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2023 medical networks

Moda Health is pleased to offer its members a variety of plan types to help fit their healthcare needs. Below are the 2023 medical provider networks for our Oregon individual, small group, and large group members. Members save money by seeing in-network providers. Check medical plan summaries to see which medical network is included with each plan.

Connexus Network

This is one of the largest preferred provider organization (PPO) medical networks in Oregon. It includes thousands of primary care providers and specialists working together with Moda Health to help keep members healthy. Groups located anywhere in Oregon can choose a plan with this network. Members can see in-network providers in all counties in Oregon and some areas in Washington and Idaho.

Health systems participating in Connexus include:

  • Adventist Health
  • Asante Health System
  • Bay Area Hospital
  • Blue Mountain Hospital
  • Columbia Memorial Hospital
  • Coquille Valley Hospital
  • Curry General Hospital
  • Good Shepherd Medical Center
  • Grande Ronde Hospital
  • Harney District Hospital
  • Hillsboro Medical Center
  • Lake District Hospital
  • Legacy Health
  • McKenzie-Willamette Medical Center
  • Mercy Medical Center
  • Mid-Columbia Medical Center
  • Morrow County Health District
  • OHSU Hospitals and Clinics
  • PeaceHealth
  • Providence Health and Services
  • Salem Health
  • Samaritan Health Services
  • Santiam Hospital
  • Silverton Hospital
  • Sky Lakes Medical Center
  • Saint Alphonsus Regional Medical Center - Baker City
  • Saint Alphonsus Regional Medical Center - Ontario
  • St. Anthony Hospital
  • St. Charles Health System
  • Tillamook County General Hospital
  • Wallowa Memorial Hospital
  • Willamette Valley Medical Center

Synergy Network

The Synergy network offers an integrated care experience to members living throughout the state, as well as border counties in Washington and Idaho. This network connects members to a Moda Medical Home or PCP360, who work together to coordinate care, and keep members feeling their best.

Health systems participating in Synergy include:

  • Adventist Health
  • Asante Health System
  • Bay Area Hospital
  • Blue Mountain Hospital
  • Columbia Memorial Hospital
  • Good Shepherd Medical Center
  • Grande Ronde Hospital
  • Harney District Hospital
  • Hillsboro Medical Center
  • Lake District Hospital
  • Legacy Health
  • Mercy Medical Center
  • Mid-Columbia Medical Center
  • Morrow County Health District
  • OHSU Hospitals and Clinics
  • PeaceHealth
  • Salem Health
  • Samaritan Health Services
  • Santiam Hospital
  • Silverton Hospital
  • Sky Lakes Medical Center
  • Saint Alphonsus Regional Medical Center - Baker City
  • Saint Alphonsus Regional Medical Center - Ontario
  • St. Anthony Hospital
  • St. Charles Health System
  • Tillamook County General Hospital
  • Wallowa Memorial Hospital
  • Willamette Valley Medical Center

Moda Select Network

Moda Select offers a personalized care experience though a clinically integrated relationship with Oregon Health & Science University (OHSU). This network is available to small groups who purchase health coverage directly from Moda or through the federal marketplace exchange. The plan is sold in three Oregon counties, Clackamas, Multnomah, and Washington.

Health systems participating in Moda Select include:

  • Adventist Health
  • Hillsboro Medical Center
  • OHSU Hospitals and Clinics

Beacon EPO Network

The Beacon EPO Network offers a personalized care experience that gives members quick access to quality care at an affordable cost. This network is available to individuals who purchase health coverage directly from Moda or through the federal marketplace exchange, and reside in Clackamas, Clatsop, Columbia, Coos, Curry, Hood River, Jackson, Josephine, Multnomah, Tillamook, Wasco, Washington or Yamhill counties. Beacon EPO plans are only available to members who reside within the Beacon EPO service area. Beacon EPO members are required to select an in-network Primary Care Physician.

Health systems participating in Beacon EPO include:

  • Adventist Health
  • Asante Health System
  • Bay Area Hospital
  • Columbia Memorial Hospital
  • Curry General Hospital
  • Hillsboro Medical Center
  • Mid-Columbia Medical Center
  • OHSU Hospitals and Clinics
  • Providence Medford Medical Center
  • Southern Coos Hospital
  • Tillamook Regional Medical Center
  • Willamette Valley Medical Center

To choose an in-network primary care provider (PCP), members can go to ShopModaPlans.com to search for a Beacon EPO provider or confirm that their PCP is in-network.

