Moda Health medical plans at a glance

Check out the key features of our PPO and HSA plan designs below.

Click on deductible amount to see benefit summary for that plan.

Click on deductible amount to see benefit summary for that plan.

Download the Standard Health Questionnaire for Washington State

To view the Summary of Benefits and Coverage (SBC) for each plan, please click on the deductible amount in the plan chart below.

A Uniform Glossary is available to help you understand the most common terms in healthcare. You may also obtain a free paper copy of the SBC or Uniform Glossary by contact Moda Health’s individual sales and service team at 866-939-0368.

Rates Beneficial Plan - Preferred Provider
Organization (PPO)
The Beneficial plan is best for those looking for a higher level of benefits and a lower total out-of-pocket cost.
Deductible Choices Office Visit Pharmacy
$1,000 / $2,500 (individual)
$3,000 / $7,500 (family)
First 4 at $20 $2 value, $15 generics, 50% brand/$250 brand name deductible
Rates Essential Plan - Preferred Provider Organization (PPO)
The Essential plan is suited to individuals shopping for a lower premium cost.
Deductible Choices Office Visit Pharmacy
$7,500 / $10,000 (individual)
$22,500 / $30,000 (family)
35% $2 value, $15 generics, 50% brand/$500 brand name deductible
Rates Preferred Plan - Preferred Provider Organization (PPO)
The Preferred plan is suited to individuals shopping for a lower premium cost.
Deductible Choices Office Visit Pharmacy
$5,000 / $7,500 (individual)
$15,000 / $22,500 (family)
First 2 at 20% $2 value, $15 generics, 50% brand/$500 brand name deductible
Rates Health Savings Account (HSA) Choice
HSA plans offer lower insurance premiums through a high deductible health plan coupled with a bank account in which you accumulate tax-advantaged savings through your contributions to pay for qualified medical expenses until your deductible is met. More about HSAs
Deductible Choices Office Visit Pharmacy
$1,250 (individual)
$2,500 (family)
20% 30%
Rates Health Savings Account (HSA) Select
The Preferred plan is suited to individuals shopping for a lower premium cost.
Deductible Choices Office Visit Pharmacy
$2,800 (individual)
$5,600 (family)
50% 50%
Rates Health Savings Account (HSA) Value
The Preferred plan is suited to individuals shopping for a lower premium cost.
Deductible Choices Office Visit Pharmacy
$5,000 (individual)
$10,000 (family)
0% 30%

Medical Networks

Moda Health offers two networks. With two options, you have can choose which network, the ODS Alaska Select network or the ODS+Providence Alaska network is best suited for you. You will be asked to make your network selection at the time of enrollment

Value Added Services

As a Moda Health member, you get much more than just health coverage - you get the tools and resources you need to help you navigate your way to better health.

myModa

As a member of Moda Health, you have access to myModa, your personalized member website. myModa helps you manage your benefits so you get the most from your plan. With myModa, you can*:

  • View your benefits, eligibility and history
  • Review prescription history and pharmacy benefits, including medication pricing information
  • View account details such as contact information and enrolled dependents
  • Check the status of pending claims, view personal claim history and access claim forms
  • Receive and view electronic Explanation of Benefits (EOBs)
  • Access tobacco cessation resources
  • Search for a provider
  • Find dental care while traveling outside the U.S.
  • Use the Dental Optimizer to assess cavity risk, estimate treatment costs and review dental health tips
  • Pay your premium online with Moda Health eBill (individual policy holders only)

Live well at any stage of life with Moda Health Be Better tools

Moda Health Be Better tools includes tools and individualized support to help you get well sooner and live well longer. Included as part of all Moda Health medical plans, Moda Health Be Better Tools is available through myModa, and includes:

ODS eDoc

This service helps you understand your symptoms and make informed health decisions. Email a specialized health professional at any time of day to get the answers you need. ODS eDoc gives you access to:

  • Board-certified physicians
  • Licensed psychologists
  • Pharmacists
  • Dentists
  • Dietitians
  • Fitness experts
  • ODS eDocVoice - leave a message for a provider and you'll get a phone response within 24 hours

ODS Registered Nurse Advice Line

The ODS Registered Nurse Advice Line allows you to get answers and information about your health over the phone, day or night. Nurses can help you with basic health situations, such as:

  • Understanding symptoms
  • Treatment for minor injuries and burns
  • Home cold and flu remedies
  • When it's time to make a doctor's appointment
  • Whether you should go to urgent care or the emergency room

Condition management and health coaching

Moda Health offers in-depth support programs for those dealing with chronic health conditions. You have access to tools and resources that help you maintain a healthy lifestyle. Individual health coaches provide you with one-on-one support. These specialized programs include:

  • Cardiac Care
  • Depression Care
  • Diabetes Care
  • Lifestyle Coaching
  • Women’s Health & Maternity Care
  • Respiratory Care
  • Spine & Joint Care

