6)hioscar.com, Sep 29, 2026

Oscar has a pharmacy clinical guideline for antidiabetic GLP-1 receptor agonists (PG152, Ver. 9); criteria are in a PDF.Employer and commercial plans:Antidiabetic Agents - Glucagon-like Peptide-1 (GLP-1) Receptor Agonists (PG152, Ver. 9)hioscar.com, Sep 29, 2026

Oscar members check coverage with the prescription search tool in their account/app or the Drug Formulary, which shows limits and whether pre-authorization is needed.Individual (ACA) plans:Log in to your Oscar account or app and use the prescription search tool to see if your medications are covered and what you can expect to pay. Or check out our Drug Formulary here (opens in new tab). It lists all the medications your plan covers (along with maximum dosage, quantity, and whether you’ll need pre-authorization).hioscar.com, Sep 29, 2026
To confirm coverage, Oscar tells providers to check the member’s policy documents or call (855) 672-2755.Employer and commercial plans:Please reference the member’s policy documents (e.g., Certificate/Evidence of Coverage, Schedule of Benefits) or to confirm coverage for Oscar Plans, contact (855) 672-2755.hioscar.com, Sep 29, 2026

No web page from Oscar Health that we could read covers: does it cover glp-1s for weight loss; recent changes.
More detail, such as exact BMI cutoffs, is in 6 PDF documents from Oscar Health, which we have not opened.
1 of its pages blocked automated reading.