Affinity EPO Network

The Affinity EPO Network offers a personalized care experience that gives members quick access to quality care at an affordable cost. This network is available to individuals who purchase health coverage directly from Moda or through the federal marketplace exchange, and reside in Baker, Crook, Douglas, Gilliam, Grant, Harney, Jefferson, Klamath, Lake, Lane, Malheur, Marion, Morrow, Polk, Sherman, Umatilla, Union, Wallowa or Wheeler counties. Affinity EPO plans are only available to members who reside within the Affinity EPO service area. Affinity EPO members are required to select an in-network Primary Care Physician.

Health systems participating in Affinity EPO include:

  • Blue Mountain Hospital
  • Good Shepherd Medical Center
  • Grande Ronde Hospital
  • Harney District Hospital
  • Lake District Hospital
  • Mercy Medical Center
  • Morrow County Health District
  • PeaceHealth
  • Salem Health
  • Santiam Memorial Hospital
  • Sky Lakes Medical Center
  • Saint Alphonsus Regional Medical Center - Baker City
  • Saint Alphonsus Regional Medical Center - Ontario
  • St. Anthony Hospital
  • St. Charles Health System
  • Wallowa Memorial Hospital

To choose an in-network primary care provider (PCP), members can go to ShopModaPlans.com to search for an Affinity EPO provider or confirm that their PCP is in-network.

Please note: Beginning Jan. 1, 2019, all Oregon Individual plans including Beacon EPO and Affinity EPO, will be connected to an Exclusive Provider Organization (EPO) network. Individual EPO plans do not have out-of-network benefits, so it is important that your patients are referred to providers within the Individual plan and network in which the patient is enrolled.

Please review your patient's Moda member ID card and check our provider directory Findcare, to ensure care is referred to other in-network Beacon EPO or Affinity EPO providers. Services provided to Moda Individual members by out-of-network providers will result in higher costs for patients enrolled in these plans.

Moda Health is pleased to offer its members a variety of plan types to help fit their healthcare needs. Below are the 2023 medical provider networks for our Alaska small group members. Members save money by seeing in-network providers. Check medical plan summaries to see which medical network is included with each plan

Endeavor Providence Network
This Alaska network covers participating physicians, clinics and ancillary providers throughout the state for our large group clients. It includes Providence Alaska Medical Center as the preferred provider of acute care services in the Anchorage area. Members also have access to the First Choice network. The Endeavor Providence Network includes over 1,100 physicians and nearly 20 hospitals. A complete listing of Endeavor Providence Network providers may be found at modahealth.com.

Endeavor Select Network
This Alaska network covers participating physicians, clinics and ancillary providers throughout the state for groups of all sizes (excluding individual). It includes Alaska Regional Hospital as the preferred provider of acute care services in the Anchorage area. Members also have access to the First Choice PPO panel for providers in Alaska.

Pioneer Network
The Pioneer Network is a network for members on individual, small and large group plans. It was developed to provide cost-effective, coordinated care for residents of the Anchorage, Fairbanks North Star, Kenai Peninsula boroughs, Ketchikan Gateway, Mat-Su and Prince of Wales-Hyder Census Area. Pioneer offers three benefit levels (tiers) of healthcare:

  • Tier One
    • Alaska Regional Hospital
    • Bartlett Regional Hospital
    • Central Peninsula Hospital
    • Fairbanks Memorial
    • Mat-Su Regional Medical Center
    • PeaceHealth Ketchikan Medical Center
    • South Peninsula Hospital
    • Moda contracted providers and First Choice (for network adequacy)
  • Tier Two
    • First Choice provider not in Tier One
  • Tier Three (Out of Network)
    • All other Alaska providers and Providence Alaska Medical Center

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Hello.

We have exciting news to share. ODS is changing its name to Moda Health.

Moda comes from the latin term "modus" and means "a way". We picked it because that's what we are here to do: help our communities find a way to better health.

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