At the HLTH25 conference in Las Vegas, Oscar Health and Elektra Health announced a novel Affordable Care Act plan designed for individuals navigating menopause, signaling an insurer response to a long-neglected phase of reproductive health. The launch, timed for the 2026 open enrollment window, comes as Oscar expands its footprint and introduces member-facing innovations intended to simplify coverage and encourage engagement.

Oscar said the 2026 plans will be sold in 573 counties across 20 states, including new market entries in Alabama and Mississippi. Open enrollment on the ACA exchanges begins Nov. 1. Alongside the menopause-focused product, Oscar is rolling out a digital reward program called Oscar Unlocks, which offers perks for completing healthy activities or administrative tasks such as shifting to paperless billing.

Company leaders framed the offerings as part of a broader strategy to make insurance more navigable and personalized. "We're really big on this idea that choice is power and within the marketplace, it has dynamics that allow us to create really personalized plan features that you can't get in a commercial marketplace or in Medicaid or Medicare," Liang said.

The introduction of menopause-specific coverage on the exchanges is notable for public health and equity advocates. Menopause spans years for many people and can involve symptoms and health risks that intersect with chronic disease management, workplace participation, and mental health. For lower-income people and those in states with limited supplemental benefits, ACA marketplace plans are often the primary route to comprehensive outpatient care. Tailored benefits could reduce out-of-pocket barriers to therapies and supportive services, but the extent of that impact will depend on benefit design, cost-sharing amounts, and provider networks.

The announcement raises policy questions about how private plans on the exchanges are addressing historically underrecognized needs and whether these targeted products will meaningfully close gaps in care. Marketplace plans can innovate with supplemental features, but they operate in a fragmented landscape where access varies by geography and income. Expansion into Alabama and Mississippi, states with sizeable rural populations and high uninsured rates in recent years, underscores potential to reach underserved communities, yet it also underscores the need for careful monitoring of affordability and network adequacy.

Community advocates will be watching whether the new offerings translate into real-world improvements: clearer coverage for symptomatic care, access to trained clinicians, and support for the social and workplace disruptions that can accompany midlife transitions. Digital rewards and personalization tools may help drive preventive care engagement, but such programs risk leaving behind those with limited digital access unless paired with outreach and alternative enrollment supports.

Oscar’s move reflects a broader marketplace trend of insurers designing specialty products aimed at specific populations. For policymakers and public health leaders, the priority will be ensuring these innovations advance equity and do not simply broaden choice for those already well-served. As open enrollment approaches, consumers and community health organizations will need transparent details about benefits, costs, and how plans meet the complex needs of people experiencing menopause.