Oscar vs. Ambetter

By the Florida Plan Finder Team | Licensed Florida Health Insurance Producer | Last Updated: May 25, 2026

Key Takeaways

Oscar Health, built specifically for the ACA marketplace in 2012, posts one of Florida's lowest 2026 increases at 26.4% but sells only in select metro counties. Ambetter, sold by Centene's Florida entity, carries one of the largest marketplace enrollments in the state but also one of 2026's steepest approved increases at 37.9%. Both compete on Florida's 2026 ACA marketplace, where 16 insurers now participate and the statewide weighted-average rate rose roughly 31.5% before subsidies — but the two carriers take very different approaches to networks, plan types, and price.

This comparison breaks down how Oscar and Ambetter differ on county availability, provider networks, plan types, 2026 premiums, and member experience — and which type of Florida enrollee each one fits best.

Compare Oscar & Ambetter Plans in Your County

A licensed Florida agent can pull Oscar and Ambetter quotes for your ZIP and confirm whether your doctors are in-network with each — at no cost to you.

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Oscar Health — Strengths

$0 telehealth and a leading app: Oscar offers $0 virtual visits 24/7 through its app for many common conditions — a standout for Bronze and high-deductible enrollees who would otherwise pay full price for office visits before meeting the deductible. Its app is consistently among the highest-rated in health insurance.

Dedicated Care Teams: Instead of a rotating call center, Oscar assigns each member a small Care Team of guides and a nurse who handle every interaction, creating continuity that traditional carriers rarely match.

Competitive metro pricing: In the counties where Oscar competes — primarily South Florida, Central Florida, and the Tampa Bay region — its Silver HMO plans are often among the lowest-cost, and its 26.4% approved increase for 2026 is one of the gentlest among Florida carriers.

Ambetter from Centene (Celtic Insurance) — Strengths

Low premiums and broad footprint: Ambetter is consistently among the lowest-cost options in Florida's most populous counties and has long carried one of the largest marketplace enrollments in the state. For subsidy-eligible shoppers who choose by price, Ambetter's Silver plans are frequently at or near the benchmark.

My Health Pays rewards: Ambetter members can earn My Health Pays reward dollars for completing a wellness visit, annual checkup, or health survey — funds that can offset premiums or be spent on everyday health items. It is one of the more generous wellness-incentive programs on the Florida exchange.

Centene scale and managed-care roots: Ambetter is backed by Centene, the country's largest Medicaid managed-care organization, which gives it deep experience serving lower-income and subsidy-eligible members transitioning between Medicaid and marketplace coverage.

Side-by-Side Comparison

Feature Oscar Ambetter
Founded / status 2012 (ACA-native) Centene's ACA brand; in FL since 2014
Plan types HMO only HMO / EPO
Florida county availability Select metro counties Broad — most populous FL counties
Telehealth $0 telehealth via Oscar app (24/7) Ambetter Telehealth included
Provider network Narrower; curated metro networks Large but value-tiered
Out-of-network coverage Emergency only Emergency only
Signature feature Dedicated Care Team; top-rated app My Health Pays rewards
2026 approved rate change +26.4% (one of the lowest in FL) +37.9% (one of the steepest in FL)

Network Differences

Oscar's Florida networks are curated rather than comprehensive — selected hospitals and physician groups in the metros it serves, HMO-only, with no out-of-network coverage except emergencies. Because Oscar is not statewide, your first check is simply whether it is sold in your county at all.

Ambetter manages cost through value-tiered networks that are broad in major metros but narrower than Florida Blue's. Its 37.9% approved increase for 2026 is among the highest in the state, so its historic price edge narrows in some counties — always confirm your doctors are in the specific Ambetter network for your plan.

The network gap between these two carriers is the single most important thing to check before you enroll, because an ACA plan only pays in full when you stay in its network.

Check Your Doctors Before You Switch Because both plans cover out-of-network care only in limited situations, search each carrier's provider directory for every doctor and hospital you use before enrolling. A plan is only a bargain if your providers are in its network.

2026 Premium Comparison

Sticker premiums rose across the board for 2026 — Florida's statewide weighted average climbed about 31.5% before subsidies. The illustrative Silver-plan figures below show how Oscar and Ambetter compare in counties where both compete.

County (35-yr-old, non-smoker, Silver) Oscar Ambetter
Miami-Dade County ~$480/mo ~$470/mo
Orange (Orlando) County ~$450/mo ~$445/mo
Hillsborough (Tampa) County ~$440/mo ~$435/mo

Approximate 2026 unsubsidized premiums for a 35-year-old non-smoker, before APTC subsidies. What you actually pay is set by the benchmark Silver plan in your rating area; more than 95% of Florida enrollees qualify for a subsidy. As a reference point, regulators cited a 28-year-old in Duval County on a Silver plan moving from about $149 to roughly $281 per month for 2026.

Who Should Choose Oscar

Who Should Choose Ambetter

Frequently Asked Questions

Are both Oscar and Ambetter available in my Florida county?

Oscar Health is available in select Florida counties only — primarily South Florida, Central Florida, and the Tampa Bay region. It is not statewide, and it offers HMO plans exclusively. Always confirm with your ZIP code on HealthCare.gov whether Oscar is sold in your county. Ambetter, sold through Centene's Florida company, is available across most of Florida's populous counties for 2026 and carries one of the largest marketplace enrollments in the state. It offers HMO and EPO plans — there is no Ambetter PPO.

Does Oscar really offer free telehealth in Florida?

Yes. Oscar Health offers $0 telehealth visits with Oscar-affiliated providers, available 24/7 through its app for many common conditions, prescriptions, and mental-health consultations. It is one of Oscar's signature benefits and is especially valuable on Bronze or high-deductible plans where in-person visits cost full price until the deductible is met.

Which costs less in Florida for 2026, Oscar or Ambetter?

It depends on your county and subsidy. For 2026, Oscar's approved rate change was +26.4% (one of the lowest in FL) and Ambetter's was +37.9% (one of the steepest in FL), but what you actually pay is set by the benchmark Silver plan in your rating area after the Advance Premium Tax Credit. More than 95% of Florida marketplace enrollees receive a subsidy, so compare the net premium for the specific Silver plans offered at your ZIP code rather than the sticker price.

Should I choose Oscar or Ambetter?

Choose Oscar if you are tech-comfortable and prefer managing coverage in an app. Choose Ambetter if you are subsidy-eligible and shopping primarily on price. The deciding factors are usually county availability, whether your doctors are in each network, plan type (HMO only vs. HMO / EPO), and the net premium after subsidies.

A licensed Florida health insurance agent can compare your 2026 options county by county and check whether your providers are in-network — at no cost to you.

Compare Plans in Your County

Related reading: Florida ACA Guide Hub | Oscar vs. Florida Blue | Ambetter vs. Molina | SunState Coverage

Licensed Florida Health Insurance Producer · NPN #21249133 ·
This resource is maintained by a licensed Florida health insurance producer. Information on this page is for general reference and is not legal or financial advice. Verify current plan details at HealthCare.gov before enrolling.