Moda Health OEBB member flu vaccines

Information about flu vaccines

Influenza vaccines are covered under OEBB’s preventive care benefit at 100 percent when you visit a contracted provider. Individual and family deductibles are waived for this preventative service.

OEBB members have access to flu vaccines through any of the following options:

  • Preferred providers. Use the Moda Health Provider Search to find the provider nearest you.
  • Participating Oregon Prescription Drug Plan (OPDP) network pharmacies.
  • Flu shot clinics, student health clinics, county health clinics, etc.

Reimbursement to providers will be based on:

  • Preferred providers contracted reimbursement fees
  • Contracted fees for pharmacies participating in the OPDP network
  • Immunizations billed by licensed flu shot clinic providers or student and county health clinics will be reimbursed at the in-network benefit level. The payment allowance will be based on the maximum plan allowable (MPA) for the geographic area.

Benefits will be based on policy provisions and covered immunizations will be limited to those that are considered the "standard of care" by the local medical community. Government agencies or medical associations such as the American Medical Association and Oregon Medical Association will set these standards for the state as a whole.

Flu vaccine billing process

  • If a member goes to a Moda Health preferred provider for a flu vaccine, the provider will submit a bill to Moda Health for reimbursement. This means no out-of-pocket expenses for the member.
  • OEBB members accessing immunizations and vaccines at a contracted OPDP network pharmacy can have their claims processed for covered benefits at the point of service by simply supplying their insurance information to the pharmacy. This means no out-of-pocket expenses for the member.
  • In some cases, members may need to pay for the immunization and bill Moda Health directly for reimbursement. Please note, members must submit a receipt for the vaccine to the address below to be eligible for reimbursement.

Please submit claims to:

Moda Health Plans
Attn: Director Medical Claims
PO BOX 40384
Portland, OR 97240-0384

For any questions, please call:

503-265-2909 or toll-free 866-923-0409

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