Care coordination

If you are dealing with a serious illness or recovering from an accident, you have access to case managers who can help you navigate the complexities of the healthcare system. A Moda Health case manager can help:

  • Communication with providers
  • Explain treatment options
  • Arrange for in-home caregivers
  • Order medical equipment

Online tracking tools*

Moda Health provides secure, online health education tools and information to help you better manage your health. Keep track of your progress by using the following tools:

  • Health and symptom evaluation
  • Medical library
  • Health helpers (tools such as health trackers, calculators and more)
  • Pharmacy costs and research
  • My health files
  • News, forums and communication
Rates Apex (PPO)
The Apex plan is best for those looking for a higher level of benefits and a lower total out-of-pocket cost.
Deductible options Office visit Pharmacy
$1,000
$2,500
$20 $2 value tier, $15 generics, 50% brand
Rates Maximizer (PPO)
The Maximizer plan is ideal for individuals who want broad coverage for a range of services, including pharmacy benefits.
Deductible options Office visit Pharmacy
$1,000
$2,500
$5,000
$30 $2 value tier, $15 generics, 50% brand
Rates Beneficial Value (PPO)
The Beneficial Value plan is suited to individuals shopping for a lower premium cost.
Deductible options Office visit Pharmacy
$1,000
$2,500
$5,000
$7,500
First 3 at $25 Optional1
1If selected, prescription rider provides $2 value tier, $15 generics, 50% brand name. View Rx rider rates
Rates Foundation (PPO)
The Foundation plan is a great, low-cost option for individuals primarily needing catastrophic coverage in case of unforeseen and serious medical needs, while still providing preventive care benefits with the deductible waived.
Deductible options Office visit Pharmacy
$5,000
$10,000
35% 35%
Rates Health Savings Account (HSA) Value
HSA plans offer lower insurance premiums through a high deductible health plan coupled with a bank account in which you accumulate tax-advantaged savings through your contributions to pay for qualified medical expenses until your deductible is met.
Deductible options Office visit Pharmacy
$2,800 (individual)
$5,600 (family)
50% 50%
Rates WellConnect
Our WellConnect plan encourages members to engage in their own healthcare. Members who seek care within our Community Care Network (CCN) enjoy a higher benefit level and receive high-quality, individualized care from an interconnected group of providers.

The WellConnect plan is only available to residents within the Community Care Network which includes the following counties: Multnomah, Washington, Clackamas, Yamhill, Polk, Marion, Lane and Deschutes.
Deductible options Office visit Pharmacy
$1,500
$3,000
First 3 at $20 $2 value tier, $15 generics, 50% brand
Rates Premium (PPO)
The Moda Health Premium plan is a comprehensive plan with a high level of benefits, including maternity and prescription coverage for both generic and brand name drugs.
Deductible options Office visit Pharmacy
$1,500 First 3 at $30 copay $2 value tier, $10 select generic or 50% brand ($500 deductible for brand only)
Rates Hybrid (PPO)
The Moda Health Hybrid plan includes catastrophic coverage, which is ideal for individuals who want a mid-level deductible pared with affordable coverage.
Deductible options Office visit Pharmacy
$2,500
$3,500
First 3 at $25 copay Not covered
Rates Basic (PPO)
The Moda Health Basic plan is a great choice for those shopping for catastrophic coverage at a lower premium cost.
Deductible options Office visit Pharmacy
$5,000
$7,500
First 3 at $35 copay Not covered
Rates HSA (PPO)
The Moda Health HSA plan provides catastrophic coverage and offers lower premiums through a tax-advantaged and high-deductible health plan.
Deductible options Office visit Pharmacy
$2,500 (individual)
$5,000 (family)
20% Not covered
Rates Premium (PPO)
The Moda Health Premium plan is a comprehensive plan with a high level of benefits, including maternity and prescription coverage for both generic and brand name drugs.
Deductible options Office visit Pharmacy
$1,500 First 3 at $30 copay $2 value tier, $10 select generic or 50% brand ($500 deductible for brand only)
Rates Hybrid (PPO)
The Moda Health Hybrid plan includes catastrophic coverage, which is ideal for individuals who want a mid-level deductible pared with affordable coverage.
Deductible options Office visit Pharmacy
$2,500
$3,500
First 3 at $25 copay Not covered
Rates Basic (PPO)
The Moda Health Basic plan is a great choice for those shopping for catastrophic coverage at a lower premium cost.
Deductible options Office visit Pharmacy
$5,000
$7,500
First 3 at $35 copay Not covered
Rates HSA (PPO)
The Moda Health HSA plan provides catastrophic coverage and offers lower premiums through a tax-advantaged and high-deductible health plan.
Deductible options Office visit Pharmacy
$2,500 (individual)
$5,000 (family)
20% Not covered

If you have any questions about our individual medical plans, please call our Washington sales team toll-free at 866-939-0368.

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Washington plans

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.

Together, we can be more, be better.

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Please select the state you live in, or the state where your employer is headquartered, so we can tailor your experience:

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