Your plan materials
Get your Summary of Benefits (SB), Evidence of Coverage (EOC), Plan Annual Notice of Changes (ANOC), Formulary and Pharmacy Directory.
Evidence of Coverage (EOC)
Use your Evidence of Coverage to find out what is covered in your plan and how your plan works.
2024
- Moda Health Central PPORX (PPO)
Crook, Deschutes, Hood River, Jefferson and Wasco Counties
- Moda Health Elements PPORX (PPO)
Clackamas, Columbia, Multnomah, Washinton and Yamhill Counties
- Moda Health + Fred Meyer PPORX (PPO)
Clackamas, Columbia, Multnomah, Washington and Yamhill Counties
- Moda Health Metro PPORX (PPO)
Clackamas, Multnomah and Washington Counties
- Moda Health Mid-Valley PPORX (PPO)
Benton, Lane, Linn, Marion and Polk Counties
- Moda + PeaceHealth PPORX (PPO)
Lane County
- Moda Health PPO (PPO)
Benton, Clackamas, Columbia, Coos, Crook, Curry, Deschutes, Douglas, Hood River, Jackson, Jefferson, Josephine, Klamath, Lane, Linn, Marion, Multnomah, Polk, Wasco, Washington and Yamhill Counties
- Moda Health Southern PPORX (PPO)
Coos, Curry, Douglas, Jackson, Josephine and Klamath Counties
- Moda Health Value PPORX (PPO)
Coos, Crook, Curry, Deschutes, Douglas, Hood River, Jackson, Jefferson, Josephine, Klamath and Wasco Counties
2023
- Moda Health PPO (PPO)
Benton, Clackamas, Columbia, Coos, Crook, Curry, Deschutes, Douglas, Hood River, Jackson, Jefferson, Josephine, Klamath, Lane, Lincoln, Linn, Marion, Multnomah, Polk, Tillamook, Wasco, Washington and Yamhill Counties
- Moda Health Central PPORX (PPO)
Crook, Deschutes, Hood River, Jefferson and Wasco Counties
- Moda Health Metro PPORX (PPO)
Clackamas, Multnomah and Washington Counties
- Moda Health Mid-Valley PPORX (PPO)
Benton, Lane, Linn, Marion and Polk Counties
- Moda Health NW PPORX (PPO)
Columbia, Lincoln, Tillamook and Yamhill Counties
- Moda Health Southern PPORX (PPO)
Coos, Curry, Douglas, Jackson, Josephine and Klamath Counties
- Moda Health Value PPORX (PPO)
Coos, Crook, Curry, Deschutes, Douglas, Hood River, Jackson, Jefferson, Josephine, Klamath and Wasco Counties
- Moda Health + Fred Meyer PPORX (PPO)
Clackamas, Columbia, Lincoln, Multnomah, Tillamook, Washington and Yamhill Counties
Summary of Benefits (SB)
Your Summary of Benefits includes highlights of your plan such as your monthly premium, annual out-of-pocket maximum, and copays for medical services.
2024
- Moda Health PPO (PPO)
- Moda Health Metro PPORX (PPO)
- Moda Health + Fred Meyer PPORX (PPO)
- Moda Health Elements PPORX (PPO)
- Moda Health PPO (PPO)
- Moda Health Central PPORX (PPO)
- Moda Health Value PPORX (PPO)
- Moda Health PPO (PPO)
- Moda Health Mid-Valley PPORX (PPO)
- Moda + PeaceHealth PPORX (PPO)
- Moda Health PPO (PPO)
- Moda Health Southern PPORX (PPO)
- Moda Health Value PPORX (PPO)
Annual Notice of Changes (ANOC)
Each fall, we will send you an Annual Notice of Changes. Review the Annual Notice of Changes to see any changes in costs, coverage and service area. These changes will take place in January.
2024
- Moda Health Central PPORX (PPO)
Crook, Deschutes, Hood River, Jefferson and Wasco Counties
- Moda Health + Fred Meyer PPORX (PPO)
Clackamas, Columbia, Multnomah, Washington and Yamhill Counties
- Moda Health Metro PPORX (PPO)
Clackamas, Multnomah and Washington Counties
- Moda Health Mid-Valley PPORX (PPO)
Benton, Lane, Linn, Marion and Polk Counties
- Moda Health PPO (PPO)
Benton, Clackamas, Columbia, Coos, Crook, Curry, Deschutes, Douglas, Hood River, Jackson, Jefferson, Josephine, Klamath, Lane, Linn, Marion, Multnomah, Polk, Wasco, Washington and Yamhill Counties
- Moda Health Southern PPORX (PPO)
Coos, Curry, Douglas, Jackson, Josephine and Klamath Counties
- Moda Health Value PPORX (PPO)
Coos, Crook, Curry, Deschutes, Douglas, Hood River, Jackson, Jefferson, Josephine, Klamath and Wasco Counties
Pharmacy Benefit Information
All the information you need regarding your pharmacy coverage, including our list of covered drugs (Formulary) and the Pharmacy Directory.
Addendum
Addendum to your Summary of Benefits (SB), Plan Annual Notice of Changes (ANOC), and Evidence of Coverage (EOC)
Last updated Oct. 1, 2023
Y0115_4006