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2019 medical networks

2020 medical networks

Moda Health is pleased to offer its members a variety of plan types to help fit their healthcare needs. Below are the 2020 medical provider networks for our Alaska 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 OHSU Hospitals and Clinics
Asante Health System PeaceHealth
Bay Area Hospital Providence Health and Services
Blue Mountain Hospital Salem Health
Columbia Memorial Hospital Samaritan Health Services
Coquille Valley Hospital Santiam Hospital
Curry General Hospital Silverton Hospital
Good Shepherd Medical Center Sky Lakes Medical Center
Grande Ronde Hospital St. Alphonsus Regional Medical Center - Baker City
Harney District Hospital St. Alphonsus Regional Medical Center - Ontario
Lake District Hospital St. Anthony Hospital
Legacy Health St. Charles Health System
Mercy Medical Center Tillamook County General Hospital
McKenzie-Willamette Medical Center Tuality Hospital
Mid-Columbia Medical Center Wallowa Memorial Hospital
Morrow County Health District 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 Salem Health
Asante Health System Samaritan Health Services
Bay Area Hospital Santiam Hospital
Columbia Memorial Hospital Silverton Hospital
Legacy Health Sky Lakes Medical Center
Mercy Medical Center St. Charles Health System
Mid-Columbia Medical Center Tillamook County General Hospital
OHSU Hospitals and Clinics Tuality Hospital
PeaceHealth  
Blue Mountain Hospital Lake District Hospital
St. Anthony Hospital Morrow County Health District
Good Shepherd Medical Center St. Alphonsus Regional Medical Center – Baker City
Grande Ronde Hospital St. Alphonsus Regional Medical Center – Ontario
Harney District Hospital Wallowa Memorial Hospital

Synergy plans are available to small and large employer groups.

Summit Network

The Summit Network offers an integrated care experience to members living in eastern Oregon. This network connects members to a Moda Moda Medical Home, who work together to coordinate care, and keep members feeling their best. Summit offers a diverse and wide selection of participating providers, offering high-quality care, close to home.

Please note: Employer groups currently offering the Summit network to their employees will transition to the Synergy network upon renewal in 2020.

Health systems participating in Summit include:

Blue Mountain Hospital Lake District Hospital
St. Anthony Hospital Morrow County Health District
Good Shepherd Medical Center St. Alphonsus Regional Medical Center – Baker City
Grande Ronde Hospital St. Alphonsus Regional Medical Center – Ontario
Harney District Hospital Wallowa Memorial Hospital

Summit plans are available to small and large employer groups.

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, Marion, Multnomah, Polk, 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:

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

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, Deschutes, Gilliam, Grant, Harney, Jefferson, Klamath, Lake, Lane, Malheur, Morrow, 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 PeaceHealth
Good Shepherd Medical Center Sky Lakes Medical Center
Grande Ronde Hospital St. Alphonsus Regional Medical Center Baker City
Harney District Hospital St. Alphonsus Regional Medical Center Ontario
Lake District Hospital St. Anthony Hospital
Mercy Medical Center St. Charles Health System
Morrow County Health District 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 2019 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, Mat-Su, and Kenai Peninsula boroughs. Pioneer offers three benefit levels (tiers) of healthcare:

  • Tier One
    For residents of Anchorage, Mat-Su, and Kenai Peninsula boroughs. Hospitals include Alaska Regional, Met-Su, Central Peninsula and South Peninsula.

  • Tier Two
    For members seeking care outside of the three boroughs. This includes First Choice Network in Alaska (excluding Providence Alaska) and Alaska Regional Hospital.

  • Tier Three
    For all other providers not in Tier One or Tier Two.

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