Moda Health group pharmacy benefits
Help your clients access medications easily and affordably
Moda Health offers flexible, transparent pharmacy benefits designed to support employer benefit strategies for cost management, while making prescriptions accessible for members. From broad pharmacy networks to innovative formulary management, our programs are built to fit your clients’ needs.
Why choose Moda Health pharmacy benefits
Extensive network access
Access to national retail networks including local and most chain pharmacies
Flexible formulary options:
Tiered pricing strategies to balance cost and access
Convenient prescription options:
90-day supplies, local retail and mail-order choices
Specialty pharmacy support:
Coordinated care for complex conditions through Ardon Health
Preferred drug program
Our preferred drug program uses tiers to deliver the right prescriptions at the right price.
- Tiers include: Value, Select, Non-Preferred, Preferred Specialty and Non-Preferred Specialty
- Each tier has a different copay or coinsurance, depending on the plan design
- Tier management helps keep pharmacy benefits sustainable while offering members affordable choices
Navitus pharmacy network
Members have access to nearly every major retail chain and thousands of independent pharmacies throughout the country.
Mail-order and 90-day supply options
For members managing chronic conditions, mail-order services and extended-day supplies make treatment more convenient and can improve adherence.
- 90-day retail fills at participating pharmacies – often at mail-order pricing
- Mail-order services through Costco or Postal Prescription Services (PPS)
Specialty medications
Ardon Health delivers specialty medications directly to members’ homes and provides
- Condition-specific education and support
- Coordination with prescribers
Formularies and medication tiers
Members can search our formulary to see medications by tier, coverage level and cost.
- Prescription drug list for Large Group
- Interactive preferred drug list for plans coverage and details
Producer resources
- Locate a pharmacy
- View formularies
- Producer Dashboard for underwriting guidelines and plan documents
Want to learn more?
Your Moda Health sales team is here to help you compare options, generate quotes and find the right fit for each of your clients.